Irritable Bowel Syndrome Message Boards | Re: Why does it take so long for IBS C?

Here's my theory.

If I'm reading Heather right, IBS is basically abnormal gastrocolic contractions. In normal people, the digestive system moves stuff along smoothly; in IBSers, the digestive system goes into violent spasms. For those with D, the spasms cause the colon to expel it's contents too rapidly. For those with C, the spasms cause the colon to lock up in a "charley horse" and nothing moves. IBS-D and IBS-C people both need to get their colons to stop spasming. That's where soluble fiber comes in: it doesn't trigger a violent gastrocolic reflex when you eat it AND it fills your colon with a nice gel stuff that keeps the colon spasms from being able to get a foothold. (Think about a closed toothpaste tube. If it's full, you can't really bear down on it; if it's partly empty you can squish it good.)

For IBS-D people, that's it. Our colon movement tends to force stuff out, so if we can just get enough SF in us to stop the violent spasming, the colon movement can continue but more calmly. In a sense, I suspect IBS-D colons with enough SF are still doing exactly what they did pre-SF, but more calmly. Spasms gone, D gone, life is good. (Okay, not quite that simple, but you get the idea.)

For IBS-C, colon spasms tend to lock up and not force stuff out, so you guys have a two-step process. You have to get enough SF in you to stop the spasming totally - spasming is bad because in you it locks up - and that's a LOT of SF. Once you've done that, though, you also have to get enough IF to tell the colon to move and move normally - just like non-IBSers do. That's quite a balancing act. Too little SF, the colon spasms. Too much IF, the colon spasms. Too little IF, the colon doesn't spasm but it's also disinclined to move at all. (You probably need a lot of water and exercise, also.)

In other words, IBS-D people can live with an overactive colon by reining in the spasms a little with some SF. IBS-C people need to get their colons totally out of spasm mode with a lot of SF, then treat them like normal colons by getting IF (but not too much), water, and exercise.

So that's my theory about why IBS-C takes longer to resolve than IBS-D and why it's trickier to manage. (On which one is worse, though, I agree with AmandaPanda: it's a choice between being burned alive or eaten by sharks.)

As a side issue, I've noticed a number of posts lately about STC (slow transit constipation, slow transit colon), slow motility, etc. If I'm reading things right, STC if NOT the same as IBS. In fact, it's the exact opposite. IBS is a hyperactive colon; STC seems to be an almost inactive one.

HTH.

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