Let’s Talk About Constipation: How Long, How Many, How Much

Education provided by Ironwood Pharmaceuticals

Do you have constipation?

Did you know that constipation can sometimes be the sign of something deeper, like IBS-C (Irritable Bowel Syndrome with Constipation)? This article will provide some key information about constipation and related symptoms that can help you facilitate a conversation with your doctor or specialist.

Goals and Actions

This article will give you the tools to recognize important symptoms that your doctor needs to know about. You are not alone – it can be frustrating and embarrassing to talk about your constipation, but there are things that your doctor needs to know about you to get you the treatment you need!


Feeling prepared to talk to your doctor about what you are experiencing starts with you taking note of your symptoms – what they are, when they happen, and how bad they are. Symptoms associated with constipation can include bloating, abdominal (belly) discomfort, belly pain, and infrequent stools associated with straining and a feeling of incomplete emptying.1,2 Some or all of these are signals to your doctor to check for IBS-C. These symptoms may be affecting your life in a real way, but many people adapt to the situation (“It is just part of my life now”) and hold back from fully expressing how it could be affecting them. Your doctor needs to know what it is like at its worst. Tracking your symptoms and keeping a list of your bowel habits (including how often and the stool type – hard and lumpy or softer) helps your doctor get a clearer picture of your condition.

A quick catchphrase that can help you remember what to discuss is “How Long, How Many, and How Much Burden?” Let’s start with “How Long.”

1.  How Long?

How many months or years has this bothered you? Another part of How Long? is a little more involved and may require some thought. Is what you are experiencing “occasional” or “chronic”? Sometimes it is hard to tell. Occasional could mean sudden or short periods of difficult, infrequent, or incomplete bowel movements. Chronic constipation means that your constipation symptoms keep coming back or seem to last a long time, more than 3 months.3 Chronic may also mean that you thought the symptoms went away and they keep coming back.

2.   How Many?

How Many? is a question that could refer to how many bowel movements you have each week and if there has been a recent change in the number. It may also refer to the number of “treatments” that you have tried. You should have an answer ready for both of these “How Manys” when you speak with your doctor. To track how many bowel movements you have and how often they are, you can keep a journal that makes it easy to share your information with your doctor. For the number of “treatments,” these may be diet changes, changing your water intake, or taking fiber, but they may also be over-the-counter medicines, like laxatives or prescription medications.2,3 Telling your doctor what you have tried already gives them a good idea of what has not worked since you are here in the office with the same outward symptom, constipation.

3.  How Much Burden?

How Much Burden? is a question that helps your doctor understand how the symptoms are affecting you.4

  • Do you miss important life events due to your symptoms?
  • Do you suffer with unpredictable symptoms and timing?
  • Do you take time off from work or not work at your best because of your symptoms?

If so, you may have more than occasional constipation and it may be IBS-C.

Key Takeaways

Think more deeply about your constipation and be prepared to discuss all aspects of your condition with your doctor. Your doctor needs your help to get you the right diagnosis and right treatment!


  1. Lacy BE et al. Bowel Disorders. Gastroenterol. 2016;150:1393-1407.
  2. Lacy BE et al. ACG Clinical Guideline: Management of Irritable Bowel Syndrome. Am J Gastroenterol. 2021;116(1):17-44.
  3. Lacy BE et al. Rome Criteria and a Diagnostic Approach to Irritable Bowel Syndrome. Journal of Clinical Medicine. 2017; 6:99. doi:10.3390/jcm6110099
  4. Shin A, Lembo A. IBS in America: Survey Summary Findings. American Gastroenterological Association. https://www.multivu.com/players/English/7634451-aga-ibs-in-america-survey/docs/survey-findings-pdf-635473172.pdf. 2015. Accessed January 13, 2023.

The information on this site is not intended to diagnose medical conditions or take the place of talking to a qualified healthcare provider about medical conditions or treatment options.

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© 2023 Ironwood Pharmaceuticals, Inc. All rights reserved.

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