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July 29, 2025 3 mins

In this video, Mary Clarke, a GI motility nurse practitioner in San Diego, addresses the difference between functional constipation and constipation-predominant Irritable Bowel Syndrome (IBS-C). Drawing from the Rome IV criteria developed by the Rome Foundation, Mary explains how functional constipation is defined by infrequent bowel movements, hard stool consistency, and difficulty evacuating—without the presence of significant pain. In contrast, IBS-C includes the same constipation symptoms plus recurrent abdominal pain related to defecation, bloating, and visceral hypersensitivity. Mary also explores the role of gut-brain interaction and how altered motility and stress can influence symptom patterns in DGBIs (Disorders of Gut-Brain Interaction). She emphasizes the importance of accurate diagnosis, as conventional treatments for constipation—like fiber supplements or OTC laxatives—may not be effective and could worsen symptoms in IBS-C. Instead, IBS-C may respond better to targeted therapies, including prescription treatments, exercise, cognitive behavioral therapy (CBT), and complementary alternative medicine (CAM). This overview helps clinicians and patients better understand how to differentiate these two GI conditions and tailor treatment plans accordingly. For more education, visit the GHAPP website or download the GHAPP Ace App.

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