Irritable Bowel Syndrome/bad constipation


Hi Heather,
You answered a question for me a few weeks back on sugar, thanks so much.  I have for 8 months IBS symptoms going back in forth between constipation and diarrhea.  However, for the last 6 weeks since my sugar episode,  I am severely, constipated, I go maybe once a week and very little.  I've been taking Acacia Senegal between 1 -2 teaspoons a day.  I finally switched last night to Murelax. Again, this morning, very little came out.
What would you do if you were in my situation?  Should I just up my in take of Acacia Senegal?  Should I take more Murelax?  I do have your fennel tea as well.  Also if you know if a really good probiotic I could take that would be great.  Thanks so much!

Hi Liz - For the Tummy Fiber Acacia to work properly, it's crucial that you start with a low dose (1/2 teaspoon twice daily) and gradually increase to a dose high enough to resolve constipation (which may be 4-5 tablespoons a day). If you get gas or bloating, that would mean you increased your dose too quickly. It can take several weeks or longer to gradually increase up to the dose you'd likely need to resolve constipation, and unfortunately you can't rush this. Tummy Fiber is not a drug or a laxative so it won't work overnight.

I think you're not really seeing results because you're still at a very low starting dose, so make sure you gradually increase this.

I really feel for the constipation folks, as it takes some patience to start slowly, increase gradually, and eventually get your daily dose up high enough to resolve symptoms. A lower dose can't worsen constipation, but it won't resolve it, either. You may want to start over following these directions and see if you have better luck.

Having the fiber at least twice a day - and you can have it more often - is also key, as you want to keep your gut filled with soluble fiber at all times. That will help prevent cramping and spasms in the first place.

It's also help to review the Five Constipation Frustrations here and, if you've been using laxatives like the Miralax, information on transitioning off them here

I don't have a ton of specific brands I recommend for probiotics as I've heard of good results for so many of them. In general, the higher the bacteria count the better, and you do want something that is labeled vegan or dairy-free. Also, make sure they don't contain FOS and inulin. Those are prebiotics (which encourage the growth of probiotics) that ferment very rapidly in the gut, so they can cause a lot of gas and bloating.

(Acacia is prebiotic too, but ferments very slowly, so it doesn't have the gas and bloating risk. But, it's a much more costly fiber so it isn't used nearly as often.)

I have heard good things about VSL #3, Digestive Advantage, Align, and Jarrow brands.

You are on the right track, hang in there, it can just take some time and patience for constipation to really resolve.


Irritable Bowel Syndrome

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Heather Van Vorous


I can address questions regarding diet, cooking, recipes, and non-pharmaceutical supplements (soluble fiber, herbal, probiotics, etc.) for IBS. I can supply information sources about diagnostic guidelines, symptoms, and the medical pathology of IBS, but I cannot give a diagnosis or analyze test results a patient has obtained. I would prefer not to answer questions about prescription drugs and diagnostic tests. PLEASE DO NOT TELL ME YOUR SYMPTOMS AND THEN ASK ME TO DIAGNOSE YOU!


I'm the founder and CEO of, an organization dedicated to serving people with Irritable Bowel Syndrome. My goal is to offer education, support, and help that allows people with IBS to successfully manage their symptoms through lifestyle modifications.

I'm the author of Eating for IBS, the only explicit dietary guide and cookbook for people with bowel disorders. Eating for IBS then led to my second book, The First Year: IBS, a comprehensive view of the disorder and every way to successfully manage it. Together, these works have become the two best-selling, best-reviewed IBS books in America.

My writing has led to an ongoing Canadian clinical research study of the groundbreaking dietary guidelines for Irritable Bowel Syndrome in Eating for IBS; this work also led to my inclusion in the 4th edition of Who's Who in Medicine and Healthcare. Today's Dietitian has featured my IBS dietary guidelines, and my work has reached gastroenterologists and internists. I'm the author of "Heather's IBS Newsletter", which is free to subscribers and is published twice monthly. As a result, I've become recognized as the foremost patient-expert on IBS in America. I've personally had IBS since age 9.

I now teach classes on managing IBS through lifestyle modifications, I developed the Heather's Tummy Care line of organic medical foods for the dietary management of IBS, and I'm planning to work with corporate HR departments to offer employee IBS education programs. I host Heather Cooks!, the Seattle television cooking show for good digestive health, which is now available on DVD and also on the HelpForIBS YouTube Channel.

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