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Constipation with bloating: a clinical approach to evaluation and management
David J Cangemi1, Adam P Laitman2, Orit Faiman2
1Division of Gastroenterology & Hepatology, Mayo Clinic, Jacksonville, FL, USA.
Annals of Medicine
|June 19, 2026
Summary
Constipation and bloating often occur together. This review covers causes, evaluation, and treatments for constipation with predominant bloating, highlighting the need for personalized medicine.
Area of Science:
- Gastroenterology
- Clinical Medicine
Background:
- Constipation and bloating are prevalent gastrointestinal symptoms frequently experienced concurrently.
- Bloating is a nonspecific symptom with complex pathophysiology, and its management alongside constipation requires careful consideration.
Purpose of the Study:
- To review the evaluation and management strategies for patients presenting with constipation and predominant bloating.
- To differentiate between common etiologies such as chronic idiopathic constipation (CIC) and irritable bowel syndrome with constipation (IBS-C).
Main Methods:
- Review of potential etiologies for constipation with bloating.
- Discussion of clinical evaluation methods to differentiate underlying causes.
- Overview of management approaches including dietary changes, biofeedback, and various pharmacologic therapies.
Main Results:
- Constipation and bloating are common co-occurring GI symptoms.
- Management strategies for constipation may improve bloating in some patients, but not all.
- Pharmacologic options include OTC treatments, plecanatide, linaclotide, lubiprostone, tenapanor, neuromodulators, and antibiotics.
Conclusions:
- While treating constipation can alleviate bloating, it is not universally effective.
- Further research into the physiology of bloating is needed for improved patient outcomes.
- Personalized medicine approaches, understanding individual pathophysiology, are crucial for optimizing treatment for bloating.
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