What Causes Constipation And Painful Bloody Bowel Movement While Having IBS?

Hi. I am a 58 year old woman who has has IBS since my 20 s. My symptoms have always been several days of constipation followed by severe stomach cramps and passing a very large plug of hard stool and then a volcano of diarrhea. Over the last year or so I have been have more and more bad constipation and a lot of gas, both upper GI and lower GI gas. And also a lot of bloating, fatigue, and generally feeling bad. Also when I have a bowel movement it is painful and there is often blood.