Stop the Struggle: How to Relieve the Symptoms of IBS Attacks - Dr. Michael Ruscio, DC

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Stop the Struggle: How to Relieve the Symptoms of IBS Attacks

Treatment Options to Relieve and Prevent Symptoms of IBS Attacks

Key Takeaways

  • Symptoms of IBS attacks include both digestive and non-digestive complaints.
  • Bloating, gas, cramps, fatigue, mood changes, and excessive pain are all potential symptoms.
  • For quick relief, consider freezing low FODMAP soups for easy access, drinking peppermint tea, or trying a gut reset with an elemental diet. 
  • Long-term treatment includes a low FODMAP diet, probiotics, stress reduction, better sleep, and immunoglobulin supplements.
  • Prevention of IBS attacks through treating any underlying conditions and getting an accurate diagnosis is key.

If you have irritable bowel syndrome (IBS), you’ve likely experienced the symptoms of IBS attacks: stomach pain, bloating, extreme diarrhea, or constipation. And that’s not all — fatigue, depression and anxiety, chronic pain, and headaches can all be part of an IBS flare-up [1, 2, 3, 4 ].

IBS is a common condition that can negatively affect one’s quality of life. In fact, it affects about 11% of the population globally [5]. For many IBS patients, symptoms arrive in well-defined episodes, lasting two to five days per month on average [5]. These episodes, or IBS attacks, interfere with work, family life, friends, and self-confidence.

The good news is there’s lots to be learned from recent gastroenterology research on IBS, including strategies that can help you to reduce and even avoid symptoms of IBS attacks. 

Many preventative treatments, like a low FODMAP diet, supplemental immunoglobins, and a daily probiotic also work great to stop an IBS attack. However, for quick relief, you may want to reach for some peppermint tea or an elemental shake. Read on to learn more about how to treat IBS, ease the symptoms, and get your life back on track.

What Are the Symptoms of IBS Attacks?

  • Bloating [6]
  • Cramping [7]
  • Indigestion/heartburn/acid reflux [8]
  • Flatulence (gas) [8]
  • Rectal bleeding caused by altered bowel habits

IBS Affects More Than Just Your Digestive Tract

Important and not often discussed, IBS symptoms can affect more than just your digestive system. IBS can take a toll on your social life and confidence, and the pain and discomfort that results from it can also impact your overall sense of well-being.

Other non-digestive symptoms of IBS attacks include:

  • Fatigue: At least 50% of IBS patients struggle with fatigue [1]
  • Chronic fatigue syndrome: More than half of chronic fatigue patients also have IBS [9]
  • Mood disruptions: Depression and/or anxiety is very common in IBS patients [10]. 
  • Excessive pain: Many IBS patients have pain symptoms, including migraine headaches, fibromyalgia pain, pelvic pain, and TMJ (lockjaw) pain [3, 9].

For women (who are more than twice as likely to be affected by IBS than men), these symptoms can often occur around or be exacerbated by the menstrual cycle [11]. Between the hormonal shifts, inconveniences, and physical and psychological discomforts of the menstrual cycle, adding IBS symptoms to the mix can take its toll.

IBS and Mental Health

Unfortunately, the correlation between anxiety/depression and IBS can be somewhat of a vicious circle. Many antidepressants — serotonin reuptake inhibitors (SSRIs) in particular — have been associated with a risk of subsequently diagnosed IBS [12]. The gut-brain connection provides a likely explanation for this, as 95% of the body’s serotonin is produced in the gut. It stands to reason that medications that alter serotonin levels can impact motility and activity in the large intestine [13].

That being said, irrespective of whether or not you’re on an SSRI, the prevalence of IBS and other gut health challenges among patients with mental health conditions is high. In fact, those with IBS are three times more likely to have anxiety and depression than healthy populations [14]. 

The exact relationship between gut disorders and mood changes is unclear, as we are unsure whether one leads to the development of the other, but the fact remains that a connection exists.

The Mood-Gut Relationship

The gut-brain connection is a very real phenomenon, and it’s a two-way street when it comes to communication. What happens in your gut affects your brain, and what happens in your brain affects your gut. 

We’ve seen psychological improvements with the introduction of probiotic supplements, gut-healing diets, and behavioral measures, and research is beginning to support the idea as well. While more research is needed on the direct impact of gut-healing treatments on mental health, the following recommendations are a great way to start addressing your symptoms of IBS attacks, including fluctuations in mood.

How to Relieve the Symptoms of IBS Attacks

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No matter which symptoms you experience during an IBS flare-up, quick relief is the goal. However, there are a number of things you can do to relieve symptoms of IBS attack that also can help prevent future episodes.

IBS flare-ups can result from an inflammatory immune response, food sensitivities or allergies, stress, poor sleep, gut bacteria imbalance, and many other factors. If you can identify the trigger (more on that to follow), you might be better equipped to take steps to calm down the flare-up. 

But you’ll likely find that the following measures can provide relief, even if you haven’t yet identified the catalyst for your IBS. Keep in mind that every IBS patient is different, and what works for someone else may not work for you. Experiment with the following approaches to find the combination of treatment options that brings you the most relief (in both the short- and long-term).

A Low FODMAP Diet

A specific category of carbohydrates called FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) is particularly difficult to digest, especially for an already taxed digestive system. Stick to low FODMAP foods, which include:

  • Certain vegetables (like carrots, zucchini, and bell peppers)
  • Fruits higher in fructose
  • Grains (including brown rice and quinoa)
  • Certain fats and dairy products
  • Eggs, meat, and fish 
  • Ground flaxseed or ground chia seed for fiber

A diet that follows low FODMAP guidelines for a week or more can give your gut a break and a chance to heal. If you suspect you might have SIBO (small intestinal bacterial overgrowth), which can sometimes be responsible for IBS flareups, you may need to stay on this diet for as long as 7 weeks to rebalance your gut.

Keep a few portions of low FODMAP soups in your freezer and have a few simple low FODMAP recipes that you can prepare if you’re not feeling well. This is a great way to be prepared for an IBS flare-up.

Gut Reset with the Elemental Diet

A gut reset is a modified fast that allows your entire digestive tract to rest and repair. Just 24-48 hours of replacing meals with an elemental diet shake can significantly calm an IBS flare. Preliminary research suggests that following an elemental diet is an effective treatment for IBS [15, 16].

Probiotics

Significant research from NIH (National Institutes of Health), including five meta-analyses (the highest quality of research), supports the use of probiotics for reducing IBS symptoms. 

Probiotics help repopulate the microbiome in the large intestine with beneficial bacteria and rebalance the microbiome in the small intestine. Probiotics help aid digestion, reduce inflammation, and help heal and seal the gut lining [17, 18, 19, 20, 21].

Stress Reduction and Relaxation Techniques

Stress and lack of sleep can be common triggers for IBS symptoms. Research suggests that stress management techniques, including yoga, meditation, cognitive behavioral therapy (CBT), exercise, and hypnotherapy can be helpful for IBS patients [22, 23, 24, 25, 26, 27, 28].

Immunoglobulin Supplements

A relatively new supplement, immunoglobulins support the immune system by binding to and neutralizing bad bacteria in the gut. Clinical trials show that immunoglobulins improve IBS symptoms and are effective for IBS patients who aren’t responsive to other therapies, like dietary changes and probiotics [29, 30, 31, 32, 33, 34, 35].

We carry a high-quality immunoglobulin supplement in our online store that helps take the guesswork out of finding an effective gut-healing formula for IBS attacks.  

Herbal Remedies

A number of herbal remedies can help with short-term relief of bloating and other digestive symptoms of IBS. Peppermint oil supplements, peppermint tea, or the herbal supplement Atrantil can help to soothe digestive symptoms. 

A 2021 meta-analysis found that peppermint oil significantly improved global IBS symptoms, including abdominal pain [36]. While peppermint oil was determined to be safe for short-term use (though you may need to keep an eye out for heartburn) it’s long-term side effects with regular use are unclear. 

You may want to save this remedy for acute IBS episodes and stick to diet, probiotics, and lifestyle changes for long-term relief. 

Medication

Medication can be part of your plan for treating the symptoms of IBS attacks. However, most IBS medications simply provide symptom relief for digestive problems and do not address the root cause of IBS flare-ups. 

  • IBS with diarrhea: Imodium (loperamide) is an over-the-counter antispasmodic that relaxes the smooth muscles of the digestive system. It can help to improve stool consistency and reduce the frequency of bowel movements. Prescription antidiarrheal medications for IBS include Viberzi (eluxadoline) and Lotronex (alosetron).
  • IBS with constipation: Over-the-counter laxatives such as GlycoLax, MiraLAX, or magnesium citrate can be very helpful for treating constipation. Fiber supplements like Metamucil (psyllium husk) may also be effective but can worsen symptoms for some if taken at the wrong time during treatment. To lessen the chance of this happening, choose low FODMAP sources of fiber such as ground flaxseeds or chia seeds, and take it after you’ve added probiotics and spoken with a medical professional.
  • Headaches and body pain: Over-the-counter NSAIDs (non-steroidal anti-inflammatory drugs) such as ibuprofen can provide relief. However, long-term use of NSAIDs is not recommended due to the potential for side effects. NSAIDs may damage the lining of the stomach and gut walls, potentially worsening IBS symptoms. Consider heating pads and ice packs to lessen your pain before moving on to NSAIDs.

Prevent Symptoms of IBS Attacks Before They Start

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IBS is a set of symptoms rather than a disease. For decades, health care professionals have not known the cause of symptoms of irritable bowel syndrome. However, research is now shedding light on the many factors that can lead to IBS, and understanding the potential causes can help you stop an IBS attack before it starts [37]. Some of these underlying factors include:

  • Gut dysbiosis: Imbalances in the microorganisms of the gut, also known as gut dysbiosis, can be a result of poor diet, stress, antibiotic use, and other lifestyle factors [38, 39].
  • Post-infectious IBS: One study suggests that food poisoning (also known as gastroenteritis) may cause between 5% and 32% of IBS cases [40]. 
  • SIBO: A meta-analysis of 50 clinical trials found SIBO (small intestine bacterial overgrowth) in more than one-third of the studied IBS patients [41].
  • Leaky gut: Increased gut permeability has also been found in IBS patients and may be the reason for IBS symptoms [42, 43, 44].
  • Food intolerances: Non-celiac gluten intolerance, lactose intolerance, or intolerance to artificial additives/ingredients can trigger IBS symptoms in some. Intolerance to high FODMAP foods may increase bloating and abdominal pain in those with an irritated bowel [45, 46, 47, 48].
  • Brain-gut dysregulation: Abnormal levels of serotonin are common in anxiety and depression, can lead to alterations in normal brain-gut communication, and may be a cause of IBS. Serotonin is an important chemical messenger involved in digestion and nervous system function, and low levels can affect bowel function, mood, and pain in those with IBS [49, 50].
  • Hypersensitivity to gas pressure: Many IBS patients are extremely sensitive to gas pressure. These patients feel the sensation of bloating even with normal levels of gas. Inflammation or altered serotonin levels may play a role in this hypersensitivity [25, 51]. 

With the help of your healthcare provider, digging into the contributing factors behind your IBS can be a game-changer for preventing future IBS flare-ups and improving your quality of life. 

Confirm Your Diagnosis

IBS shares symptoms with other digestive conditions, including celiac disease and inflammatory bowel diseases (IBD) such as Crohn’s disease and ulcerative colitis. 

Traditionally, invasive procedures such as colonoscopy and biopsy have been used to rule out IBD and celiac disease in IBS patients. Thankfully, a simple IBS blood test can now identify many IBS patients and can be used to distinguish IBS-D (IBS with diarrhea) and IBS-M (IBS with mixed diarrhea and constipation) from these other conditions.

There are a number of treatment options for IBS that can help you to improve your overall digestive health, but treatments for IBS may differ from other gastrointestinal disorders, so a clear diagnosis is important.

Long-Term Treatment of IBS

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Long-term treatment of IBS doesn’t have to be difficult. In fact, many of the treatment options outlined above, including the low FODMAP diet and probiotics are also great for preventing future flare-ups. If these therapies give you immediate relief during an attack, it may be worthwhile to keep them as part of your regular routine. Keep in mind that it can take a few weeks to see the full benefit of these treatments. 

If an anti-inflammatory diet and probiotics alone don’t seem to be lowering the frequency, duration, or severity of your attacks, it’s probably time to address any underlying causes. This is where it may be useful to recruit a healthcare professional to see if you need a more targeted treatment like herbal antimicrobials for a gut bacteria imbalance or immunoglobulins for a leaky gut. 

With the help of a digestive expert or functional medical doctor, you will find what works for you to treat your IBS symptoms in the long term. Don’t forget to implement lifestyle changes, like stress management and regular exercise, and you’ll be well on your way to long-term IBS relief in no time.

Get a Handle on IBS Attacks

There is much you can do to relieve the symptoms of IBS attacks.

While medication can be helpful for specific symptoms of an IBS flare-up, dietary changes, probiotics, targeted supplements, and stress reduction are more effective for bringing the gut back into balance.

If you experience frequent IBS attacks, getting on a path to better gut health can help you to prevent flare-ups and improve your quality of life. My book, Healthy Gut, Healthy You, provides an in-depth guide to better gut health. If you want personal guidance for your IBS treatment plan, consider making an appointment with a health coach or functional health practitioner at our clinic

The Ruscio Institute has developed a range of high quality formulations to help our patients and audience. If you’re interested in learning more about these products, please click here. Note that there are many other options available, and we encourage you to research which products may be right for you.

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Discussion

I care about answering your questions and sharing my knowledge with you. Leave a comment or connect with me on social media asking any health question you may have and I just might incorporate it into our next listener questions podcast episode just for you!