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Evidence Based

This article is based on scientific evidence, written by experts and fact checked by experts.

Our team of licensed nutritionists and dietitians strive to be objective, unbiased, honest and to present both sides of the argument.

This article contains scientific references. The numbers in the parentheses (1, 2, 3) are clickable links to peer-reviewed scientific papers.

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

Written by on December 18, 2020

Written by on December 18, 2020 — Reviewed by Aimee Gallo

Dr. Michael Ruscio is a DC, Naturopathic Practitioner, researcher, and clinician. He serves as an Adjunct Professor at the University of Bridgeport and has published numerous papers in scientific journals as well as the book Healthy Gut, Healthy You. He also founded the Ruscio Institute of Functional Health, where he helps patients with a wide range of GI conditions and serves as the Head of Research.

Treatment Options to Relieve and Prevent Symptoms of IBS Attacks

If you have irritable bowel syndrome, you’ve likely experienced the symptoms of IBS attacks: stomach pain, bloating, extreme diarrhea or constipation. And that’s not all — fatigue [1, 2], depression and anxiety [3, 4, 5, 6], headaches [7, 8], and more can all be part of an IBS flare-up.

IBS is a common condition that can negatively affect one’s quality of life [9]. For many IBS patients, symptoms arrive in well-defined episodes, lasting, 2-5 days on average [10]. 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 IBS research, including strategies that can help you to reduce and even avoid symptoms of IBS attack. Read on to learn more about how to ease these symptoms and get your life back on track.

symptoms of IBS attack: Woman sitting on a couch while clutching her stomach in pain

What Are the Symptoms of IBS Attacks?

Abdominal pain and altered bowel movements are the defining symptoms of an IBS attack. However, there are many other common symptoms that you may also experience during an IBS attack, including:

  • Bloating [11]
  • Cramping [12]
  • Indigestion [13]
  • Heartburn [13]
  • Acid reflux [13]
  • Flatulence (gas) [12]
  • Rectal bleeding caused by altered bowel habits

IBS Affects More Than Just Your Digestive Tract

symptoms of IBS attack: Woman resting her head on her arms

What’s not often discussed is that IBS symptoms can affect more than just your digestive system. For example:

  • At least 50% of IBS patients struggle with fatigue [1].
  • More than half of chronic fatigue patients also have IBS [2].
  • Depression and/or anxiety is very common in IBS patients [3, 4, 5, 6, 14].
  • Many IBS patients have pain symptoms, including migraine headaches , fibromyalgia pain, pelvic pain, and TMJ (lockjaw) jaw pain [2, 7].

How to Relieve the Symptoms of IBS Attacks

No matter which symptoms you experience during an IBS flare-up, you want to find relief quickly. There are a number of things you can do to relieve symptoms of IBS attack.

Keep in mind that every IBS patient is different, and what works for you may not work for someone else. Experiment with these approaches to find the combination of treatment options that brings you the most relief:

Treatments to Calm a Gut Flare Up

Treatments to Calm a Gut Flare Up

IBS flare-ups start in the gut, so it makes sense to treat the root cause of the problem. These treatment options are highly recommended for bringing the gut back into balance:

  • Gut reset: 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 fasting and eating elemental diets are effective treatments for IBS [15, 16].
  • Low FODMAP foods: If you can’t do a gut reset, the next best choice is eating easy-to-digest meals that are low in fermentable carbohydrates, or low FODMAPs. 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.
  • Stress Reduction and Relaxation Techniques: stress and lack of sleep can be a common trigger for IBS symptoms. Research suggests that stress management techniques, including yoga [17], meditation [18], exercise [19], cognitive behavioral therapy [20, 21], and hypnotherapy [22, 23] can be helpful for IBS patients.
  • Probiotics: Significant research evidence, including five meta-analyses (highest quality research evidence) [24, 25, 26, 27, 28], supports the use of probiotics for reducing IBS symptoms.
  • Immunoglobulins: A relatively new supplement, immunoglobulins support the immune system by binding to and neutralizing bad bacteria in the gut. Clinical trials have shown that immunoglobulins improve IBS symptoms [29, 30, 31, 32, 33, 34, 35] and can be effective, even for IBS patients that don’t respond to other therapies [31].
  • Herbal remedies: A number of herbal remedies can help with bloating and other digestive symptoms. Peppermint oil supplements, peppermint tea, or the herbal supplement Atrantil can help to soothe digestive symptoms.

Medication

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

  • For IBS with diarrhea, Imodium (loperamide) is an over-the-counter medication that relaxes the smooth muscles of the digestive system and can help to improve stool consistency and reduce the frequency of bowel movements. Prescription antidiarrheal medications for IBS include Viberzi (eluxadoline) and Lotronex (alosetron).
  • For IBS with constipation, over-the-counter laxatives such as Glycolax, Miralax, or magnesium citrate can be very helpful. Fiber supplements may also be effective but can worsen symptoms for some. Choose low FODMAP sources of fiber such as ground flaxseeds or chia seeds.
  • For headaches and body pain associated with an IBS attack, over-the-counter NSAIDs (non-steroidal anti-inflammatory drugs) such as ibuprofen can provide relief. Long-term use of NSAIDs is not recommended due to side effects that can damage the gut, potentially worsening IBS symptoms.

Can IBS Attacks Be Prevented?

symptoms of IBS attack: Woman smiling while eating a salad

IBS is a set of symptoms rather than a disease. For decades, health care professionals did not know the cause of symptoms of irritable bowel syndrome. However, research is now shedding light on the many factors that can lead to IBS [36]. These include:

  • Gut dysbiosis: Imbalances in the microorganisms of the gut [37], also known as gut dysbiosis, can be a result of poor diet, stress, antibiotic use, and other lifestyle factors [38].
  • Post-infectious IBS: One study suggests that food poisoning (also known as gastroenteritis) may cause between 5% and 32% of IBS cases [39].
  • SIBO: A meta-analysis of 50 clinical trials found SIBO (bacterial overgrowth in the small intestine) in more than one-third of the studied IBS patients [40].
  • Leaky gut: Leaky gut has also been found in IBS patients [41, 42] and may be the reason for some IBS symptoms [43].
  • Food intolerances: Non-celiac gluten intolerance [44], lactose intolerance [45], or intolerance to artificial additives or ingredients [46] can trigger IBS symptoms in some. Intolerance to high FODMAPs foods may increase bloating and abdominal pain [47].
  • Brain-gut dysregulation: Another potential cause of IBS symptoms is alterations in normal brain-gut communications [48]. Low levels of serotonin, a chemical messenger involved in digestion, brain, and nervous system functions can affect bowel function and also may cause pain and mood disorders in IBS [49].
  • 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 [50] or altered serotonin levels [51] may play a role in this hypersensitivity.

All of this research gives us much more insight into managing IBS symptoms. If you suffer from frequent IBS attacks, there are steps you can take to prevent IBS flare-ups and improve your quality of life.

Long-Term Treatment of IBS

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

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.

Treatment Options

Long-term treatment of IBS is a step-by-step approach that should start with the most fundamental approaches.

For some patients, an anti-inflammatory diet, probiotics, and lifestyle changes are all that’s needed to get control of IBS symptoms. For patients who don’t respond fully to these fundamental steps, more targeted approaches are available, including a low FODMAP diet and antimicrobial treatments. Research shows that herbal antimicrobial treatments are as effective as standard antibiotic treatment with Rifaximin [52].

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 medicine practitioner at our clinic.

Get a Handle on IBS

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

While medication can be helpful for specific symptoms of an IBS flare-up, modified fasting or 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.

➕ References
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