Jack Harley
Reviewed by Dr Michael Yapko
Thursday, August 13, 2020
Jack Harley
Thursday, August 13, 2020

How to Calm an IBS Flare-Up: Tools, Tips & Tactics

Contents

Looking for ways to calm an IBS flare-up? You're not alone. Irritable bowel syndrome (IBS) is a common gastrointestinal condition affecting around 15% of people, with symptoms including stomach cramps, bloating, diarrhea, and constipation. Although IBS is typically a chronic (long-lasting) condition, many people's symptoms come and go. If you're experiencing an increase in symptoms, here are some helpful strategies to soothe an IBS flare-up.

What is an IBS flare-up?

During an IBS flare-up (sometimes known as “IBS attack”) you may experience more gut symptoms, such as stomach cramps, bloating, diarrhea, and constipation. An IBS flare-up can last anywhere from a few hours to a few months at a time.

So, what causes an IBS flare-up? An increase in symptoms can sometimes be triggered by eating certain foods or from anxiety or stress. However, even if you're doing all the 'right' things, an IBS flare-up can still happen with no obvious cause.

There's no cure for IBS but there are things you can do to help relieve symptoms and reduce the chance of future episodes.

Infographic showing 8 tips to calm an IBS flare-up

What is IBS?

IBS is a common gastrointestinal condition that affects around 1 in 7 people worldwide and is almost twice as common in women as it is in men. While IBS can occur at any age, most people start to notice their symptoms between 20 and 30 years old.

A healthcare professional can diagnose whether you have IBS based on your symptoms. You might have IBS if you have recurrent abdominal pain for at least one day per week in the past three months, and two or more of the following:

  • Changes in stool frequency
  • Changes in stool appearance 
  • Pain or relief of pain associated with a bowel movement

Signs of an IBS flare-up

Some people will experience IBS on a daily basis, while others can go long periods of time without symptoms. An IBS flare-up means that you are experiencing a sudden increase in IBS symptoms over a period of time. Signs of an IBS flare-up may differ from person to person, though they can commonly include:

  • Abdominal pain 
  • Swelling or bloating of the abdomen 
  • Passing excessive gas 
  • A feeling that the bowels are not empty after passing stools
  • Diarrhea or constipation

Some people also experience some less common symptoms, such as:

  • Headache 
  • Joint or muscle pain 
  • Fatigue 
  • Frequent urination 
  • Feelings of anxiety or depression 

How long does an IBS flare-up last?

An episode of IBS (also known as a ‘flare-up’ or an ‘IBS attack’) may last for several hours, several days, or even months at a time. After a flare-up, your symptoms may lower in severity or disappear completely.

Many people experience IBS in waves, in which symptoms may come and go over several days or weeks.

What causes an IBS flare-up?

It's unclear what causes episodes of IBS symptoms, but several studies have shown the following factors may play a part in IBS flare-ups:

  • Eating ‘trigger’ foods: High FODMAPs foods (foods that are poorly digested by the gut) may cause IBS symptoms. 
  • Stress: both short and long-term stress, for example from situations at work or in life in general, can increase gut problems. 
  • Gastrointestinal infection: Especially in severe cases, gut infections have been shown to trigger IBS symptoms.
  • Psychological condition: anxiety, depression and post-traumatic stress disorder can all bring on an IBS flare-up.

How to manage an IBS flare-up at home

There is no cure for IBS, but a range of strategies may help manage a flare-up. Many approaches may also be used to prevent or reduce the chance of an episode of IBS.

1. Avoid high-FODMAP foods

Foods that are high in ‘FODMAPS’ (small carbohydrate molecules that cause bacteria in the gut to release gas) may cause IBS symptoms. A diet low in FODMAPs reduces symptoms of IBS in most people.

To calm an IBS flare-up, avoid high-FODMAP foods such as: 

  • Fructans (a fructose molecule that stores carbohydrates): such as garlic, onion, wheat, rye, and broccoli 
  • Oligosaccharides (a type of carbohydrate): such as chickpeas, lentils, tofu, and beans 
  • Lactose and dairy: Such as cow’s milk, yogurt, and ice-cream 
  • Fructose (fruit sugar): such as apples, mangoes, watermelon, and honey 
  • Polyols (naturally occurring sugar alcohols): such as nectarines, peaches, plums, cauliflower, and mushrooms

Instead, choose low-FODMAP options that include: 

  • Some grains: gluten-free oats and white, brown and basmati rice 
  • White meats: poultry and fish 
  • Cooked vegetables: carrots, peas, potato, Swiss chard, eggplant, and kale 
  • Nuts and seeds: flaxseed, pecans, pine nuts, almonds

A low FODMAP diet involves eliminating high FODMAP foods, then slowly reintroducing them, one at a time, and noting any changes in symptoms. This two-step approach should help identify foods that trigger a flare-up. 

2. Try gut-directed hypnotherapy

You might not have heard of hypnotherapy as a treatment for health conditions, but it’s been proven to help IBS symptoms and can even treat other conditions such as chronic pain or smoking addiction. In hypnotherapy, you are gently brought into a relaxed state, then given helpful suggestions targeting your subconscious.

A recent study showed that gut-directed hypnotherapy is equally effective as the low-FODMAP diet in reducing IBS symptoms—which is good news for people wanting to improve their symptoms without overhauling their diet and lifestyle. Gut-directed hypnotherapy has been shown to significantly reduce symptoms of IBS in over 50% of people.  You can try gut-directed hypnotherapy by visiting a gut-directed hypnotherapist or using a mobile app like Nerva (based on this recent study).

How hypnotherapy exactly works is still unclear to researchers, but it is thought to work by helping you:

  • Reduce sensitivity to pain in regions of the brain 
  • Restore signals of the gut-brain connection to normal
  • Reduce levels of anxiety and depression, which may worsen pain 

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3. Reduce stress 

Stress can worsen symptoms of a flare-up because of the gut-brain connection (literally a chemical connection between your gut and brain). This is why relaxation techniques that work for the mind can also help calm the gut. Two common ways to reduce stress and episodes of IBS are:

  • Mindfulness meditation: Meditation can calm the mind and the gut. In several studies, meditation was shown to lower gut symptoms of pain and bloating. Researchers believe this is due to reducing pain signals that can cause a flare-up of IBS symptoms.
  • Yoga: Yoga is a mind and body practice that combines breathing with movement. In adolescents, it has been shown to reduce symptoms of IBS and anxiety.

4. Try peppermint oil 

Peppermint oil is a herbal supplement that has been used as a natural remedy for centuries. It has been approved by the Food and Drug Administration (FDA) for the treatment of IBS and is well supported by evidence from clinical studies.

The active ingredient in peppermint oil is menthol, which has a cooling effect. Menthol dulls pain receptors and relaxes the muscles of the colon. Peppermint oil can help reduce pain, bloating, and constipation and has even been shown to be more effective than antispasmodics in relieving overall symptoms of IBS.

Peppermint oil is available over-the-counter in capsule form and is well tolerated by most people. However, in rare cases, peppermint oil may cause side-effects such as gastric reflux. If you don’t feel comfortable taking peppermint oil, you can always try sipping peppermint tea. 

5. Reduce caffeine intake 

Coffee and other sources of caffeine may worsen symptoms of IBS during a flare-up. Even without IBS, caffeine is known to have a laxative effect on the body with diarrhea being a common side-effect of overconsumption. One study showed coffee-drinkers were 50% more likely to develop IBS than those who did not drink coffee.

It’s best to avoid caffeine during a flare-up. Try cutting out all forms of caffeine—this means teas, soft drinks, coffee, and chocolate—and watch for any changes in your symptoms.

6. Heat therapy 

Heat therapy is a traditional home remedy for pain and offers a gentler approach than taking medications when your stomach is already upset. 

Heat therapy works by reducing blood flow to relax the muscles of the abdomen. It has been shown to relieve certain kinds of back pain more effectively than ibuprofen and is a good choice for treating pain in IBS.

Try applying something warm, like a hot-pack or hot water bottle, to your belly. Make sure you place a towel between your skin and the heat source to avoid being burned.

7. Exercise 

Increasing your levels of exercise may provide relief from an IBS episode. Exercise helps relieve your symptoms as it can stimulate normal contractions of the intestines while also reducing stress.

In one study, participants who took part in 20 to 30 minutes of moderate-intensity exercise noted significant improvements in abdominal pain and quality of life compared to the control group. Although this study was conducted over a longer time-frame, even a single session may be beneficial in fighting a flare-up. 

Common medical treatments for IBS

Since the exact cause of IBS is not known, the goal of treatment is to reduce symptoms. If diet and lifestyle changes don’t improve your symptoms, your healthcare provider may recommend IBS medications. Some common medications include:

  • IBS medications: Some medications can help with IBS by either slowing the movement of material through the bowel to reduce diarrhea or by increasing fluid production in the small intestine to reduce constipation. Alosetron (Lotronex) or Lubiprostone (Amitiza) are two common IBS medications.
  • Antispasmodics: These are designed to relax the smooth muscles of the colon to ease cramping and spasms. Two such medications are hyoscine (Levsin) and dicyclomine (Bentyl). They may cause side effects that include dry mouth, palpitations, and difficulty urinating.
  • Antidiarrheals: These medications can be useful in treating severe diarrhea. But they should be taken with caution— antidiarrheals may have side effects such as nausea and vomiting and should be taken under close supervision. Loperamide (Imodium) is an example of an Antidiarrheal medication.
  • Antidepressant medications: Certain antidepressants can help relieve diarrhea and constipation and may treat pain in IBS. They are often prescribed in lower doses for IBS than for depression.  Antidepressants for IBS should be taken under supervision as side effects can include insomnia, nausea, and weight gain or loss. Some tricyclic antidepressants used for IBS include imipramine (Tofranil) and selective serotonin reuptake inhibitors (SSRIs) such as citalopram (Celexa).

When to see a doctor

If you’ve tried at-home remedies and haven’t seen a change in your symptoms, it might be time to talk to a healthcare provider. Sometimes, you may experience symptoms similar to those of IBS that are actually caused by a different condition. These include: 

  • Dizziness 
  • Progressive worsening pain
  • Symptoms that occur at night and cause you to wake up repeatedly 
  • Lack of appetite 
  • Blood in stools 
  • Vomiting

If you experience any of these symptoms, you should visit a doctor as soon as possible. In addition to assessing your symptoms, several tests can be performed to find out if you have a different medical condition.

A Word from Mindset Health

An IBS flare-up can be frustrating and may cause a range of digestive symptoms. If you’re experiencing a flare, there are several at-home remedies you can try, such as gut-directed hypnotherapy, removing high-FODMAP foods from your diet, heat therapy, avoiding caffeine, exercising, and reducing stress. You may also wish to talk to your healthcare provider about medications to treat IBS symptoms and check that another condition isn’t causing your digestive symptoms. 

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Take control of your IBS in 6 weeks with Nerva

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89% of users report improved gut symptoms

Our Sources

Mindset Health only uses high-quality sources, including peer-reviewed research, to support our articles. We work with experts to ensure our content is helpful, accurate and trustworthy.

  1. Overview, I., 2020. Irritable Bowel Syndrome: Overview. [online] Ncbi.nlm.nih.gov. Available at: <https://www.ncbi.nlm.nih.gov/books/NBK279416/> [Accessed 10 August 2020]. https://www.ncbi.nlm.nih.gov/books/NBK279416
  2. nhs.uk. 2020. Irritable Bowel Syndrome (IBS). [online] Available at: <https://www.nhs.uk/conditions/irritable-bowel-syndrome-ibs/> [Accessed 10 August 2020]. https://www.nhs.uk/conditions/irritable-bowel-syndrome-ibs/
  3. Bommelaer, G., Poynard, T., Le Pen, C., Gaudin, A.F., Maurel, F., Priol, G., Amouretti, M., Frexinos, J., Ruszniewski, P. and El Hasnaoui, A., 2004. Prevalence of irritable bowel syndrome (IBS) and variability of diagnostic criteria. Gastroenterologie clinique et biologique, 28(6-7), pp.554-561. https://pubmed.ncbi.nlm.nih.gov/15243388/
  4. Schmulson, M.J. and Drossman, D.A., 2017. What is new in Rome IV. Journal of neurogastroenterology and motility, 23(2), p.151. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5383110/
  5. Cady, R.K., Farmer, K., Dexter, J.K. and Hall, J., 2012. The bowel and migraine: update on celiac disease and irritable bowel syndrome. Current pain and headache reports, 16(3), pp.278-286. https://link.springer.com/article/10.1007%2Fs11916-012-0258-y
  6. Cain, K.C., Jarrett, M.E., Burr, R.L., Rosen, S., Hertig, V.L. and Heitkemper, M.M., 2009. Gender differences in gastrointestinal, psychological, and somatic symptoms in irritable bowel syndrome. Digestive diseases and sciences, 54(7), p.1542. https://link.springer.com/content/pdf/10.1007/s10620-008-0516-3.pdf
  7. Schneider, M.A. and Fletcher, P.C., 2008. ‘I feel as if my IBS is keeping me hostage!’Exploring the negative impact of irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD) upon university‐aged women. International journal of nursing practice, 14(2), pp.135-148. https://insights.ovid.com/international-nursing-practice/ijnp/2008/04/000/feel-ibs-keeping-hostage-exploring-negative-impact/9/00063413
  8. Gibson, P.R. and Shepherd, S.J., 2010. Evidence‐based dietary management of functional gastrointestinal symptoms: the FODMAP approach. Journal of gastroenterology and hepatology, 25(2), pp.252-258. https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1440-1746.2009.06149.x
  9. White, D.L., Savas, L.S., Daci, K., Elserag, R., Graham, D.P., Fitzgerald, S.J., Smith, S.L., Tan, G. and El‐Serag, H.B., 2010. Trauma history and risk of the irritable bowel syndrome in women veterans. Alimentary pharmacology & therapeutics, 32(4), pp.551-561. https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1365-2036.2010.04387.x
  10. Hanevik, K., Dizdar, V., Langeland, N. and Hausken, T., 2009. Development of functional gastrointestinal disorders after Giardia lamblia infection. BMC gastroenterology, 9(1), p.27. https://link.springer.com/article/10.1186/1471-230X-9-27
  11. Fond, G., Loundou, A., Hamdani, N., Boukouaci, W., Dargel, A., Oliveira, J., Roger, M., Tamouza, R., Leboyer, M. and Boyer, L., 2014. Anxiety and depression comorbidities in irritable bowel syndrome (IBS): a systematic review and meta-analysis. European archives of psychiatry and clinical neuroscience, 264(8), pp.651-660. https://link.springer.com/article/10.1007/s00406-014-0502-z
  12. Halmos, E.P., Power, V.A., Shepherd, S.J., Gibson, P.R. and Muir, J.G., 2014. A diet low in FODMAPs reduces symptoms of irritable bowel syndrome. Gastroenterology, 146(1), pp.67-75. https://research.monash.edu/en/publications/a-diet-low-in-fodmaps-reduces-symptoms-of-irritable-bowel-syndrom
  13. Fedewa, A. and Rao, S.S., 2014. Dietary fructose intolerance, fructan intolerance and FODMAPs. Current gastroenterology reports, 16(1), p.370. https://link.springer.com/content/pdf/10.1007/s11894-013-0370-0.pdf
  14. Shepherd, S. and Gibson, P., 2014. The Complete Low-FODMAP Diet: The revolutionary plan for managing symptoms in IBS, Crohn’s disease, coeliac disease and other digestive disorders. Random House. https://books.google.co.uk/books?hl=en&lr=&id=-gQiBQAAQBAJ&oi=fnd&pg=PT11&dq=flaxseed+low+fodmap&ots=WNJNlBmDUd&sig=8k1cKpwLUmqTBrogiBc6dOPuytI&redir_esc=y#v=onepage&q=flaxseed low fodmap&f=false
  15. Collison, D.R., 1972. Medical hypnotherapy. Medical Journal of Australia, 1(13), pp.643-649. https://onlinelibrary.wiley.com/doi/abs/10.5694/j.1326-5377.1972.tb46979.x
  16. Abbot, N.C., Stead, L.F., White, A.R. and Barnes, J., 1998. Hypnotherapy for smoking cessation. Cochrane Database of Systematic Reviews, (2). https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD001008/abstract
  17. Lindfors, P., Unge, P., Arvidsson, P., Nyhlin, H., Björnsson, E., Abrahamsson, H. and Simrén, M., 2012. Effects of gut-directed hypnotherapy on IBS in different clinical settings—results from two randomized, controlled trials. American Journal of Gastroenterology, 107(2), pp.276-285. https://pubmed.ncbi.nlm.nih.gov/21971535/
  18. Peters, S.L., Yao, C.K., Philpott, H., Yelland, G.W., Muir, J.G. and Gibson, P.R., 2016. Randomised clinical trial: the efficacy of gut‐directed hypnotherapy is similar to that of the low FODMAP diet for the treatment of irritable bowel syndrome. Alimentary pharmacology & therapeutics, 44(5), pp.447-459. https://onlinelibrary.wiley.com/doi/full/10.1111/apt.13706
  19. Vasant, D.H. and Whorwell, P.J., 2019. Gut‐focused hypnotherapy for Functional Gastrointestinal Disorders: Evidence‐base, practical aspects, and the Manchester Protocol. Neurogastroenterology & Motility, 31(8), p.e13573. https://onlinelibrary.wiley.com/doi/full/10.1111/nmo.13573
  20. Blanchard, E.B., Lackner, J.M., Jaccard, J., Rowell, D., Carosella, A.M., Powell, C., Sanders, K., Krasner, S. and Kuhn, E., 2008. The role of stress in symptom exacerbation among IBS patients. Journal of Psychosomatic research, 64(2), pp.119-128. https://www.sciencedirect.com/science/article/pii/S0022399907003923?casa_token=Psz0b2WQAEcAAAAA:XRL5SfBi0QMrFmY1-HQkPQfsw004sjWwbvxcoMhg9Six1yWIaRkkskAPPq1HS2dT74hPIgTk
  21. Gaylord, S.A., Palsson, O.S., Garland, E.L., Faurot, K.R., Coble, R.S., Mann, J.D., Frey, W., Leniek, K. and Whitehead, W.E., 2011. Mindfulness training reduces the severity of irritable bowel syndrome in women: results of a randomized controlled trial. The American journal of gastroenterology, 106(9), p.1678. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6502251/
  22. Kuttner, L., Chambers, C.T., Hardial, J., Israel, D.M., Jacobson, K. and Evans, K., 2006. A randomized trial of yoga for adolescents with irritable bowel syndrome. Pain Research and Management, 11. https://www.hindawi.com/journals/prm/2006/731628/
  23. Alam, M.S., Roy, P.K., Miah, A.R., Mollick, S.H., Khan, M.R., Mahmud, M.C. and Khatun, S., 2013. Efficacy of Peppermint oil in diarrhea predominant IBS-a double blind randomized placebo-controlled study. Mymensingh medical journal: MMJ, 22(1), p.27. https://pubmed.ncbi.nlm.nih.gov/23416804/
  24. Ford, A.C., Talley, N.J., Spiegel, B.M., Foxx-Orenstein, A.E., Schiller, L., Quigley, E.M. and Moayyedi, P., 2008. Effect of fibre, antispasmodics, and peppermint oil in the treatment of irritable bowel syndrome: systematic review and meta-analysis. Bmj, 337, p.a2313. https://www.bmj.com/content/337/bmj.a2313.full
  25. Cappello, G., Spezzaferro, M., Grossi, L., Manzoli, L. and Marzio, L., 2007. Peppermint oil (Mintoil®) in the treatment of irritable bowel syndrome: A prospective double blind placebo-controlled randomized trial. Digestive and liver disease, 39(6), pp.530-536. https://www.sciencedirect.com/science/article/pii/S1590865807000618?casa_token=ocIvDVeoL-oAAAAA:KHlW8MFUFoFWt0Bib0yHP8AShC6FOP6dZSOV-yvTHVhPqmbcFbM70u5AwR5LOFzHbju_PJRk
  26. Koochakpoor, G., Salari-Moghaddam, A., Keshteli, A.H., Esmaillzadeh, A. and Adibi, P., 2020. Association of coffee and caffeine intake with irritable bowel syndrome in adults. https://assets.researchsquare.com/files/rs-35477/v1/f66dd60d-ffb0-4669-b3c0-8f222e6ec81d.pdf
  27. Nadler, S.F., Steiner, D.J., Erasala, G.N., Hengehold, D.A., Hinkle, R.T., Goodale, M.B., Abeln, S.B. and Weingand, K.W., 2002. Continuous low-level heat wrap therapy provides more efficacy than ibuprofen and acetaminophen for acute low back pain. Spine, 27(10), pp.1012-1017. https://pubmed.ncbi.nlm.nih.gov/12004166/
  28. Johannesson, E., Simrén, M., Strid, H., Bajor, A. and Sadik, R., 2011. Physical activity improves symptoms in irritable bowel syndrome: a randomized controlled trial. American Journal of Gastroenterology, 106(5), pp.915-922. https://pubmed.ncbi.nlm.nih.gov/21206488/
  29. Wilkins, T., Pepitone, C., Alex, B. and Schade, R.R., 2012. Diagnosis and management of IBS in adults. American family physician, 86(5), pp.419-426. https://www.aafp.org/afp/2012/0901/p419.html
  30. Hanauer, S.B., 2008. The role of loperamide in gastrointestinal disorders. Reviews in gastroenterological disorders, 8(1), p.15. http://medreviews.com/sites/default/files/2016-11/RIGD_81_15_0.pdf
  31. Fakhoury, M., Negrulj, R., Mooranian, A. and Al-Salami, H., 2014. Inflammatory bowel disease: clinical aspects and treatments. Journal of inflammation research, 7, p.113. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4106026/

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