Woman sitting on bed with hands on her stomach while experiencing an IBS flare up

IBS Flare Up: Treatment and Prevention

Medically reviewed on Sept 20, 2023 by Jillian Foglesong Stabile, MD, FAAFP. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.

Table of contents

Irritable bowel syndrome (IBS) occurs when there’s a chronic disturbance in the normal functioning of the digestive system, particularly the intestines. As a result, people with IBS can experience a variety of symptoms. These include but are not limited to abdominal pain, bloating, and irregular bowel movements. [1]

While there’s no way to prevent IBS itself, there are ways to combat IBS symptom flare ups. Below, we discuss exactly what IBS flare ups are and what you can do to avoid and manage them.

What Is an IBS Flare Up?

Irritable bowel syndrome (IBS) is a type of chronic gastrointestinal disorder. Chronic conditions are long-lasting and will persist over time. In the case of IBS, the digestive tract becomes especially sensitive, and bowel muscles can contract in irregular ways. In effect, many people who have IBS experience [1]:

  • Abdominal pain
  • Diarrhea
  • Constipation
  • Bloating

IBS flare ups, in which symptoms become more severe or intense than usual, can occur at any time and are often unpredictable. That said, IBS attack triggers include [2]:

  • Food choices
  • Caffeine or alcohol intake
  • Stress levels
  • Artificial sugars
  • Infectious diarrhea

Unfortunately, the more IBS flare ups people experience, the more susceptible the intestines become to these triggers. [2]

How to Treat an IBS Flare Up

While healthcare providers have not yet identified the cause of IBS,[3] they do recommend several strategies to help reduce the severity of IBS symptoms. The first recommendation is often a dietary change, such as [1]:

  • Increasing fiber – Fiber-rich fruits, vegetables, grains, and nuts can help regulate bowel movement and reduce abdominal pain.Healthcare providers recommend increasing your dietary intake of fiber to 20 to 35 grams. [4]
  • Drinking more water – It was found that drinking two liters of water a day, which supports digestive health and toxin removal, can lessen the intensity of IBS symptoms, including bloating, abdominal pain, constipation, and diarrhea. [5]
  • Avoiding caffeine – Because caffeine can cause diarrhea, people with IBS should try to avoid it. Highly caffeinated beverages include coffee, certain teas, and sodas. Chocolate and some over-the-counter pain medications can also contain caffeine. [6]
  • Limiting dairy – For people who are lactose intolerant, limiting dairy can reduce the severity of IBS symptoms. Lactose-laden [foods that cause gas](https://www.everlywell.com/blog/food-sensitivity/foods-that-cause-gas) like cheese and ice cream often cause bloating. [6]
  • Reducing carbohydrates – Foods with fermentable short-chain carbohydrates (FODMAPs) can be difficult to digest. These include vegetables like artichoke, asparagus, and cauliflower; fruits like apples, cherries, and mango; dairy; legumes; wheat, rye, and barley; breads and cereals; cashews and pistachios; and high-fructose treats. Incorporating a low-fructose diet and limiting high FODMAP foods can reduce the amount of irritants passing through the digestive system. These include eggplant, cantaloupe, eggs, oats, dark chocolate, and more. [7]

Secondly, people with IBS can incorporate probiotics rich in Bifidobacterium. These increase the amount of “good bacteria” in the gut, thus supporting healthy digestion and bowel movement. They can also reduce the severity of IBS symptoms. [2]

It’s also important to note that certain lifestyle changes can help manage IBS symptoms. For example [1]:

  • Exercising regularly
  • Avoiding smoking tobacco
  • Eating smaller meals throughout the day
  • Avoiding foods that trigger IBS symptoms
  • Prioritizing relaxation to mitigate high stress levels

For people who do have depression or anxiety that contributes to abdominal pain, a healthcare provider may prescribe an antidepressant, cognitive behavioral therapy, or hypnotherapy. There are also medicines to help treat IBS symptoms like diarrhea and constipation directly. [1]

How to Prevent an IBS Flare Up

Ultimately, healthcare providers do not know the direct cause of IBS flare ups. However, they do have a few theories [1]:

  • Dysmotility – Gastrointestinal dysmotility impacts the way your bowel muscles contract. Associated symptoms include vomiting, bloating, diarrhea, and constipation. [8]
  • Visceral hypersensitivity – About 40% of people with IBS are diagnosed with visceral hypersensitivity. People with visceral hypersensitivity have a lower pain tolerance than the rest of the population. As a result, the normal functioning of organs, such as the digestive organs, can cause discomfort. [9]
  • Brain-gut dysfunction – The enteric nervous system (ENS) lives in your gastrointestinal tract and is often called the “little brain.” It contains hundreds of millions of nerve cells that stretch from the esophagus to the rectum. Miscommunication between these nerves, the brain, and the gut can cause constipation, diarrhea, bloating, pain, and stomach upset. [10]

All that said, the only way to prevent IBS symptoms is to avoid their triggers, such as certain foods. To manage it properly, however, you’ll need to undergo a proper diagnosis. A physical exam can help identify the severity of your condition. [1]

You may then undergo a flexible sigmoidoscopy to assess your bowel movements or a colonoscopy to examine the entire colon. [1]

Assess Your Symptoms With Everlywell

An IBS flare up is typically characterized by severe IBS symptoms, including diarrhea, constipation, and abdominal pain.

If you commonly experience gastrointestinal distress, bloating, or indigestion, consider taking Everlywell’s Food Sensitivity Test. This at-home test is designed to help you learn what foods may be causing your discomfort due to IgG food sensitivities.

Buy Food Sensitivity Test

Or, to speak with a healthcare provider about your symptoms, try our telehealth services. From the comfort of your own home, you can receive an assessment of your condition and possible prescriptions and lifestyle recommendations to reduce triggers in your day-to-day.

Reach out today to learn more.

Low Fructose Diet: Recommended Foods

High FODMAP Foods: What to Know

8 Foods That Can Cause Gas

Common Fructose Intolerance Symptoms

References

  1. Irritable Bowel Syndrome (IBS). Cleveland Clinic. Published September 24, 2020. URL. Accessed September 12, 2023.
  2. Best ways to battle irritable bowel syndrome. Harvard Health Publishing. Published July 29, 2015. URL. Accessed September 12, 2023.
  3. Irritable Bowel Syndrome (IBS). NIH. URL. Accessed September 12, 2023.
  4. El-Salhy M, et al. Dietary fiber in irritable bowel syndrome (Review). Int J Mol Med. Published July 19, 2017. URL. Accessed September 12, 2023.
  5. The Connection Between Hydration & IBS. ACRIPC. URL. Accessed September 12, 2023.
  6. 5 Foods to Avoid if You Have IBS. Johns Hopkins Medicine. URL. Accessed September 12, 2023.
  7. Low FODMAP Diet. Cleveland Clinic. Published February 24, 2022. URL. Accessed September 12, 2023.
  8. Expanding insights into autoimmune GI dysmotility. Mayo Clinic. Published July 23, 2022. URL. Accessed September 12, 2023.
  9. Cleveland Clinic. Published May 11, 2022. URL. Accessed September 12, 2023.
  10. The Brain-Gut Connection. Johns Hopkins Medicine. URL. Accessed September 12, 2023.
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