An IBS flare-up or attack is a sudden intensification of gastrointestinal symptoms associated with IBS. They can upend even the most carefully made plans for a patient’s daily routine, and many IBS patients live in dread of the familiar twist in their stomach heralding one of these flares. However, the more you know, the more you can be prepared.
We’ve prepared a comprehensive guide to understanding IBS flare-ups and attacks, with suggestions for how to treat them when they happen:
Understanding Irritable Bowel Syndrome (IBS)
Knowledge is power and understanding what IBS is can help you prepare for its unpleasant consequences. Irritable Bowel Syndrome is a cluster of gastrointestinal symptoms, such as digestive discomfort and abnormal bowel movements like constipation or diarrhea, cramping, or bloating. These occur often enough to indicate an issue but are not consistently displayed. What this means is that there are patients with very mild IBS who only occasionally experience symptoms, whereas there are patients with more severe manifestations that require medical intervention. Flare-ups mark the appearance or worsening of one or more of these symptoms and can be mild to severe in appearance.
The exact cause of IBS is unknown. Scientific theories abound about its development, revolving around the gut-brain axis, resulting in dysfunctional signals from the brain to the stomach and intestines. Other theories involve a reduction in the integrity of the mucosal lining and increased permeation between epithelial cells. Still, others theorize about an imbalance in the gut microbiota, impacting proper digestion and overproduction of gas.
Regardless of the source, IBS can be debilitating, however, it manifests, and recognizing the symptoms can empower patients to acknowledge them and treat them before they become a problem.
IBS Flare-up Symptoms
An IBS flare-up or ‘IBS attack’ is a sudden rise in intensity or frequency of symptoms. These symptoms come as a result of gastrointestinal dysfunction, and can appear concomitantly or on their own:
What does an IBS flare-up feel like?
- Bloating
- Excessive gas
- Cramps or pain in the abdominal region
- Constipation, diarrhea, or a combination of both
- Appearance of mucus in your poop
- Feeling the need to poop right after you’ve done so
Causes of an IBS Flare-up
Unfortunately, IBS flare-ups can be unpredictable – both in terms of triggers, symptoms, and flare duration. They can last days or even weeks, resulting from several different causes:
Food Triggers
One of the most common triggers for a flare-up is consuming food or drink that irritates the gut lining. Caffeinated or alcoholic drinks such as coffee or alcohol can dehydrate the intestinal lining, weakening the integrity of the gut walls. Many times, IBS patients struggle with dairy foods containing high amounts of fat, which take longer and more energy to digest and increase gas production in the large intestine. Greasy and/or overly processed substances such as those common in fast food can also cause gastrointestinal distress and lead to flare-ups.
Stress
The nervous system plays a huge role in regulating digestion. The peripheral nervous system is responsible for the fight-or-flight reaction, through the stimulation of the sympathetic system, associated with stress, or the parasympathetic system, which increases digestion. These systems act like a light switch, with the body being in a state of “on” with the arousing sympathetic system or “off” with the calming parasympathetic system. Therefore, high levels of stress are negatively correlated with (i.e. decrease) effective digestion.
Stress also plays a role in activating the immune system, with high levels of cortisol over time increasing the reactivity of the gastrointestinal tract. Someone with an already hypersensitive digestive system, such as an IBS patient, will experience much more reaction from their immune system against their own GI tract when they are stressed, leading to a flare-up.
Bacterial Infection
Every individual has a unique balance of microbes lining their intestinal tract. Most of the time, they maintain balance with each other and assist in digestion. However, if something happens to disrupt this balance (which could even be spontaneous!) or a pathogenic organism is introduced into the environment (such as Clostridium bacter., a common suspect in food poisoning), this can lead to a bacterial infection. An infection is when the colonization of the bacteria results in harm to the host, i.e. you, which can cause an immune reaction and consequent flare-up.
IBS Flare-up Care
You may have done everything right and still experience a flare-up. After all, preventative care is limited by real-world circumstances. Here are a few tips to help manage the symptoms of a flare-up while it happens:
Eating with IBS Flare-up
This is not the time to double down on your dietary fiber consumption, as so many internet articles suggest. Fiber is great for regulating digestion and can aid in preventing constipation by enhancing digestive uptake, but will speed up bowel movements in a manner that could cause additional cramping and discomfort (not to mention diarrhea) in the middle of a flare-up. Soft foods, nutrient-rich vegetable and bone broth, and simple fare like white rice while the IBS attack persists can give your gut a much-needed rest, while providing the raw material your body needs to make energy.
Avoid Gut Irritants
This goes for both consumables and medication. NSAIDs, or non-steroidal anti-inflammatory drugs, such as Advil can irritate the gut lining. They are often marketed as pain-relievers, but patients with sensitive GI tracts should reduce their usage as much as possible. Caffeine and alcohol can dehydrate the mucosal lining, depriving cells of water in which vital cellular processes occur to aid digestion. Excessively fatty material, such as that found in fried or overly processed ‘fast foods’ is the hardest substance for your stomach and intestines to digest; therefore limiting their intake during a flare-up is a solid practice.
Rest
Your body is pulling an overtime shift trying to get your gut under control, but you shouldn’t! Make sure to get the requisite 7-9 hours of sleep during this time so your body can heal and reregulate digestive processes. In fact, not getting enough sleep has been linked to an influx of pro-inflammatory cytokines by the immune system, which can impair digestive health and lead to IBS symptom recurrence.
Reduce Stress
This is easier said than done, but reducing stress can a) remove a potent trigger of flare-ups, b) enhance digestion, and c) potentially decrease the time of flare-up period and help your body heal faster. Trying not to focus on stress is, admittedly, like trying not to focus on an elephant in the room; therefore, researchers suggest the ‘red balloon’ method in this analogy—trying to find something else to focus on in the room. Never had time for that hobby sitting in the corner? Here’s a great time to recenter yourself and take a break—your body is demanding it, after all!
Gentle Exercise
In the middle of a flare-up, it can be hard to even think about getting exercise. We aren’t suggesting running a marathon; but a short walk to get the blood circulating, a little stretching, or light yoga have shown to increase digestive efficiency, and reduce pain symptoms. That said, it is important to listen to your body and not strain yourself. Straining or overexerting yourself can leave you with a longer flare-up than usual, as your body struggles to make up for the energy deficit from digestion and exercise at the same time.
Seeking Immediate Relief
For patients looking for quick strategies to mitigate the painful side effects of an IBS flare-up, consider taking an OTC pain relief medication (other than Advil), sipping on ginger tea, and using a heating pad to combat painful cramps and abdominal aches.
It’s not easy being burdened with such a painful condition. Food, stress, and your emotional well-being all factor into the condition, which is why holistic lifestyle changes can make all the difference. Hydration is essential to gut repair, move a bit every day, and create a calming bedtime routine to optimize sleep quality, which all help lower stress levels, reduce gut symptoms, and strengthen your immune system.
How long do flare-ups last?
There’s no set timeline for an IBS flare-up—some episodes may pass within a few hours, while others can persist for days or even weeks. The duration largely depends on the individual, the severity of the flare, and how quickly effective management strategies are put in place. Factors such as diet, stress levels, gut sensitivity, and underlying triggers all play a role in how long symptoms last.
Flare-ups can be painful, unpredictable, and even debilitating at times. However, the key is to focus on gut healing and symptom management rather than simply waiting for it to pass. Prioritizing your gut health through dietary adjustments, stress reduction, or targeted therapy can help shorten the duration and intensity of a flare. Remember to listen to your body, give yourself time to recover, and take proactive steps toward long-term symptom control.
How can we help you at Evinature?
Evinature has a personalized protocol designed for IBS patients to control the frequency of their flare-ups and maintain remission. Take our free assessment here, and you will be assigned one of three potential nutraceutical treatments, assigned based on the level of severity.
Our DivertX supplements combine curcumin and Coptis to reduce gut inflammation and restore the integrity of the gut lining. Combined with our Exhale supplement, instrumental in decreasing the side effects of stress on the body, this combined package is designed with the patient in mind to help manage the ‘terms and conditions’ of IBS.
If you have any questions, you can also reach out to our Clinical Support team, who can provide insight and advice on how to use our Evinature supplements.
Summer Pitocchelli-Schwartzman
