What is an IBS Attack?
Irritable bowel syndrome (IBS) is a digestive system disorder that causes abdominal pain and problems with bowel movements. People with IBS may have diarrhea, constipation, or both. IBS episodes are often called IBS flare-ups or IBS attacks. The attacks can be very uncomfortable and disruptive to your life.
An IBS attack can happen suddenly or gradually over the course of a few days. It usually causes abdominal pain with constipation or diarrhea, and can sometimes cause nausea or vomiting.
Once other medical issues are ruled out, the goal is to treat your symptoms so you feel better. It typically takes a few days to a week to treat and calm the symptoms.
IBS attacks do get better. Afterwards, you and your doctor may need to do some digging and testing. But just because you had one IBS attack doesn’t mean you will continually have them. —Dr. Shria Kumar
What IBS attacks feel like
Symptoms of an IBS attack vary depending on the type of IBS you have—IBS-D with diarrhea, IBS-C with constipation, or IBS-M with both.
Most common symptoms
- Abdominal (stomach) pain and cramping that may be worse after eating and often goes away when you have a bowel movement
- A change in your bowel pattern, such as new diarrhea or constipation
Make sure you tell your doctor about things like weight loss and bleeding. It is important to be sure that an IBS attack is truly an IBS attack—and not something else masquerading. —Dr. Kumar
Other symptoms you may have
- Bloating and swelling of your abdomen
- Increased urgency to have a bowel movement
- Incontinence (if you can’t get to a toilet in time)
- A feeling that you haven’t fully emptied your bowel
- Mucus in your stool
What triggers IBS attacks
IBS attacks can happen out of nowhere. Sometimes stress and lifestyle changes, including a major change in your diet, can be triggers. Medication changes, like starting a new drug or taking antibiotics, can also lead to a flare-up.
Even minor things, such as a stomach bug or traveling, can bring on symptoms.
Ask your doctor: Do I need any further testing? —Dr. Kumar
How to stop IBS attacks
You can’t always predict when there will be a trigger, but there are ways to prevent and treat IBS attacks. It’s important to keep up with regular doctor visits and to lead a healthy lifestyle, which includes eating a balanced diet, exercising, and getting enough sleep.
You should be having daily bowel movements and avoiding straining during bowel movements. Medications and diet changes can help if your bowel habits are irregular or difficult.
Stopping and preventing IBS flares requires making changes to your diet and lifestyle, and you may have to take medication.
Changes to your diet
To prevent IBS attacks, follow a balanced diet that’s high in fiber and low in fat. You may need to avoid certain foods that trigger your attacks. A FODMAP diet, which avoids foods that are likely to cause gas, is often recommended.
- Avoid beans, which can cause gas and are very common triggers for people with IBS.
- Reduce fruits that are high fructose (like apples and watermelon); choose low-fructose fruits like berries and pineapple.
- Eat less of certain vegetables such as broccoli, onions, and brussel sprouts, which can cause symptoms in some people; better options include eggplant, sweet potatoes, and carrots.
- Avoid spicy foods; some people with IBS like to get creative with herbs to make sure their meals are still flavorful and enjoyable.
What to eat during and after an IBS attack
In general, bland foods are best. Avoid spicy foods, heavy meals, and alcohol. Lactose can make symptoms worse, so avoiding dairy products during a flare is important. You can re-introduce these foods as your symptoms improve.
Exercise, sleep, and stress
Stress can lead to IBS attacks. IBS is believed to be caused by problems with how your gut and brain work together, so stressful events can lead to physical symptoms.
To help manage stress levels, exercise at a moderate intensity 3–5 times a week, get enough sleep (at least 7–8 hours a night), and continue doing activities you enjoy, including socializing with friends and family. You can also try relaxation techniques.
It may help to see a mental health professional for talk therapy or medication, especially if you have anxiety or depression.
Some medications for prevention help regulate bowel movements and avoid indigestion and acid reflux, while others act as anti-spasmodics to relieve pain. They include:
- Anti-diarrheal agents like loperamide (Imodium) can help if you have loose stools.
- Constipation medications like Miralax or Senna help you have regular bowel movements.
- Antacid medications like famotidine (acid suppressants), Tums, or pantoprazole (a proton pump inhibitor) can help prevent indigestion and acid reflux.
- Antispasmodic medications like dicyclomine can treat abdominal pain.
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