Managing IBS Flare-Ups: Tips for Finding Relief

IBS flare ups (also known as IBS attacks) are never fun, but for those who suffer from IBS know they can occur from time to time. IBS flare ups can come on with no warning and can be triggered by eating certain foods or stress, leading to significant discomfort which can impact on quality of life.

In this article, we’ll explore what IBS flare ups are, the potential triggers and dietitian’s top tips for finding relief during an IBS flare up.

In this article you will learn:

• What is IBS?
• What is an IBS flare up?
• How long do IBS flare ups last?
• What can trigger an IBS attack?
• How can I manage symptoms of an IBS attack?
• When should I see a doctor for my IBS symptoms, and what types of treatment are available?

IBS, otherwise known as Irritable Bowel Syndrome is a common gut disorder that affects almost 30% of Australians. The condition is characterised by symptoms such as excess gas, abdominal pain, bloating, constipation and diarrhea, which can be triggered by factors such as food, stress, alcohol, caffeine and mood ^(1,3).

IBS is generally diagnosed based on symptom history and your GP will undertake routine blood and stool tests to rule out other conditions such as coeliac disease and inflammatory bowel disease.

Although there is no cure for IBS, symptoms may change overtime and with the right strategies IBS can be managed successfully. IBS does not present a serious threat to your physical health and will not increase chances of developing cancer ^(1,3).

Put simply, an IBS flare up is when you experience a sudden increase in IBS-like symptoms over a certain period of time ⁽⁴⁾.

Symptoms of an IBS attack include nausea, constipation, diarrhoea, abdominal discomfort, feeling that bowels are not completely empty after passing a bowel motion, excessive gas, bloating, and changes in stool frequency ⁽¹⁾.

It varies, IBS flare ups can last days to weeks to months which can have a great impact on day to day tasks and quality of life.

If you’re experiencing a flare up and your symptoms persist for longer than a month, or longer than what’s normal for you, seek support from a GP or an Accredited Practicing Dietitian (APD) who can work with you to manage your symptoms via lifestyle modifications, particularly diet ⁽⁵⁾.

An IBS flare up can often be triggered by anxiety, stress, eating certain foods or drinks, for example caffeine, or gastrointestinal infections ⁽⁵⁾. However, it’s worth noting that an IBS flare-up can still happen with no obvious cause, as not all triggers are completely understood by scientists ⁽⁵⁾.

Although IBS is not curable, there are many helpful strategies you can implement when experiencing an IBS flare up. Here are my top tips as a Dietitian to help reduce symptoms during an IBS attack.

Stress can be a huge culprit to bringing on an IBS flare up. That’s because the brain and the gut are connected by what’s known as ‘the gut brain axis’. According to recent research, our brain and gut communicate with each other via the vagus nerve, where signals are sent in both directions from these major organs. So when we are feeling stressed, this can have a direct effect on our gut, and exacerbate symptoms, leading to an IBS flare up ⁽⁶⁾.

Therefore, trying to reduce stress can be super important in the management of IBS flare ups. Ways to reduce your stress may include:

Exercise is a great way to help improve our digestive health. Gentle movement causes your digestive system to have gentle contractions of the intestines and can also give you relief from stress ⁽⁵⁾, which in turn can reduce IBS symptoms.

Applying heat to your stomach may help soothe pain or discomfort caused from an IBS flare up. This is because heat reduces blood flow and relaxes the muscles in the abdomen. You can apply heat to your abdomen by using a heat pack or hot water bottle.

Triggering foods vary for everyone, yet if you have IBS you may have heard of FODMAPs. FODMAPs are a group of short-chain carbohydrates (aka sugars) found in certain foods which are poorly absorbed by some people. When they reach the intestines, they can draw in water, and produce excess gas leading to IBS like symptoms ⁽⁵⁾.

When experiencing a flare up of IBS symptoms, limiting the amount of high FODMAP foods from your diet may help alleviate symptoms ⁽⁵⁾.

The major categories of FODMAP’s include foods such as:

Fructans – garlic, onion, wheat, rye and broccoli
Oligosaccharides – chickpeas, lentils, tofu and beans
Lactose and dairy – cows milk, ice cream and yoghurt
Fructose – apples, mangoes, watermelon and honey
Polyols – nectarines, peaches, plums, cauliflower and mushrooms

*Please note: these are just some of the many FODMAP foods, an extensive list of high FODMAP foods can be found via the MONASH University FODMAP Diet App.

Also, it’s important to know that FODMAPs are not the only food triggers to IBS. Caffeine, chilli/spicy foods, fatty foods, alcohol and carbonated drinks e.g. soft drinks can all play a role in triggering symptoms, too.

With so many potential food triggers, it can be extremely challenging trying to navigate IBS triggers on your own. It’s also not advised to remove all these triggers above, as usually a person will only have one, or a couple of triggers linked to their symptoms. Eliminating major food groups without professional support for long periods of can have a number of negative health benefits e.g.

a) increase the risk of nutritional deficiencies
b) increase anxiety around food restriction, making social settings difficult
c) reduce the diversity of bacteria in our microbiome, which can potentially worsen conditions like IBS

These are just some of the reasons why it’s so important to seek professional advice from a clinically trained FODMAP Dietitian. Not only can they help manage your flare up symptoms, they can reduce the likelihood of flare ups in the future while helping to add more, not less into your diet in the long term. ^(5-6).

If you’ve had little success in managing an IBS flare up, and it’s affecting your daily living, and quality of life, it may be best to speak with your Doctor. Sometimes, the symptoms of IBS can overlap other medical conditions which may be more serious. These symptoms include:

If you have any of these symptoms above or are concerned, speak to your Doctor to determine if about further investigation may be necessary. ⁽¹⁾

The symptoms of an IBS attack, the severity and length look different for everyone. It may take time and some experimenting to find a strategy which works best for you and your IBS. Once you find a routine that can relieve these symptoms. you will be able to manage and monitor to avoid further flare-ups.

Seeking individualised support from an Accredited Practising Dietitian can be a great way to identify your triggers to assist in improving your IBS symptoms. If you’re struggling with IBS, or have any other gut concerns you’d like help with, speak with one of our friendly consultants today to learn more about our 26 week program, and how we can help you today.

Maegan Wilson
Accredited Practising Dietitian
BHNutr & MNutr&Diet