How to Deal With an IBS Attack

Woman on bed with cramps
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As you may well know, an attack from irritable bowel syndrome (IBS) can be debilitating. Crippling pain, panic about finding a bathroom, embarrassment that your symptoms may become known to others, and fears of having an accident can all add up to be quite a nightmare. Once you have had a bad IBS attack, it is common to remain on edge, wondering when the next attack will occur.

Luckily, there are things that you can do to help yourself when you are having a bad IBS attack and things you can do to reduce your risk for experiencing a future attack.

Note: This article discusses ways to handle the pain and bathroom symptoms associated with IBS. If your symptoms are unusual or particularly severe, or accompanied by fever, difficulty breathing, persistent vomiting, or signs of bleeding, you should seek medical attention immediately. 

During the Attack

The most important thing to do during an IBS attack is to remain as calm as possible. This is tough may be tough to do because attacks can be so awful, but the calmer you can keep yourself, the quieter your symptoms will be. Here are some things you can do to soothe your agitation and your symptoms:

1. Use heat.

During an IBS attack, it can be very helpful to apply heat to your abdomen, using either a heating pad or a hot water bottle. Just be sure to place some clothing in between the heat source and your skin to protect yourself from a burn. Besides offering some well-needed psychological soothing, the heat may help to relax the muscles of your colon, helping to reduce spasms and cramping.

2. Sip some tea.

Sipping a warm cup of IBS-friendly tea can provide you with some much-needed soothing. And peppermint tea may offer an addition benefit in terms of reducing the spasms and cramps that are causing you pain, and perhaps repeated trips to the bathroom.

3. Breathe deeply.

As you may know, the body's natural stress response can impact your digestive system, worsening your symptoms.

When you breathe deeply, you are sending a message to your body's emergency response system that there is no emergency, which can help to calm your body, turn off the "alarm," and help to quiet your symptoms. Breathing deeply also can help to calm your central nervous system and thus reduce your pain experience. It is best to practice deep breathing exercises on a regular basis so that you can get the most benefit from them when you are in the midst of an attack.

4. Use calming self-talk.

During a bad IBS attack, you want to talk to yourself as if you were soothing a good friend who is in distress. Doing so will cut through those panic-related thoughts that only serve to agitate your system further. Here are some helpful things to say to yourself during a bad attack:

  • "Slow down, I will get to the bathroom on time. I need to work to keep myself as calm as I can while I find my way to a bathroom."
  • "No one will judge me. Other people will not think badly of me if they realize that I am having stomach trouble. People are generally kind and sympathetic when faced with illness in others."
  • "My body will hold it in. I need to remember that my body is very good at holding things in until I reach a bathroom. The calmer I remain, the easier it will be for my rectal muscles to do their job."
  • "This will pass. My doctor has reassured me that my diagnosis is IBS, which means that these terrible symptoms will quiet down. I just need to take good care of myself to help make that happen."

5. Use pain management strategies.

Pain during an IBS attack can be quite intense. However, you no longer have to be a passive victim. Since anxiety can enhance the pain experience, your deep breathing and calming self-talk will both help to lessen the pain experience. Guided imagery is a mind-body technique in which you enlist the power of your imagination to bring about a sense of pain reduction.

After the Attack

Once you have had a bad attack, it is common to be very worried about having another attack. You may find that you go on alert, scanning your body for signs and symptoms that it is going to get bad again. The problem with this is that this anxiety about future attacks may actually increase your chances of having another attack. The following steps will help you to break out of this Catch-22 situation:

1. Remain calm in the face of early symptoms.

Sometimes a stomach rumble is just a stomach rumble. Kick in your deep breathing and see if by remaining calm you are able to keep your system quiet.

2. Keep a symptom diary.

Keeping track of your symptoms can help you to identify any possible patterns in terms of triggers for your attacks. For example, knowing that you are more likely to attacks in the morning can help you to plan your day better so as to put yourself in situations where you are better able to comfortably handle any symptoms that might arise.

3. Practice regular stress management activities.

Regular use of mind/body practices can help to keep your body calm and thus lower your chance of being triggered into another attack. There is also some evidence that keeping your body calm can improve the health of your gut bacteria, again reducing the chance of experiencing IBS symptoms. Here are some There are a variety of things that you can do to keep your baseline anxiety level low to reduce the probability that you will have continued IBS attacks. Here are some examples:

4. Eat carefully.

After a bad IBS attack, your system might be more sensitive than usual. Choose foods that you know are safe and soothing. You may want to eat small meals, spaced evenly throughout your day as large meals can contribute to gut spasms. You may also want to try the low-FODMAP diet, which has significant research support for easing IBS symptoms. After an acute IBS attack, it may be helpful to limit your foods to those that are low in FODMAPs until you feel better. Just be aware that it is not recommended that you be on the low-FODMAP diet indefinitely, due to a concern about nutritional deficiencies from unnecessary food restriction.

5. Work with Your Doctor

It is important that your doctor be aware of the severity of your symptoms. They are in the best position to make sure that you have the correct diagnosis. If your attacks are quite frequent, your doctor may prescribe a medication. Some medications are available that address specific IBS symptoms when they are happening, while others are available for directly treating either diarrhea predominant IBS or constipation predominant IBS

Sources:

Farhadi, A. “I Have IBS…Now What?!!!SanitizAir, Inc. 2007.

Ford AC, Moayyedi P, Lacy BE, Lembo AJ, Saito YA, Schiller LR, Soffer EE, Spiegel BMR, Quigley EMM. "American College of Gastroenterology Monograph on the Management of Irritable Bowel Syndrome and Chronic Idiopathic Constipation" American Journal of Gastroenterology 2014 109:S2-S26.

Nanayakkara WS, Skidmore PM, O’Brien L, Wilkinson TJ, Gearry RB. "Efficacy of the low FODMAP diet for treating irritable bowel syndrome: the evidence to date." Clinical and Experimental Gastroenterology 2016;9:131-42.

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