What are the symptoms of an IBS flare-up? A doctor’s guide 

Summary: Irritable Bowel Syndrome (IBS) is a common, chronic gut disorder causing abdominal pain, bloating, and bowel habit changes. Flare-ups can be triggered by diet, stress, hormonal changes, and illness. Managing IBS involves dietary adjustments, stress management, and sometimes medication. Hola Health’s online doctors can help with symptom management, prescriptions, dietary advice, referrals, and medical certificates via telehealth.

What is Irritable Bowel Syndrome (IBS)?

Recently, I was volunteering as a safety marshal at a marathon. I was talking to another volunteer, who was recently diagnosed with Ulcerative Colitis after years of being told he had IBS. He asked me if his GP had missed the diagnosis for all these years and it got me thinking about this blog. Irritable bowel syndrome (IBS) is a common gastrointestinal disorder that affects the intestines. It is characterised by abdominal pain, bloating, and changes in bowel habits. While the exact cause is unknown, IBS is often linked to diet, stress, the balance of healthy bacteria in the gut (the microbiome), and heightened sensitivity of the gut. The condition is chronic in nature (occurs over a longer period of time) and tends to flare up intermittently. 

Symptoms of an IBS flare-up

An IBS flare-up can present with a range of symptoms, including: 

• Abdominal cramping or pain (often relieved by-passing stool) 
• Bloating and excessive gas 
• Changes in bowel movements, such as diarrhoea, constipation, or alternating between the two 
• A feeling of incomplete evacuation (this can sometimes be a sign of bowel or rectal cancer so make sure you discuss this with your doctor if you have this symptom).  
• Mucus in the stool (this can be a sign of more serious inflammation within the bowel, so if you develop this, make sure to discuss this with your doctor). 

Also read: How to relieve IBS pain instantly: Doctor’s guide

Other symptoms that may occur during an IBS flare-up

Some individuals may experience additional symptoms, including: 

• Fatigue 
• Nausea 
• Headaches 
• Increased anxiety or stress levels 
• Poor sleep quality 

Triggers

IBS flare-ups can be triggered by various factors, including: 

• Dietary triggers: High-FODMAP foods (those high in certain fermentable sugars that can cause bloating, gas, and discomfort in people with IBS), dairy, caffeine, alcohol, processed foods, and spicy foods 
• Stress and anxiety: Emotional stress can impact gut motility and exacerbate symptoms 
• Hormonal fluctuations: Many women report worsened IBS symptoms during their periods 
• Infections or illnesses: Gastrointestinal infections can trigger or worsen IBS symptoms 
• Changes in routine: Disruptions in meal timings, sleep, and travel can contribute to flare-ups 

What does a bad IBS attack feel like?

A severe IBS attack can cause intense abdominal pain and cramping, making it difficult to focus on daily activities. Some individuals experience urgent diarrhoea or prolonged constipation, leading to discomfort and distress. In severe cases, symptoms can mimic other gastrointestinal conditions, making it crucial to seek medical advice if symptoms persist or worsen. 

When to consult a doctor

As doctors, we consider irritable bowel syndrome (IBS) a diagnosis of exclusion. If you have symptoms of IBS, your doctor must first rule out more serious conditions such as coeliac disease, bowel cancer, and inflammatory bowel disease (including Crohn’s disease and ulcerative colitis). While IBS is a manageable condition, there are times when medical attention is essential. You should consult a doctor if you experience: 

• Unexplained weight loss 
• Rectal bleeding or black stools 
• Severe or persistent abdominal pain 
• Difficulty swallowing 
• Persistent nausea or vomiting 
• Symptoms that disrupt your daily life despite dietary and lifestyle changes 
• A feeling of incomplete emptying 
• Regular passage of mucus or slime 

Tips for managing IBS flare-ups

Managing IBS effectively often requires a combination of lifestyle adjustments, dietary changes, and stress management. Useful strategies include: 

• Keeping a food diary to identify triggers 
• Eating smaller, more frequent meals 
• Drinking plenty of water 
• Engaging in regular physical activity 
• Managing stress through relaxation techniques such as yoga or meditation 
• Considering probiotic supplements to support gut health 

How do you calm an IBS flare-up?

When experiencing a flare-up, try the following approaches: 

• Apply heat: A warm compress or heating pad on the abdomen can relieve cramps. Be careful not to do this too frequently or you may develop marks on your tummy (Google erythema ab igne to see what I’m talking about!) 
• Stay hydrated: Drink water to prevent dehydration, especially if experiencing diarrhoea 
• Try herbal teas: Peppermint or ginger tea can soothe the digestive system 
• Use relaxation techniques: Deep breathing and mindfulness can help alleviate stress-related symptoms 

What should I eat during an IBS flare-up?

A bland diet can help ease symptoms during an IBS flare-up. Consider eating: 

• Plain rice, potatoes, or gluten-free pasta 
• Orso or quinoa 
• Cooked vegetables (such as carrots or zucchini) 
• Lean proteins like chicken or fish 
• Bananas or other low-FODMAP fruits 
• Lactose-free dairy alternatives 

Also read: Bloating, pain, and gas: When to talk to a GP

Can I prevent IBS flare-ups?

While IBS cannot be cured, symptoms can often be minimised with consistent management strategies: 

• Follow a low-FODMAP diet if recommended by a healthcare professional 
• Manage stress levels through meditation, therapy, or regular exercise 
• Avoid known food triggers 
• Maintain a regular sleep schedule 
• Stay physically active to support gut motility 

FAQ

What is the biggest trigger for IBS?

Dietary triggers, particularly high-FODMAP foods, are among the most common causes of IBS flare-ups. Stress and hormonal changes can also play a significant role. 

What are the types of IBS?

IBS is classified into different types based on predominant symptoms: 

• IBS-D (diarrhoea-predominant) 
• IBS-C (constipation-predominant) 
• IBS-M (mixed, alternating between diarrhoea and constipation) 
• IBS-U (unclassified) 

How long does it take for IBS flare-ups to go away?

Flare-ups can last anywhere from a few hours to several days, depending on the severity and management strategies used. 

Can you relieve IBS pain instantly?

While there is no instant cure, applying heat, drinking herbal tea, practising relaxation techniques, and taking prescribed medications can help alleviate discomfort quickly. 

Can a telehealth doctor help?

If you struggle with IBS or need help managing flare-ups, a telehealth doctor can provide guidance and support. 

How can Hola Health’s online doctor help via telehealth?

Hola Health’s online doctors can assist with various aspects of IBS management, including: 

• Instant online consults: Get professional advice from the comfort of your home without needing to visit a clinic. 
• Dietary guidance: Doctors can recommend dietary changes, such as the low-FODMAP diet, and refer you to a dietitian if needed. 
• Prescriptions: If medication is required to help manage IBS symptoms, online doctors can issue online scripts sent directly to your phone. 
• Referrals for further tests: If your symptoms indicate another underlying condition, a doctor can refer you for additional investigations or specialist care. 
• Medical certificates: If IBS flare-ups are affecting your daily life, an online doctor can provide a medical certificate online for work or study leave. 

Take control of your IBS with the right support. Book an online consultation with Hola Health today!