While there is no cure for IBS, management of IBS symptoms will help relieve your pain. Medication, dietary changes, and other lifestyle modifications can all help with IBS. Your doctor will work with you to figure out the cause of your IBS symptoms and create a treatment plan. Here’s what you need to know about the causes of IBS pain and how to treat it for relief.
How a Sensitivity to Pain May Impact Your IBS
When your belly gets crampy and painful, it’s most likely because of constipation or diarrhea. If your pain gets better after you go to the bathroom, then it’s related to those symptoms. The pain is caused by a contraction of the intestines, according to Norman Gilinsky, MD, a gastroenterologist and a professor in the department of internal medicine at the University of Cincinnati College of Medicine in Ohio. “An old term for IBS was spastic colon, a contraction of muscle in the intestines. However, there is no structural abnormality when one does a colonoscopy, CT scan, et cetera,” says Dr. Gilinsky. In other words, there is nothing wrong physically with the intestines that causes the pain of IBS. Rather, the pain results from the way the digestive tract functions and responds to triggers, including stress and certain foods. People who have IBS have also been found to be more sensitive to pain. “IBS is characterized by what’s called hypersensitivity,” says Gilinsky. “IBS patients seem to be hypersensitive to discomfort, and the greater the discomfort in patients with IBS, the greater the potential psychological overlay, be it depression or anxiety.” RELATED: What to Eat and What to Avoid When You Have Diarrhea
Tips to Ease Discomfort
Although doctors believe that in some cases the pain associated with IBS may originate in the person’s head, that’s not the whole picture. “Patients who are debilitated by abdominal pain in the setting of IBS may have significant underlying depression,” says Gilinsky. “Those patients should benefit from formal psychological evaluation and possibly even antidepressant medication to help moderate the discomfort.” And when IBS pain is a side effect of bowel dysfunction — like diarrhea or constipation — those symptoms need to be dealt with to manage pain. “Constipation will increase pressure in their bellies, so it’s important to treat constipation,” says Gilinsky. “When bowels move, discomfort, bloating, and distension in bellies improve also.” You can manage constipation and diarrhea with the following measures.
More fiber in the diet Soluble fiber sources such as apples, oranges, strawberries, peas, avocados, carrots, sweet potatoes, oats, beans, and barley slow down the digestive tract and help with diarrhea. Insoluble fiber, including from broccoli, zucchini, cabbage, leafy greens, whole grains, brown rice, flaxseeds, and chia seeds, helps speed up the digestive tract, alleviating constipation.Laxatives If you have constipation-dominant IBS, a laxative can help you move your bowels. But check with your doctor before using over-the-counter laxatives, as they may irritate your intestines. It is also possible to become dependent on them.Antidiarrheal medications For people who experience frequent diarrhea, an over-the-counter drug like Imodium (loperamide) may help. It slows down movement through the intestines and improves the consistency of stools.Medications prescribed by your doctor These may include antidepressants and antispasmodic medications, which treat spasms in the gut.Elimination of common irritants Dairy products, fattening foods, and gas-producing foods, such as carbonated beverages, caffeine, raw fruits, and cruciferous vegetables like broccoli, cauliflower, and cabbage can irritate the GI tract. Some people find a low-FODMAP diet improves IBS symptoms. The diet involves eliminating foods that are high in certain carbohydrates called FODMAPs, or fermentable oligosaccharides, disaccharides, monosaccharides, and polyols. Research has found that 50 to 86 percent of people with IBS show improvement in their symptoms on a low-FODMAP diet, according to a review published in January 2017 in the journal Gastroenterology & Hepatology.Exercise Physical activity can help ease the discomfort of IBS symptoms by reducing stress and improving bowel function. A study published in February 2018 in Cytokine suggested that low- to moderate-intensity aerobic exercise relieves IBS symptoms. Another study, published in PLoS One in April 2015, concluded that yoga and mindfulness improve overall quality of life, which in turn decreases IBS symptoms.Stress reduction Anxiety and stress are known to trigger people with IBS. Finding ways to manage stress can help ease symptoms. A study published in Aliment Pharmacological Therapy involving 69 patients with IBS found that those who practiced deep breathing and other relaxation techniques for five weeks had fewer IBS symptoms than those who didn’t.Plenty of fluids You should drink six to eight glasses of water each day and avoid beverages that can make IBS symptoms worse, including alcohol, caffeinated drinks, and carbonated drinks.
It’s very important to make sure your IBS pain is correctly identified and is not actually caused by something else. “The physician needs to rule out other causes for the pain,” says Gilinsky. If the pain is truly from IBS, Gilinsky notes that good general management of the condition can help to reduce it. Once you get constipation and diarrhea under control, your belly should feel much better. And making healthy lifestyle changes — like eating a healthy diet and getting regular exercise — will help both your mind and body be less stressed as well as pain-free.