when ibs is out of control?

During an IBS flare-up (sometimes known as “IBS attack”) you may experience more gut symptoms, such as stomach cramps, bloating, diarrhea, and constipation. An IBS flare-up can last anywhere from a few hours to a few months at a time.

So, what causes an IBS flare-up? An increase in symptoms can sometimes be triggered by eating certain foods or from anxiety or stress. However, even if you're doing all the 'right' things, an IBS flare-up can still happen with no obvious cause.

There's no cure for IBS but there are things you can do to help relieve symptoms and reduce the chance of future episodes.

‍

IBS is a common gastrointestinal condition that affects around 1 in 7 people worldwide and is almost twice as common in women as it is in men. While IBS can occur at any age, most people start to notice their symptoms between 20 and 30 years old.

A healthcare professional can diagnose whether you have IBS based on your symptoms. You might have IBS if you have recurrent abdominal pain for at least one day per week in the past three months, and two or more of the following:

Some people will experience IBS on a daily basis, while others can go long periods of time without symptoms. An IBS flare up means that you are experiencing a sudden increase in IBS symptoms over a period of time. So what does an IBS flare up feel like? Common symptoms of an IBS attack can include:

Some people also experience some less common symptoms, such as:

IBS flare up duration is different for everyone. Most people's IBS symptoms will flare-up for 2-4 days, after which your symptoms may lower in severity or disappear completely. Many people experience IBS in waves, in which symptoms may come and go over several days or weeks.IBS attacks can be managed to reduce symptoms or shorten duration using several management techniques (which we discuss below).

It's unclear what causes episodes of IBS symptoms, but several studies have shown the following factors may play a part in IBS flare-ups:

There is no cure for IBS, but a range of strategies may help manage a flare-up. Many approaches may also be used to prevent or reduce the chance of an episode of IBS.

It's difficult to know what foods to eat with an IBS flare up, with foods that are high in ‘FODMAPS’ (small carbohydrate molecules that cause bacteria in the gut to release gas) often triggering IBS symptoms. A diet low in FODMAPs reduces symptoms of IBS in most people.

To calm an IBS flare-up, avoid high-FODMAP foods such as:

So what foods should you eat during an IBS flare up?

A low FODMAP diet involves eliminating high FODMAP foods, then slowly reintroducing them, one at a time, and noting any changes in symptoms. This two-step approach should help identify foods that trigger a flare-up.

You might not have heard of hypnotherapy as a treatment for health conditions, but it’s been proven to help IBS symptoms and can even treat other conditions such as chronic pain or smoking addiction. In hypnotherapy, you are gently brought into a relaxed and focused state, where you then use visualizations and suggestions to improve your gut-brain connection. It's one of the best natural remedies for IBS flare ups and requires no drugs or diets to see results.

A recent study showed that gut-directed hypnotherapy is equally effective as the low-FODMAP diet in reducing IBS symptoms—which is good news for people wanting to improve their symptoms without overhauling their diet and lifestyle. Gut-directed hypnotherapy has been shown to significantly reduce symptoms of IBS in over 50% of people.  You can try gut-directed hypnotherapy by visiting a gut-directed hypnotherapist or using a mobile app like Nerva (based on this recent study).

How hypnotherapy exactly works is still unclear to researchers, but it is thought to work by helping you:

Cramping, abdominal pain, bloating, diarrhea, and constipation are tough to handle at any time. But if a combination of these symptoms occurs over three or more months, you may have a condition called irritable bowel syndrome (IBS). It's the most common diagnosis made by gastroenterologists, accounting for as many as 3.5 million physician visits per year. "I see someone with this condition every day," says gastroenterologist Dr. Jacqueline Wolf, associate professor of medicine at Harvard Medical School.

There are many theories about what exactly causes IBS: problems with the nerves or muscles in the gut, an overgrowth of certain bacteria in the small intestine or a change in bacteria in the colon, an inability to digest certain foods, or stomach or bowel inflammation. Some people have symptoms every day, while others experience long symptom-free periods. IBS does not lead to serious disease, but it does significantly affect your quality of life. "People say it's ruining their lives or that they have a constant ache after they eat," says Dr. Wolf.

While we don't know what causes IBS, we do know that flare-ups are often triggered by food, caffeine, stress, carbonated drinks, artificial sugars, or infectious diarrhea. The more IBS episodes you have, the more sensitive your gut becomes to triggers.

Dr. Wolf uses a number of different strategies to help people battle IBS. She recommends trying dietary changes first. You may be unable to digest insoluble fiber found in the skin of fruits and vegetables, or a sugar in dairy products called lactose. "It's different for everyone," says Dr. Wolf. She suggests a diet approach that eliminates foods with poorly digested sugars and fibers known as FODMAPs (see "The IBS buzzword: FODMAPs").

Dr. Wolf also recommends probiotics, which are colonies of good bacteria that are typically freeze-dried. You can find them in most drug stores and supermarkets, as capsules or tablets to swallow and loose powder to sprinkle on food. You'll want a product that's labeled for viability through the end of shelf life, not at the time of manufacture. "The type of bacteria in the probiotic is very important," says Dr. Wolf. Her research shows that a type of bacteria called Bifidobacterium is often effective at relieving the symptoms of IBS.

Another supplement she suggests is enteric-coated peppermint capsules, which are available over the counter. "It can't be used in people with heartburn, but otherwise it decreases cramping just as well as a common antispasmodic medication, and it also decreases bloating," says Dr. Wolf.

• cook homemade meals using fresh ingredients when you can.
• keep a diary of what you eat and any symptoms you get – try to avoid things that trigger your IBS.
• try to find ways to relax.
• get plenty of exercise.
• try probiotics for a month to see if they help.

An IBS flare-up can be frustrating and may cause a range of digestive symptoms. If you're experiencing a flare, there are several at-home remedies you can try, such as gut-directed hypnotherapy, removing high-FODMAP foods from your diet, heat therapy, avoiding caffeine, exercising, and reducing stress.