IBS flare-up: what triggers it and what helps?

What does a flare-up look like?

The NHS lists the main IBS symptoms as:

• stomach pain or cramps, usually worse after eating and better after a poo
• bloating, where your tummy feels full and swollen
• diarrhea, sometimes needing to go suddenly
• constipation, straining and feeling you can’t empty fully

It also says there may be days when symptoms are better and days when they’re worse. Those worse days are flare-ups.

Common triggers

According to the NHS, flare-ups can happen for no obvious reason. Sometimes they have a trigger, such as:

• alcohol
• caffeine
• certain foods, such as spicy or fatty food
• stress and anxiety
• regular antibiotic use

The NIH adds that women with IBS often have more symptoms during their periods (more in period poops).

Everyone’s list is a bit different. That’s why the NHS suggests keeping a diary of what you eat and any symptoms you get.

What can help day to day

From the NHS IBS diet and lifestyle page:

• don’t delay or skip meals, and don’t eat too quickly
• try to drink at least 8 to 10 drinks of fluid a day (around 1.5 liters), like water or herbal tea
• limit fatty, spicy or processed food
• no more than 3 portions of fresh fruit a day
• no more than 3 cups of tea, coffee or other caffeinated drinks a day
• go easy on alcohol and fizzy drinks
• try to find ways to relax, and get plenty of exercise

For bloating, cramps and farting, the NHS suggests regular oats, up to 1 tablespoon of linseeds a day, avoiding sorbitol, and avoiding hard-to-digest foods like cabbage, broccoli, cauliflower, brussels sprouts, beans and onions. A pharmacist can suggest medicines like Buscopan or peppermint oil.

For diarrhea, the NHS suggests cutting down on high-fiber foods like wholegrains, nuts and seeds, avoiding sorbitol, and asking a pharmacist about loperamide. Drink plenty of water.

For constipation, it suggests drinking water and eating more soluble fiber, such as oats, pulses, carrots, peeled potatoes and linseeds.

Spotting your pattern

A flare-up is easier to understand afterwards if you have notes from the days before.

Thu 20:00  Dinner (photo): curry, naan, 2 beers  tags: gluten, FODMAPs
Fri 08:30  Coffee (text): large latte  tags: caffeine, dairy
Fri 09:10  Poop: type 6
Fri 11:00  Poop: type 7
Fri  Paper note: stressful deadline, crampy
Sat 09:00  Poop: type 5

PoopAI makes the meal and poop side quick: snap a photo, add tags like caffeine, gluten or FODMAPs, and tap the Bristol type. The weekly report shows when the loose days bunch up. Pain and stress are notes you’d keep yourself, because the app doesn’t log symptoms.

When to see a GP

The NHS says see a GP if:

• diet changes and pharmacy medicines aren’t helping
• you need to avoid lots of different foods to control symptoms

Get an urgent GP appointment or call NHS 111 if you’ve lost a lot of weight for no reason, you’re bleeding from your bottom or have bloody diarrhea, or you find a hard lump or swelling in your tummy.

The NIH says your doctor might suggest diet changes, medicines, probiotics or therapies like CBT or gut-directed hypnotherapy. You may need to try a few things to find what works.

Wrap-up

Flare-ups are frustrating, partly because they don’t always have a clear cause. Look after the basics, keep a simple log, and treat your GP as a partner when the usual tricks stop working.