Understanding IBS Pain — Types, Causes, and Solutions
Chronic disease can be painful. In fact, the National Institutes of Health state that pain affects more people than diabetes, heart disease, and cancer – combined.
Chronic pain is the most common cause of long-term disability. It is also the most common reason that Americans seek medical treatment in the American healthcare system. In 2006, the National Center for Health Statistics estimated that 76.2 million Americans – one in every four – have suffered from pain that lasts longer than four hours.
So, this begs the question – if your irritable bowel syndrome (IBS) is causing you pain, how do you manage or cope with it?
Where Do You Feel IBS Pain?
The location of typical IBS pain varies from person-to-person, and as it turns out, “typical" IBS pain is anything but typical.
According to VeryWell, “One of the things that make IBS so challenging and worrisome is that its pain can present itself in a very changeable manner." This means that even if someone with IBS has a “typical" pattern, it can change in severity, location, how it feels, and when it occurs.
The most common locations for IBS pain to occur are:
- Upper abdomen: when pain occurs in this location, it is often associated with bloating. It also tends to happen after a meal.
- Middle abdomen: this abdominal pain tends to cause a “cramping" sensation around the umbilicus (the belly button.)
- Lower abdomen: when pain occurs here, it is often relieved after passing a bowel movement.
Although these areas are “typical" locations, the pain can radiate into the back and the upper torso. This means that the pain can occur anywhere in the upper portion of the body, which is why IBS pain is so unpredictable.
Traditional IBS Pain Treatment
There is a wide range of options when it comes to treatment of IBS. We’ll discuss “natural" treatment options for IBS, which is used when symptoms of IBS are mild. Once symptoms are more severe, these “natural" treatments are used in conjunction with medications.
For those people with IBS-C, or IBS with constipation:
- A fiber supplement helps to control constipation. An example is a psyllium (Metamucil is one such brand), but there are plenty of fiber supplements to choose from. It is important to consume an adequate amount of water with a fiber supplement.
- A laxative may be prescribed if adding a fiber supplement doesn’t help to relieve constipation symptoms. Examples include polyethylene glycol (Miralax) and magnesium hydroxide oral (Phillips’ Milk of Magnesia).
For those people with IBS-D, or IBS with diarrhea:
- Anti-diarrheal medications are often recommended. Some can be picked up over-the-counter. For example, loperamide (Imodium) is typically recommended. When symptoms become severe, your physician may prescribe cholestyramine (Prevalite), colestipol (Colestid), or colesevelam (Welchol).
- If you have painful bowel spasms, anticholinergic medications are often prescribed. An example is dicyclomine (Bentyl), which also helps with diarrhea. However, it has a downside – it can then cause constipation.
- Antidepressants from multiple drug categories can be prescribed as well. They work in numerous ways to reduce pain associated with IBS.
- Certain pain medications that work on the nervous system are also helpful for IBS pain; examples include pregabalin (Lyrica) and gabapentin (Neurontin).
There are also some medications that are specific to IBS. They work in specific ways, and their descriptions are beyond the scope of this article, but they include alosetron (Lotronex), eluxadoline (Viberzi), rifaximin (Xifaxan), lubiprostone (Amitiza), and linaclotide (Linzess).
Natural IBS Pain Treatment
So, how can you treat your IBS pain naturally?
These treatments work best if your symptoms are mild, or when you use them in conjunction with traditional therapies.
First, keep a log of the foods that you are eating. You can then pinpoint what foods are causing you pain. Then, eliminate those foods from your diet entirely.
And while you’re changing your diet, begin to eat a high-fiber diet. Consuming a diet rich in fibers will regulate your bowel movements, which is helpful whether you have IBS-C or IBS-D.
Other helpful tips, according to Mayo Clinic, include getting plenty of fluids, exercising regularly, and getting adequate rest.
If you’re still struggling, it may be time to meet with a dietitian. Have you ever heard of FODMAPs? Neither have most people, but eliminating them from your diet can make a world of difference.
FODMAP is an acronym for “fermentable oligo-, di-, and monosaccharides and polyols" – specific carbohydrates that are found in certain grains, fruits, vegetables, and dairy products. A dietitian can give you advice on how to pinpoint FODMAPs and eliminate them from your diet, should this be the cause of your discomfort.
How to Relieve IBS Pain Fast
Unfortunately, there is no “fast" way to relieve IBS pain.
As with any chronic condition, the pain is chronic and it tends to come and go. We must figure out the triggers and that can take time and energy. However, some tricks can temporarily relieve the pain – but the pain can return if we’re not careful with the triggers.
For example, applying a headed compress to the abdomen is helpful. According to VeryWell, “Applying warmth to your belly will not only help soothe you psychologically, but it can also speed up pain relief. Research indicates that the best results are achieved with low-level and continuous heat."
Utilizing other self-soothing techniques are helpful as well. These are helpful because they can distract from the pain.
For example, having a hot cup of tea or coffee, talking with a friend, taking a yoga class, using visualization techniques, meditation, and deep breathing techniques are all great tools.
And while we’re talking about teas, there are specific teas that may help with tummy troubles:
- Peppermint tea is known to help with all times of stomach maladies.
- Anise tea can help with constipation.
- Chamomile tea and fennel tea can help with constipation but are contraindicated on a low-FODMAP diet.
IBS and Inflammation
Research has shown that some people with IBS experience persistent inflammation in digestive tract tissue.
The inflammation may have begun during a stomach virus as an immune response to fight against infection. The immune response causes inflammation, leading to pain in the abdomen, cramping, and diarrhea.
For most people, inflammation subsides once the body senses that it no longer needs to protect itself against an infection. But for some people with IBS, the inflammation continues, as does the abdominal pain, cramping, and diarrhea.
Inflammation in the digestive tract may also be caused by food allergies, changes in gut bacteria, or genetic predisposition.
Research has shown that anti-inflammatory drugs do not cause a significant reduction in IBS symptoms; but making dietary and lifestyle changes in response to symptoms is more helpful.
Many of these possible changes are discussed throughout this article.
Cramping
Cramping is caused by spasms in your large intestine. Normally, the muscles in the large intestine contract and relax rhythmically to push the contents of the bowel through the digestive system.
When this rhythm is interrupted, painful cramping can occur, usually connected to diarrhea or constipation.
Diarrhea
Diarrhea happens when the large intestine works too quickly and powerfully. It is often accompanied by painful cramps and can lead to dehydration.
Food sensitivities are an identified cause of diarrhea. Working with a doctor or nutritionist to create a personalized diet is one way to avoid eating foods that will cause diarrhea.
You can also keep a food log to keep track of what you eat and your body’s reactions before working with a specialist.
Stress and anxiety have an impact on diarrhea as well, so building stress-reducing practices into your life can be helpful. These include mindfulness, meditation, journaling, exercising, and anything else that lessens stress for you.
If you are experiencing diarrhea frequently or for long stretches of time, you may want to visit your doctor. They can prescribe medications that will prevent severe cramping and painful diarrhea.
Constipation
Constipation occurs when parts of the intestine cramp. Then, the contents of the bowel are not able to pass through.
Constipation can be extremely painful and can worsen as the colon continues to remove water from the fecal matter. This leaves hardened stool resting inside the bowel.
People who have IBS with constipation often use several different treatments to manage the condition:
- Increasing dietary fiber is one way to treat constipation. Fiber softens the stool, allowing it to make its way through the digestive system. Taking fiber supplements is also an option.
- Like diarrhea, constipation can also be impacted by stress. Introducing stress management practices into your life may reduce the frequency of constipation.
- Prescription medication and laxatives may also be helpful. You should consult your doctor about both, as some laxatives are habit-forming and can be harmful if you take them too often.
Bloating
IBS bloating can range from uncomfortable to highly painful. It can be caused by eating too much or too fast. It may also result from eating foods to which you are allergic or sensitive.
To prevent bloating, you can eat small, frequent meals throughout the day. Eat slowly to avoid consuming too much; this will also keep you from not chewing enough and eating larger pieces of food, which are more difficult to digest.
You can also avoid dairy products, fatty foods, legumes, and cruciferous vegetables, such as broccoli and cauliflower. All of these foods increase gas production, leading to bloating and cramps.
If you’re already struggling with painful bloating, you can soothe it by staying hydrated and drinking peppermint tea.
Visceral Hypersensitivity
Many people with IBS experience visceral hypersensitivity. This means that they experience pain in internal organs at a higher level than other people.
For people with IBS, this is particularly true in the rectal area.
One treatment for visceral hypersensitivity is prescription medication that reduces the irritability of nerves in the gut. They include tricyclic drugs, selective serotonin reuptake inhibitors, and selective noradrenaline and serotonin inhibitors.
Alternative treatments for visceral hypersensitivity include cognitive behavioral therapy to relieve stress and anxiety, which can trigger hypersensitivity. Others have found success with acupuncture.
Mental Health
While anxiety and depression are not examples of physical pain, people who have IBS often deal with one or both of these issues. It is important for both your physical and emotional health to treat them if they come up.
The bowel is partially controlled by the nervous system. Some experts believe that people with IBS have a bowel that is more sensitive to stress. Because of this, anxiety and depression can make IBS symptoms worse.
If you’re struggling with anxiety or depression, there are many things that you can do to treat it. Seeking out counseling is one option; a psychiatrist or doctor may also prescribe antidepressants or anti-anxiety medication.
If your IBS pain has become debilitating or is significantly impacting your life, it’s a good idea to visit a doctor. They may be able to administer tests, prescribe medication, or suggest options that you are not yet aware of.