How to cope with agonising IBS pain?

[TummyBloop]

Hello everyone,

I rarely have an IBS attack anymore and I have seemed to grow out of my IBS a bit :D. But occasionally I will have one, most likely after eating a lot of food, or really rich food, or food with lots of onion or garlic. The “attack” would usually last for an absolute maximum of 30 minutes, with intense stomach cramps which come and go in multiple waves and diarrhoea. Usually after I have had the diarrhoea/have emptied my bowels it settles down. These attacks are so agonisingly painful. In the moment I want to go to hospital to help me. I become pallid and horrifically dizzy I fear I would faint because the cramps are so bad. I always scream a lot because it’s so painful and I hit myself repeatedly and sometimes bite myself, because I am desperate for relief. Luckily I have never had a attack out in public, but I don’t know how I would cope. What are some strategies you could suggest to help me cope by myself with this pain in the moment? Is it unusual for me to scream or to feel this way? I can’t help it, it’s just too much for me. My sister occasionally gets stomach cramps and diarrhoea like me too, but she never screams when she is in that terrible pain. How does she do it? I would really appreciate any advice you have for me.

Thank you!

[littlehelp]

You can try taking your mind off the pain during this crisis. You can consider watching a movie/ music or reading. This may help with the pain.

However, I will advice you take lots of water. Taking (warm) water regularly will play a crucial role as an intermittent episode prevention. Try to reduce your acid intake. Exercise more often in the morning. I believe following this if not prevent entirely, will reduce the rate of the cramps.

I hope you get well soon.

[Margie71]

I understand how scared and overwhelmed you get when the severe pain hits you

I guess most people don’t hit themselves, although maybe they do and don’t talk about it. Try heat on your abdomen, IBGard, Tylenol. Why do you eat large amounts of rich food? Probably not a good idea. Try to stay away from onions and other foods you have found to cause you pain. Try to relax. None of it is easy.

[xjrs]

Unfortunately as you know certain foods or an amount of food can trigger IBS. Isn't it best to try to avoid these attacks in the first place, particularly if you know what triggers them, then you wouldn't have to worry about them happening in public, because they wouldn't happen?

Just in case some of this information helps you here is some information about IBS that I have shared with others in this group:

IBS can be due to a number or combination of factors - these can be stress (including stress from early life experiences) which impacts the communication between the brain and the digestive system. There are lots of free webinars online at the moment regarding mindfulness meditation which might help. Plus you can ask to be referred for CBT or something similar to reduce your anxiety - I would have thought online appointments are available. Exercise can play a major role in IBS in terms of reducing stress, helping your gut microbiome and regulating bowel movements.

There is also not absorbing certain types of carbohydrates called FODMAPs very well, the residue ending up in the colon and bacteria feeding off them causing symptoms. Ordinarily feeding gut bacteria is a really good thing - when you feed good gut bacteria these produce by-products that have great health effects in the gut and throughout the body. However, in some people with IBS bad bugs might have the upper hand over good - these bad bugs may cause symptoms such as pain or disordered bowel movements. There is an interesting infographic on this here:

gutmicrobiotaforhealth.com/.... This is why it’s worth trying probiotics such as Alflorex (which has been scientifically studied for IBS) or Symprove to crowd out the bad bugs and make their numbers die down. If that doesn't work you can try the FODMAP elimination and reintroduction diet. This is normally under the guidance of a nutritionist via GP referral - this may not be possible at the moment so you can read about it online. If you download the Monash University FODMAP app it will tell you which foods contain FODMAPs and in what quantities. You can eliminate all FODMAPs for 2 weeks and then introduce each type of FODMAP one at a time starting in small quantities, increasing over a 3 day period and wait up to 4 days for symptoms. I go much slower than this - only introducing a small amount (1/4 to 1/3 of a normal portion size) of the same food for 3 days and then increase if tolerable or no symptoms and cut back to the previous amount if symptoms for longer and then try to increment again . I've read your microbiome can adapt to handling a new food if introduced very slowly and your bad bugs are under control with a good probiotic. Ideally you want to eat as many FODMAPs as you can since they are good for your health. Many people with IBS don't have diverse gut bacteria - it has been found that people who lack a diverse microbiome are more prone to diseases in general. In the long run, if you can get your symptoms under control, the ideal situation is to have a very varied diet - lots of different coloured fruits and vegetables, a variety of protein and carbohydrate sources including cereal fibres. This may seem a long way off, but with the right treatment all of this is possible. Last year all I could consume to control my IBS was white rice, protein and limited low fodmap veg. Using the approach above (particularly introducing Alflorex) I am now able to consume far more foods - more than I've ever dreamed of including wholewheat bread which is unheard of for me.

If you are also suffering from pain, you may be suffering from visceral hypersensitivity (functional abdominal pain) - there is info about it here:

iffgd.org/lower-gi-disorder...

It is where the brain interprets the normal activity of the bowel as pain - this is due to a wearing down of neurons in pain control centres of the brain which can be caused by PTSD, neglect or abuse in childhood, extreme stressful events etc. The first line treatment is nerve pain agents such as low dose amitriptyline. There is a theory that being on something like amitriptyline for 6-12 months can help the pain control centre neurons to regenerate. Note that amitriptyline can cause constipation, but this can be helpful in people who are diarrhea dominant. Unfortunately I couldn't tolerate these. Linaclotide (for IBS-C only) & Alflorex have helped me with this intestinal pain.

You may also find assistance with anti-spasmodic medication such as mebeverine (Colofac) or enteric coated peppermint.

You can find some info on self management here:

theibsnetwork.org/the-self-...

[TummyBloop]

Hello everyone!

Thank you for your replies. I think most of the time I just eat what I want and I’m fine, but sometimes I might accidentally overeat and that seems to cause I really bad stomach cramp, so I’ll be sure to be more careful and limit the amount of sugary things I have in a day (this usually seems to be the trigger for me). I would try to watch a movie or something to get my mind off of the pain but when I have an “attack” I feel like I have to be on the toilet and it feels so severe that I can’t focus and I would writhe in pain. I feel a bit alone because I feel that I’m the only one who reacts in such a strong way. Does anyone else can’t help but moan or scream in pain? I feel like a weirdo.