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Managing an IBS Flare

By Laura Coster

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Irritable bowel syndrome (IBS) is thought to affect 7-21% of the world’s population, which we think is a very significant amount out of 7 billion people! At the Gut Health Clinic, we want to help as many people as possible manage their symptoms through evidence-based and dietitian-led nutritional care. We also work as a holistic team and utilise non-diet approaches – both can make a world of difference to those we support.

What is IBS and how do I know if I have a flare-up?

IBS is a long-term condition that is a collection of altered bowel habits that often have other associated symptoms. What’s key between an IBS diagnosis and other conditions like Inflammatory Bowel Disease is that there is no underlying disease in those with IBS. 

Example symptoms of those with IBS (some may experience 2 or fewer):

  • Constipation2 (Type 1-2 stools, less than 3 movements a week)
  • Diarrhoea2 (Type 6-7 stools)
  • Gut pain
  • Bloating
  • An increase in passing a lot of wind (flatulence)
  • Nausea 

What causes an IBS flare-up?

Flare-ups can last for a few hours to a few weeks depending on the triggers and how you manage it.

Common triggers are:

  • Caffeine
  • Spicy food (more so for those with diarrhoea and if you’re male)
  • Alcohol
  • Very high-fat meals
  • Stress and anxiety

Some ‘myths’

  • Dairy (unless you have lactose intolerance or a dairy allergy)
  • Gluten (unless you have coeliac disease)

How can you manage a flare-up?

Diet approaches 

For those with diarrhoea:

  • Reducing your alcohol, caffeine (teas and coffees, cola-like fizzy drinks), and how much spicy food you have
  • A lower FODMAP diet (it’s best to try the other suggestions first as some may find it tricky – always speak with a dietitian before starting). Remember this doesn’t mean a no-fodmap diet, just lower the content during the period of the flare, and then return to your personalised FODMAP diet if that has been recommended for you by a dietitian. 

For those with constipation

  • Including higher fibre starchy foods e.g., oats, wholemeal bread
  • Ground linseed (to take 1-3 tablespoons a day, each with a glass of water)
  • Aiming for your 2L of fluid a day to help mix with the fibre and soften your stools
  • 1-2 kiwifruit per day

IBS Treatment Package
at The Gut Health Clinic

Non-diet approaches

  • There is good research that various probiotics can help reduce IBS symptoms. There are many types available with different benefits for you to choose from – here’s a handy list 
  • Working on the gut-brain axis e.g., gut-directed hypnotherapy, CBT and other mindfulness approaches
  • Peppermint oil can relax a tense intestine and studies have found that a peppermint oil supplement can significantly reduce tummy pain as well as help with bloating and excess wind.
  • A heat-pack on the tummy or painful site can bring relief for many. 
  • There’s also a range of medications that can help some individuals – this includes over the counter medications such as Buscopan, as well as “central neuromodulators” which target the gut-brain pain pathway. We’ll do a full post on medication for IBS in the future. 

Summary

Following this advice long-term may significantly reduce your frequency of flare-ups. It’s important to find your personal balance as restricting things continuously may be unnecessary – food and drinks are to be enjoyed as you can manage!

If you’re struggling with frequent IBS flares, or need some help managing your symptoms then we can help you in the clinic. Check out our IBS package to help make managing your IBS more accessible. 

Laura has over 8 years of experience supporting clients in the NHS and privately in the UK, helping them to achieve success across a full range of needs. She is a specialist in managing both eating disorders and gut symptoms conditions through various dietary techniques.

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