Irritable bowel syndrome, or IBS, is a chronic condition, but symptoms often come in waves. You might feel relatively well for a while, only for symptoms to suddenly worsen during stress, after a trigger food, or around a change in routine.

Common flare-up symptoms include abdominal pain, bloating, diarrhoea, constipation, and urgency to go to the bathroom. While some IBS symptoms might always be present, they’re usually not as severe as they are during a flare-up.

Flare-ups aren’t inevitable. Understanding the triggers can help prevent or manage symptoms when they hit. Find out more below.

What Is an IBS Flare-Up?

An IBS flare-up is a temporary worsening of symptoms. It can last hours, days, or sometimes even longer. Flare-ups usually occur due to the presence of triggers like stress, hormonal changes, or a specific food.

Flare-ups aren’t the same for everyone. The symptoms present depend on the person’s IBS subtype; IBS-D, IBS-C, or IBS-M. For example, a person with IBS-D might experience more diarrhoea, while someone with IBS-C may be more constipated. If you have a mix of the two, you would fall under IBS-M.

Common IBS Flare-Up Causes

Stress and Anxiety

Stress and anxiety are one of the most common causes of IBS flare-ups. The gut-brain axis describes how effects in the brain can impact the gut and vice versa. Stress triggers the release of cortisol and activates the sympathetic nervous system. This can alter gut sensitivity and motility, leading to increased IBS symptoms.

Food Triggers

What you eat can influence how your gut behaves. Certain foods may affect gut motility, fermentation, gas production, or sensitivity, which can make IBS symptoms worse. Common triggers include:

• Fatty foods

• Alcohol

• Caffeine

• Spicy foods

• High-fodmap foods

Triggers aren’t the same for everyone, so people often need to identify their own patterns and triggers over time. With the help of a registered dietician or nutritionist, an elimination diet can help narrow down the culprits.

Hormonal Changes

Many women notice IBS flare-ups becoming worse around their menstrual cycle. Hormonal fluctuations, particularly changes in oestrogen and progesterone, can affect gut motility, sensitivity, and inflammation. As a result, symptoms like bloating, cramping, diarrhoea, and constipation often become more noticeable before or during a period.

Infection, Illness, and Lifestyle Factors

Numerous factors alter your gut’s motility and sensitivity. Poor sleep, gut infections, antibiotics, and even just travel and routine disruption can affect everything from gut microbiome diversity to speed of transit. People may find that their IBS symptoms become more noticeable when these factors are present.

IBS Flare-Up Symptoms

IBS flare-ups are associated with the following symptoms:

• Cramping

• Bloating

• Diarrhoea

• Constipation

• Nausea

• Excessive gas

• Urgency

• Fatigue

During a flare-up, symptoms aren’t always consistent. They can fluctuate throughout the day, depending on your stress levels, diet, or wakefulness.

How to Manage an IBS Flare-Up

Short-Term Symptom Relief

If you’re currently experiencing a flare-up, there are a few basic things you can do:

• Hydration

• Smaller meals

• Gentle low-trigger foods

• Heat packs for cramping

• Light movement rather than complete inactivity

The aim is to reduce irritation and give your gut time to settle. Hydration, smaller meals, and temporarily sticking to familiar low-trigger foods can help some people feel more in control while symptoms pass.

Managing Stress During a Flare-Up

Stress is a big factor in IBS flare-ups. The problem is that stress is a part of life. Sometimes, it’s unavoidable. Rather than trying to prevent stress, think about how you can manage it. Breathing exercises are a great way to deal with stress in the moment. Just taking three deep breaths, for example, can help settle a person in under a minute.

Practice other relaxation techniques and ensure you’re getting enough sleep. Stress can occur due to accumulated fatigue, especially if you’re managing a flare-up. That’s why recovery is critical.

Medication and Medical Support

Over-the-counter symptom relief may help some people manage diarrhoea, constipation, or cramping during a flare-up. However, it’s best to use these carefully and follow the packet instructions, as some treatments can cause side effects or make symptoms worse if used too often. If you’re needing them regularly, speak to a healthcare professional.

When an IBS Flare-Up Might Be Something Else

Not every digestive flare-up is necessarily caused by IBS. It’s important to seek medical advice if symptoms feel unusually severe, suddenly change, or are accompanied by red-flag symptoms such as:

• Blood in your stool

• Unexplained weight loss

• Fever

• Severe or persistent abdominal pain

Conditions like inflammatory bowel disease (IBD), infections, coeliac disease, and bowel cancer can sometimes mimic IBS symptoms. Getting properly assessed can help rule out more serious causes and ensure you receive the right treatment.

The Functional Gut Clinic offers a range of tests to eliminate other potential causes of your IBS symptoms, helping to diagnose IBS by process of elimination. Our team can help support your journey by providing you with the results you need to progress with the best treatment pathway for you. Learn more about our IBS support today.