IBS Flare Up: Causes, Diet, Fatigue and Mindfulness
21 min read | Updated on:
IBS, or irritable bowel syndrome, is a chronic condition that affects the large intestine. People with IBS may experience abdominal pain, bloating, gas, diarrhea, and constipation. There is no cure for IBS, but there are treatments that can help to manage the symptoms. An IBS flare up is a period of time when the symptoms of IBS are particularly severe. During a flare, people may experience more abdominal pain, diarrhea, and constipation. Flares can last for days or weeks, and they can be unpredictable.
The cause of IBS is not fully understood, but it is thought to be a combination of factors. One of them is abnormalities in the digestive system: There may be problems with the muscles in the intestine, or with the nerves that control them. Problems include:
Slow transit time: This means that food moves more slowly through the intestine. This can cause constipation.
Gut dysbiosis: This is an imbalance of good and bad bacteria in the gut. It has been linked to IBS, although the exact relationship is not clear.
Small intestinal bacterial overgrowth (SIBO): This is an overgrowth of bacteria in the small intestine. It can cause bloating, gas, and diarrhea.
Food intolerances: Some people with IBS may be intolerant to certain foods, such as lactose or gluten.
Stress: Stress can worsen the symptoms of IBS.
Genetics: IBS may be more common in people who have a family history of the condition.
Other common reasons include may be psychological factors and diet.
The symptoms of IBS can vary from person to person. They may be mild, moderate, or severe. The most common symptoms include:
Abdominal pain: This is the most common symptom of IBS. The pain may be cramp-like, and it may be relieved by passing stool or gas.
Bloating: This is a feeling of fullness or tightness in the abdomen.
Gas: People with IBS may have more gas than usual.
Diarrhea: This is a loose, watery stool. It may be mild or severe.
Constipation: This is a hard, dry stool that is difficult to pass.
Other symptoms may include nausea, fatigue, and difficulty sleeping. To keep track of your daily bowel movements, consider reading this article on how to effectively use a poop tracker app.
What causes IBS flare ups?
There is no single cause or trigger for IBS flares for everyone. However, there are several factors that may trigger a flare, including:
Family history: If you have a family history of IBS, you may be more likely to develop the condition.
Stress: Stress can be a major trigger for IBS flares. Try to find ways to manage your stress levels, such as yoga, meditation, or exercise.
Diet: Certain foods can trigger IBS flares. Common triggers include dairy products, gluten, caffeine, alcohol, and fatty foods. Keeping a food diary can help you to identify your own personal triggers.
Hormonal changes: Fluctuations in hormones can trigger IBS flares. This is often the case for women who experience flares around the time of their menstrual period.
Medications: Some medications can trigger IBS flares, such as antibiotics, painkillers, and antidepressants. If you think your medication is causing flares, talk to your doctor. Although it is commonly accepted that antibiotics can sometimes make irritable bowel syndrome (IBS) symptoms worse because they disrupt the balance of bacteria in the gut, if you are currently taking them and notice your IBS worsening, be sure to tell your doctor so they can reevaluate your treatment.[3][4]
What does an IBS flare feel like?
Everyone experiences IBS differently, so the symptoms of a flare can vary from person to person. However, common symptoms include abdominal pain, bloating, gas, diarrhea, and constipation. These symptoms can range from mild to severe.
How long do IBS flares last?
There is no set duration for how long an IBS flare could last for you. Some people may only experience a flare for a few days, while others may have flares that last for weeks or even months. You may need to track your past flareups to determine the average length of a flare. You can download the CareClinic app to determine the average length of each flare-up using the reports and logs feature in the App.
Can I prevent IBS flare ups?
There is no sure way to prevent an IBS flare up, but there are some lifestyle changes that may help to reduce the frequency and severity of flares. These include:
Managing stress: Stress can be a major trigger for IBS flares. Try to find ways to manage your stress levels, such as yoga, meditation, or exercise.
Identifying triggers: Keeping a food diary can help you to identify your own personal triggers. Once you know what triggers a flare, you can try to avoid those triggers.
Eating a healthy diet: Choose a nutritionally complete diet suited to your bowel pattern and tolerances. Increase soluble fiber gradually when recommended.
Exercising regularly: Exercise can help to relieve stress and improve gut motility.
Getting enough sleep: Sleep plays an important role in gut health. aim for at least 8 hours of sleep per night.
If you have an IBS flare, there are a few treatment options available to relieve your symptoms:
Drink plenty of fluids: This will help to prevent dehydration and make it easier to pass poop. Learn more about tracking your water intake and remaining hydrated.
Take over-the-counter medications: Medicines such as loperamide may relieve diarrhea. Ask a pharmacist or clinician whether they suit your symptoms. Do not use an antidiarrheal to manage bloody diarrhea or fever without medical advice.
Fiber supplements: such as psyllium husk, can help to relieve constipation.
Avoid trigger foods: If you know what foods trigger your flares, try to avoid those foods.
Get plenty of rest: Allow enough time for sleep and rest. Persistent or severe fatigue needs its own assessment, as described below.
Exercise regularly: Exercise can help to improve gut motility and reduce stress levels.
Medications: Your doctor may prescribe medications to help relieve your IBS symptoms. Common medications include antidepressants such as amitriptyline and selective serotonin reuptake inhibitors (SSRIs), as well as antispasmodics such as dicyclomine.[6]
What you should eat if you have IBS flares
Ask your clinician or dietitian whether a limited low-FODMAP trial is appropriate. It should include planned food reintroduction rather than indefinite restriction.
Food tolerance is individual. The following foods may fit your diet, but portions, fiber type, and ingredients matter. A food being processed does not by itself establish that it will trigger symptoms.
Brown rice: Brown rice is a good source of fiber.
Vegetables: Vegetables are a good source of fiber and nutrients.
Fruit: Fruit is a good source of fiber, vitamins, and minerals.
Lean protein: Lean protein, such as chicken or fish, is a good option for people with IBS.
Probiotics: Probiotics are live bacteria that can help to improve gut health.
Yogurt: Yogurt is a good source of probiotics.[7][8][9]
Choosing an IBS Diet During a Flare
An irritable bowel syndrome diet, often called an IBS diet, should match your bowel pattern and the foods that trigger symptoms. There is no single best diet for IBS. For IBS-C, a clinician may recommend more well-tolerated soluble fiber. IBS-D or prominent bloating may require a different approach. Because individual response varies, increase fiber gradually and stop the increase if symptoms worsen. NIDDK guidance for IBS diet and nutrition notes that changes help different people and that adding too much fiber at once can trigger gas and bloating.
Instead of assuming one IBS treatment diet will work for everyone, change one factor at a time and track symptoms. Diets for IBS work best when they remain nutritionally complete and are individualized with a clinician or registered dietitian, especially when symptoms alternate between constipation and diarrhea.
Anti-Inflammatory Diet vs Low-FODMAP for IBS
An anti-inflammatory diet for IBS and a low-FODMAP diet are not the same plan. An IBS anti-inflammatory diet describes an overall dietary pattern. A low-FODMAP plan is temporary and reduces specific fermentable carbohydrates to identify symptom triggers. When comparing an anti-inflammatory diet vs FODMAP restriction, the American College of Gastroenterology IBS guideline recommends a limited trial of a low-FODMAP diet for global IBS symptoms. Evidence is limited for an anti-inflammatory diet as a stand-alone treatment for an IBS flare.
Is low FODMAP anti-inflammatory?
Not necessarily. Some foods that fit an anti-inflammatory pattern are high in FODMAPs, and a low-FODMAP food list does not by itself define an anti-inflammatory pattern. A low FODMAP anti-inflammatory diet therefore requires individual food choices rather than one universal list. Rather than treating a list of anti-inflammatory foods for IBS as universally safe, test tolerated foods individually. If you want to combine a low FODMAP and anti-inflammatory diet, a registered dietitian can help preserve nutrition while you eliminate and reintroduce foods. Follow the structured reintroduction step rather than leaving broad food groups out indefinitely. NIDDK describes a short low-FODMAP trial followed by gradual food reintroduction.
Mindfulness meditation for IBS
Mindfulness meditation for IBS means practicing nonjudgmental attention to the present moment. Notice a thought, feeling, or sensation, then gently return to your chosen focus. The practice has Buddhist roots, but health programs can teach it in a secular setting. You do not have to empty your mind or feel calm to take part.
IBS involves gut-brain communication. Stress can increase symptom distress, and unpredictable bowel symptoms can themselves be stressful. Mindfulness offers one way to respond to that cycle alongside dietary treatment and medical care. It does not mean symptoms are imagined or that you caused them by worrying. Planning bathroom access, allowing breaks, and asking trusted people for support can also make daily activities more manageable.
Does meditation help with IBS?
It helps some people, but the results are not a guarantee. In a randomized trial of 75 women with IBS, an eight-week mindfulness program reduced overall bowel symptom severity more than a support group. Benefits remained at three months. This was structured training, not a test of a single recording during a flare. The study cannot establish the best meditation for everyone or promise immediate pain relief. A review of meditation studies in IBS also examines possible benefits and the limits of the evidence.
For ongoing symptoms, ask about gut-brain therapies delivered by a trained clinician. NIDDK describes cognitive behavioral therapy, gut-directed hypnotherapy, and relaxation training as IBS treatment options. Mindfulness-based cognitive therapy combines mindfulness practice with elements of CBT. These approaches differ from one another, and an app should identify which approach it actually provides.
A short guided meditation for IBS
Try this brief attention exercise at a comfortable time. It is a way to practice responding to stress, not a method for diagnosing or stopping an attack.
Sit with support and set aside up to five minutes. Keep your eyes open if that feels easier. You can stop to use the bathroom whenever needed.
Notice where your feet touch the floor or how the chair supports you. Let your shoulders soften without forcing them.
Breathe normally. Notice a few breaths without holding your breath or trying to take unusually deep breaths.
When your attention wanders to pain or worry, acknowledge it and return to the feeling of your feet, a sound in the room, or your breathing. Returning is the practice.
Finish by looking around the room and deciding what you need next, such as a drink, a rest, or help.
A body scan notices sensations in different areas of the body. Loving-kindness practice uses phrases of goodwill toward yourself and others. Mindful walking or gentle yoga may suit someone who finds sitting uncomfortable. None is established as the best option for every person with IBS. Relaxation exercises for IBS can also include progressive muscle relaxation, with an instructor helping you adapt them if muscle tension or movement hurts.
When choosing an IBS meditation app or guided recording, look for a named qualified instructor, clear descriptions of the approach, realistic claims, and a way to pause. A general meditation app is not automatically a clinically tested IBS treatment. Start with a short session at a repeatable time, increase only if comfortable, and avoid treating missed days as failure. You can also notice sounds or sensations during an ordinary daily activity.
A mindfulness journal can record what you tried and how it felt. Use an IBS symptom tracker to compare bowel symptoms, practice, sleep, and daily function over time. A diary can support a discussion with your clinician, but it does not prove that meditation caused an improvement. If IBS and depression, anxiety, or isolation are affecting you, seek support rather than relying on meditation alone.
IBS fatigue during and after a flare
Tiredness and a lack of energy can accompany irritable bowel syndrome. The NHS includes tiredness among symptoms associated with IBS. People may describe this as exhaustion, lethargy, or feeling drained during an attack and afterward. That association does not establish the cause of persistent fatigue in an individual.
Fatigue means feeling short of energy. Sleepiness means feeling likely to fall asleep. Weakness can mean a loss of muscle strength, which deserves separate attention, especially if it is new or progressive. Tell your clinician which experience you mean and how it affects work, meals, exercise, and everyday tasks. Extreme fatigue or feeling tired all the time should not automatically be attributed to IBS.
Why a flare can leave you exhausted
Pain, worry, and disrupted sleep can leave you depleted. Frequent diarrhea can contribute to dehydration, while eating less to avoid symptoms can reduce your energy intake. A demanding symptom-management routine can add to the burden. These are possible contributors to investigate, not proof that any one factor explains your tiredness. IBS is distinct from inflammatory bowel disease, so fatigue alone is not evidence of ongoing bowel inflammation.
If fatigue occurs after eating or continues after an IBS attack, note the timing, portion size, bowel symptoms, and sleep from the previous night. Also record headache, dizziness, menstrual changes, and new medicines. These details can help a clinician assess the pattern. Stress, anxiety, and depression can coexist with physical causes of fatigue. Finding one does not rule out the others.
What helps IBS fatigue?
IBS fatigue treatment starts with identifying what is contributing to the loss of energy. Managing bowel symptoms may help daily function, but a bowel medicine is not a general treatment for exhaustion.
Keep regular meals and enough food overall. Use the individualized diet guidance above. A dietitian can help you choose tolerated fruits, vegetables, grains such as oats or rice, protein, and other foods without unnecessary restrictions. Probiotic foods are not a proven cure for fatigue, and tolerance varies.
Review your own triggers, including fatty or spicy meals, caffeine, alcohol, and carbonated drinks. Change one factor at a time rather than removing several food groups. Extra caffeine can interfere with sleep or worsen bowel symptoms.
Drink regularly, particularly with diarrhea. Ask a pharmacist or clinician about oral rehydration solution when fluid losses are significant. Follow any fluid limits prescribed for another condition.
Protect time for sleep and rest. Gentle walking, stretching, or another tolerated activity may fit better than pushing through exhaustion. If activity repeatedly causes a marked delayed worsening, discuss that pattern with a clinician before increasing exercise.
Review medicines with your prescriber or pharmacist. Antidiarrheals, laxatives, antispasmodics, and some antidepressants address different bowel symptoms, and some can cause drowsiness. Do not stop a prescribed medicine or add supplements solely to treat fatigue without advice.
Keep a brief diary of energy, sleep, meals, stool changes, medicines, and what you could do that day. Allow practical support from family or friends, plan breaks, and keep time for enjoyable activities. Set achievable goals instead of judging progress by constant symptom control.
When tiredness needs a different explanation
Arrange a medical review if fatigue lasts a few weeks without a clear explanation, interferes with daily life, or persists despite improvement in bowel symptoms. Your clinician may assess anemia, thyroid disease, diabetes, sleep apnea, mood problems, medication effects, and nutritional intake. The NHS fatigue guidance explains why tests depend on the symptoms and suspected cause.
Celiac disease can resemble IBS and can be associated with anemia. Discuss testing before starting a gluten-free diet because restriction can affect test results. IBS and chronic fatigue syndrome, also called ME/CFS, are different diagnoses. Prolonged exhaustion, unrefreshing sleep, cognitive difficulty, or worsening after activity require their own assessment. Do not diagnose either condition from a symptom checklist.
When to seek urgent medical help
Seek urgent medical advice for blood in the stool, unexplained weight loss, a new hard abdominal lump, or fatigue with shortness of breath, palpitations, or unusual paleness. Severe dehydration, fainting, confusion, severe or worsening abdominal pain, or inability to keep fluids down also needs prompt care. These symptoms should not be managed as an ordinary IBS flare or postponed while trying meditation.
Using the CareClinic App to manage IBS Flareups
CareClinic can help you to keep track of your IBS flares and symptoms. This can be helpful in identifying your triggers and finding ways to prevent future flares.
CareClinic also has a built-in symptom tracker that can help you to manage symptoms over time. This can be helpful in monitoring the severity of your flares and determining which treatments are effective.
In addition to the symptom tracker you can also use CareClinic to:
Tracking your bowel movements
Set reminders for taking medication
Track your diet and exercise
Manage stress levels
Monitor your sleep patterns
Keep a journal
Bring your symptom, food, sleep and energy records to your clinician to discuss what has changed and whether your management plan needs adjusting.
FAQS
Questions that come up often regarding IBS.
What is the best way of managing symptoms of inflammatory bowel disease?
There is not currently a cure for IBD, but there are treatments available that can help to manage the symptoms and prevent flares.
Does drinking carbonated beverages affect IBS?
There is no clear evidence that carbonated beverages affect IBS. However, some people find that their symptoms are worsened by these drinks. If you think that carbonated beverages are triggering your symptoms, you may want to avoid them.
Is it possible to have IBS and celiac disease?
IBS and celiac disease are distinct conditions, and IBS-like symptoms can occur in someone with celiac disease. Celiac disease involves an immune reaction to gluten that damages the small intestine. IBS is not defined by that immune reaction. A clinician can assess overlapping symptoms and decide whether testing is needed.
What is the difference between IBS and IBD?
IBS is a chronic condition that affects the gastrointestinal tract. IBD is a group of chronic inflammatory diseases that affect the gastrointestinal tract. IBS does not cause inflammation, while IBD can cause inflammation in the digestive tract. IBD includes conditions such as Crohn’s disease and ulcerative colitis.
What are some natural remedies for IBS?
There are many natural remedies that are thought to be helpful in treating IBS. These remedies include probiotics, fiber supplements, peppermint oil, and chamomile tea. It is important to speak with a doctor before taking any natural remedy, as some may interact with medications.
Peppermint oil is thought to be helpful in treating IBS. Coated peppermint oil capsules may help some IBS symptoms, but can worsen heartburn. Ask a clinician or pharmacist whether they are appropriate rather than treating peppermint oil as an anti-inflammatory medicine.
What is an IBS attack?
An IBS attack is a sudden worsening of symptoms. Attacks can be triggered by stress, certain foods, or hormone changes. During an attack, people may experience abdominal pain, bloating, diarrhea, and constipation. IBS attacks can last for a few days to a few weeks.
Can spicy food cause IBS?
There is no clear evidence that spicy food causes IBS. However, some people find that their symptoms are worsened by spicy food. If you think that spicy food is triggering your symptoms, you may want to avoid it.
What about acidic foods?
There is no clear evidence that acidic foods cause IBS. However, some people find that their symptoms are worsened by acidic foods. If you think that acidic food is triggering your symptoms, you may want to avoid it.
Can IBS cause muscle pain?
Backache can occur alongside IBS, as described in the NHS IBS symptoms guidance. Leg pain or new muscle weakness should not automatically be attributed to IBS. A clinician can assess persistent, new or worsening pain and consider other causes. You can record pain severity, location and timing to support that assessment.
Is it normal to experience weight loss with IBS?
Unexplained weight loss needs medical assessment and should not be assumed to be an ordinary IBS symptom. A record of weight changes and food intake can support that assessment. A weight tracker can help record the change, but tracking should not delay care.
What are the good gut bacterias and which are bad?
Gut microbes have varied roles in digestion and health. Effects depend on the species, strain, and context, so dividing them into universally good or bad groups is misleading. A probiotic label alone does not establish that a product will improve IBS. Ask your clinician before using a supplement.
Can IBS cause urinary problems?
People with IBS may experience urinary frequency or urgency due to pelvic floor dysfunction. Pelvic floor dysfunction is a condition that affects the muscles of the pelvic floor. The Pelvic floor muscles support the bladder and help to control urinary function. If you are experiencing urinary problems, it is important to see a doctor for a diagnosis.
What is the difference between IBS and GERD?
IBS affects bowel function. GERD involves stomach contents flowing back into the esophagus and can damage its lining. The two conditions can coexist, but their treatments have different purposes.
If you have IBS and acid reflux, your clinician may recommend acid-suppressing medicine for the reflux. Our guide to omeprazole for IBS with reflux explains this distinction. Omeprazole is not a general treatment for IBS or fatigue. The NHS omeprazole guidance describes its acid-related uses and advises checking treatment with a pharmacist or doctor.
What is the difference between IBS and diverticulitis?
IBS is a chronic condition that affects the gastrointestinal tract. Diverticulitis involves inflammation of diverticula, which are small pouches in the colon wall. Having pouches alone is called diverticulosis. These are different from IBS and need their own assessment when symptoms suggest them.
What is the difference between IBS and celiac disease?
IBS is a chronic condition that affects the gastrointestinal tract. Celiac disease is an immune-mediated condition in which gluten damages the small intestine. IBS does not cause that damage. Similar symptoms do not distinguish the two, so ask about testing before restricting gluten.
Do you manage IBS-C and IBS-D in the same way?
IBS-C means constipation-predominant IBS, while IBS-D means diarrhea-predominant IBS. Treatment should match the bowel pattern. Soluble fiber may help some people, but adding fiber quickly can worsen bloating. Medicines for diarrhea and constipation have different purposes. Use the diet guidance above and ask your clinician or dietitian how to adapt it to your symptoms.
Tips on starting an elimination diet
If you suspect that a food is triggering your IBS symptoms, you may want to try an elimination diet. An elimination diet involves removing suspected trigger foods from your diet for a period of time and then gradually reintroducing them one at a time. This will help you to identify which foods are triggering your symptoms.
When starting an elimination diet, it is important to:
Agree on a limited, structured trial with your clinician or dietitian. Avoid removing multiple food groups without a plan to maintain nutrition.
Gradually reintroduce suspected trigger foods one at a time, while monitoring your symptoms.
Keep a food diary to track which foods trigger your symptoms.
Work with a registered dietitian to ensure that you are getting the nutrients you need.
In Summary
IBS can cause recurring bowel symptoms and can affect energy and daily life. An individual plan may include food adjustments, bowel treatment, and support for stress and sleep. Persistent fatigue, unexplained weight loss, or a change from your usual symptom pattern needs medical assessment.
Choose manageable changes, track how you feel, and review ongoing symptoms with your clinician. If you suspect that a food is triggering your IBS symptoms, you may want to try an elimination diet. The CareClinic app was designed for those with IBS, to track, manage and understand triggers and more information about their symptoms. To get started managing your condition download the App for iOS or Android today by clicking here.
References
Disclaimer: The information on this page is provided for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a licensed health-care provider about any questions you may have regarding a medical condition. If you have an emergency, call your local emergency number immediately.
“The Mysteries and Underdiagnosis of SIBO”. https://time.com/6155603/sibo-symptoms-diagnosis-difficult/
“Definition and Facts for Irritable Bowel Syndrome – NIDDK”. https://www.niddk.nih.gov/health-information/digestive-diseases/irritable-bowel-syndrome/definition-facts
“Common IBS Triggers To Avoid”. https://health.clevelandclinic.org/ibs-triggers
“Impact of psychological stress on irritable bowel syndrome – PMC”. https://pmc.ncbi.nlm.nih.gov/articles/PMC4202343/
“13 Tips to Avoid IBS Flare-Ups – United Hospital Center Gastroenterology”. https://wvgastrocenter.com/13-tips-to-avoid-ibs-flare-ups/
“Treatment for Irritable Bowel Syndrome – NIDDK”. https://www.niddk.nih.gov/health-information/digestive-diseases/irritable-bowel-syndrome/treatment
“IBS? A low-FODMAP diet may help – Harvard Health”. https://www.health.harvard.edu/staying-healthy/ibs-a-low-fodmap-diet-may-help
“Your Guide to the Low-FODMAP Diet”. https://health.clevelandclinic.org/low-fodmap-diet
“Probiotics Primer: What Science Says About Using Bacteria to Treat Disease”. https://time.com/3030985/probiotics-primer-what-science-says-about-using-bacteria-to-treat-disease/
Alexandra Vlasceanu
Medically Reviewed
Alexandra V., BPT is a licensed physiotherapist (Carol Davila University of Medicine & Pharmacy) with additional clinical training in Medicine. She merges seven years' musculoskeletal-rehab experience with plain-language writing to deliver evidence-based prevention and pain-management guidance for CareClinic readers. Alexandra's goal is to turn clinical science into clear, actionable tips, information meant to educate, not replace individual medical advice.
