Having an IBS (Irritable Bowel Syndrome) flare is no fun.

To illustrate, imagine this scenario:

I live a 90-minute drive over remote mountain roads from the nearest city, and I make the trip once a week, to resupply my groceries and other necessities. It’s an all-day affair. I leave after I drop my kids off at school, and I return around 5:30 pm. It’s challenging on the best of days, but even more so on one of the days when I used to have an IBS flare.

One January day, I found myself pulled over on the side of the road in the pouring rain, frantically digging a hole, trying to keep out of sight, while my belly cramped. I knew I was in for a crappy day when that happened (pun intended!).

Later that day, I had trouble finding a decent public restroom. Belly rebelling, I managed to make it into a not-so-clean bathroom in a local grocery store.

On this day, I felt not only crampy in my belly, but exhausted, stressed, and fed up with this process! Unfairly, my IBS flare days often seemed to happen on my town days. I was pretty motivated to figure out not only how I could prevent these flare days, but also how to stop them from ever happening! Because, you know, life happens, and I had things I wanted to get done!

So to help you have less frequent and less severe IBS flares, I want to share how IBS patients and practitioners work through an IBS flare, and some bigger picture strategies for unraveling their root causes.

What is an IBS flare?

 

 

IBS, or Irritable Bowel Syndrome is a broad, non-specific digestive disorder. IBS typically waxes and wanes, much to the chagrin of sufferers. Sometimes it’s quiet, and not causing much trouble. But other times, it decides to rear its ugly head. In general, IBS symptoms may include:

• Bloating
• Gas
• Constipation OR Diarrhea
• Alternating Bouts of Constipation and Diarrhea
• Urgent need to use the bathroom, or stool is difficult to pass
• Clear, white mucous in the stool

The specifics can look different for each of us, but an IBS flare is an increase in the frequency or intensity of the symptoms. For me, this looked like frequent stool (up to 5-6 times in a day, though it might be even more for you), cramping, pain or soreness, along with fatigue, dehydration, and general malaise. As a practitioner, I have found that a food allergy flare looks quite similar, which suggests to me that IBS symptoms are likely to be connected with food sensitivities or allergies (more on that in a minute).

What Causes IBS?

 

 

If you’ve been given a diagnosis of IBS, it’s likely you have these symptoms. But this doesn’t mean that you or your doctor know what’s causing them. The IBS diagnosis is usually given when other digestive pathology, like Crohn’s, Colitis, or other diseases are ruled out.

But from a Functional Medicine or Nutrition perspective, there are a lot of possible causes, and you owe it to yourself to try to uncover them.

One of the main causes of IBS that is well within your control is food allergies or sensitivities. Many of you with IBS are already aware that certain foods flare your symptoms and you avoid them like the plague. But clearly identifying all of those trigger foods can be a game changer. (To read more about how to figure out your particular food triggers, check out Food Intolerance Primer: What I Wish I Had Known here.) Another commonly overlooked cause of IBS is Small Intestinal Bacterial Overgrowth, or SIBO. Some studies suggest that as many as 85% of IBS cases are actually caused by SIBO. In SIBO, bacterial overgrowth in the small intestine can cause malabsorption issues, diarrhea OR constipation, bloating, gas, and many other symptoms. (Sounds like IBS, right?) In addition to SIBO, other potential root causes of IBS are underlying, previously hidden infections, including parasites, fungus, bacteria in the large intestine, or things like Lyme disease. Other potential players or contributors include mold, stress, environmental toxins, or poor water quality in your home.

How to Repair IBS and Restore Normal Gut Function

 

 

As tempting as it is to want a quick, easy fix for a problem like IBS, restoring normal gut function is more of a long-game. But even in the worst cases, there is hope for a more normal life. The first step to repairing your gut function isn’t to dive into every possible solution you can think of. Instead, you want to zoom out, and really understand what you’re seeing in context. Gathering information about your story, family history, the triggering events that may have started your problem, your collection of test results, understanding when, where, and how often your symptoms occur, and your current diet and stool habits can really help in creating the right solution. Once you have this information, you can begin to adjust your current diet and habits that are likely to lead to a change in your symptoms. This can often mean adding digestive supports like stomach acid, enzymes, or probiotics, removing foods that may be aggravating your gut lining, adding in nutrients that appear to be deficient, or even focusing on stress management. After you have adjusted these parts of your life, if you still have symptoms, now is the time to consider testing for deeper dysfunction, like infections or SIBO. (If you’d like to see all this mapped out, with some suggested action steps you can take on your own, I invite you to download your free copy of Roadmap to Recovery. I go into a bit more detail about what this looks like in real life, and provide you with some things you can do right now to get started.)

What to Do When You Have An IBS Flare

 

 

Even when you are diligent, and work really hard to avoid an IBS flare, they sometimes happen anyway (Damn it!). So what then? In a lot of ways, living with IBS or other bowel disorders is about learning how to minimize your flares. You may never be able to completely eliminate your symptoms, but you CAN certainly minimize them and live well in spite of them. I do want to make sure to say that not ALL of these tips is likely to help you. Choose two or three to test next time you have a flare, and see how you respond. If your body doesn’t like what you’ve chosen, now you know to move on to something else. You can keep a running list that details what works for your body and what doesn’t. This list is GOLD, because you now have a personalized tip sheet to turn to when symptoms get out of hand. If you have already created a Functional Nutrition Matrix, you can note these details in the “Mediators” section. These are important clues that help detail what your body is doing and why. This is at the heart of the Functional method of practice. I asked around my community of chronic illness bloggers and Functional Nutrition professionals to find out what they do themselves, or what they recommend to their clients when they experience an IBS flare.

Here is the list of tips they shared to quickly work through an IBS flare:

#1: Simplify Your Diet and go back to your known safe foods:

 

I find my flares often happen when I decided to get a little more adventurous on purpose. The first thing I do in response is to try to identify what the food trigger may have been, and return to foods I absolutely know to be safe. And I add a “note to self” to continue avoiding that trigger food while I work on my gut repair.

Here are some other SIMPLIFY tips from IBS patients and practitioners:

 

Shauna Gourley, Certified Bulletproof Coach and FDN: “Fasting works fast!”

Jessica Donces, FDN, Owner Optimize to Thrive: “I suggest basic, easy-to-digest animal proteins. They are broken down and digested earlier on compared to veggies, therefore “easier” on the gut in terms of symptoms one may be experiencing with IBS. Also, elemental diets can be a great tool, there are several different types.”

Amber Blackburn, IBS patient: “My biggest tip when I have a bad flare up is I start eating basically only from the BRAT (Bananas, Rice, Apples and Toast) diet. And I do that for a few days at least until my gut feels better.”

Marya Mesa, IBD patient, blogger at Chronic Mom Life: “I had IBS for years and now IBD – ulcerative colitis. When I flare I keep it very simple… stock, yogurt, smoothies, eggs, bananas, avocados.”

Candace Mantle, IBS patient: “I’ve also got Crohn’s disease. When I flare I just eat chicken, white rice and mashed potatoes. This allows my digestive system to rest.”

Collin Wong, IBD patient, blogger at Collin’s IBD Chronicles: “When I have a flare with IBD, I just avoid fried foods and spicy foods and keep it to steamed foods, and soluble fibers.”

Nicole NIckley, FDN Practitioner with The Health Mission: “Fasting with bone broth, chamomile tea, homeopathy (Ignatia Amara, or Nux Vomica remedies), and digestive essential oils blends, topically.”

Natalie Gardner, IBD patient and blogger at The Spoonie Mummy: “I have IBD (Crohns) and an Ileostomy. One of the first things I turn to when I feel like I’m starting to flare is the Low Residue diet (also known as a low fiber diet).

#2: Add binders

 

Binders, such as activated charcoal, bentonite clay, or citrus pectin, can bind up toxins or inflammation in your gut.

Nicole Nickley, FDN Practitioner at The Health Mission: “I had a flare up from my Thanksgiving feast and took GI Detox (you can get it here) and that took care of symptoms.”

I do want to add the caveat about binders: If you already trend toward constipation, you may want to skip these, or try them carefully and assess your reaction. Binders may cause or increase constipation. Here are a few specific products to explore (you can access most of these inside my online supplement dispensary at FullScript):

• GI-Detox+ by Bio-Botanical Research
• Activated Charcoal by Integrative Therapeutics
• Activated Charcoal by Nature’s Way
• Pectasol-C Modified Citrus Pectin by EcoNugenics
• Modified Citrus Pectin by Vital Nutrients, or Allergy Research Group

In addition to these shared tips, here are a few more than I have used myself for my flares, and might suggest for you if you are experiencing a flare.

#3: Plain water enemas, or coffee enemas, 1-2 x per day

 

I’ve found this practice greatly reduces the length of my IBS flares, especially since I generally trend toward constipation. Plus it allows my body to detox a little bit more thoroughly. I only recommend this frequency of enemas for a short period of time, maybe 1-2 days. To do enemas more frequently may lead to nutritional deficiencies and dehydration.

 Here are instructions on how to perform an enema.  Here is the enema kit I prefer.

#4: Return to your tried and true stress-reduction techniques

 

Stress has a huge impact on the digestive system. Any kind of stress can slow down (or speed up!) your digestion and appetite. If stress is part of your symptom flare, be sure to think about stress-relief techniques as part of your solution. For me, this includes:

• breathing exercises
• meditation apps, such as Stop, Think, Breathe
• self-hypnosis recordings

You can also use any other stress relief methods you have found work. 

This might include yoga, or walks outdoors, dancing, a hobby you enjoy, singing, time with people you love. Whatever feeds you and helps you feel happy is stress relief!

Rachel Romaine, FDN Practitioner with Present Day Wellness, recommends belly massage and a hot water bottle to relieve belly stress and pain. If you’re not too sore, massage in slow, small circles, moving always in a clockwise direction.



If I missed any stress relief techniques you like, please add yours in the comment.

#5: Include soothing, demulcent, or carminative supplements or essential oils:

 

This is a very bioindividual recommendation, because while some of these may help soothe your gut, some could irritate your gut. But many people find relief using herbs or botanicals orally, such as:

• deglycyrrhized licorice (DGL)
• aloe vera
• marshmallow
• cold soak slippery elm tea
• mastic gum to soothe the lining of the gut.

Rachel Romaine, FDN Practitioner with Present Day Wellness also suggests carminative herbs, which are herbs to support digestion. She includes fennel, ginger, peppermint, sage, and chamomile. 
You can listen to her describe how to she uses these herbs for digestive support here.

Kara Louise, Certified Integrative Health Coach, Holistic Health Practitioner, and Functional Medicine Practitioner, and owner of Life Hub Center says:

“There are several essential oils that can help keep the digestive system in a state of relative calm. These are my favorites:

DiGize (Young Living brand) is an essential oil blend that includes Fennel, Tarragon, Ginger, Peppermint, Juniper, Lemongrass, Anise, and Patchouli. DiGize can be used internally (either via a couple drops in a capsule), rubbed on the lower belly, or via under the tongue. DiGize also helps relieve digestive problems like indigestion, heartburn, gas, and bloating to name a few. It is also known to help fight off candida and intestinal parasites making it an all-in-one essential oil blend that’s a must-have for every at-home medicine cabinet.

Marjoram, Basil and Peppermint are three single essential oils that when added to Epsom salt baths (3 drops each to a cup or more of Epsom salts) help relieve the cramping that is associated with irritable bowel. (Peppermint happens to be a great oil to keep with you at all time to help relieve stomach upset and nausea. It’s also great on the roof of your mouth to relieve headaches.)

Oregano is a “hot” oil that has strong anti-bacterial qualities. Many individuals have found it to be beneficial as part of their anti-candida therapy and to balance their microbiome. It’s best to work with a health coach trained in essential oil usage when it comes to using oregano.

Essential oils are powerful, strong and therapeutic. My two tips when it comes to essential oil usage are: (1) find the right company who can track your oil from Seed to Seal to be the best quality; (2) work with someone who is trained on aromatic medicine and can help you with an individualized approach to using essential oils as part of your healing journey.”

You can reach out to Kara at Life Hub Center here.

 

#6: Back off on probiotics temporarily

 

For some people, especially if SIBO is an issue, probiotics may aggravate symptoms. Back off on probiotics for a few days while you restore balance and calm inflammation.

#7: Increase antioxidants

 

Vitamins A, C, & E, CoQ10, or glutathione will help repair the inflammatory damage in your guts, whatever the cause. Give your cells the nutrients they need to do repair work! One simple way you can do this is by eating a rainbow of foods, if you can tolerate them, or by using  herbal teas, which contain plant phenols which are natural antioxidants. While a nutrient-dense diet is always the preferred way to get these nutrients into your body, you can also include nutritional supplements to meet your needs.

#8 : Hydration

 

The body needs adequate hydration to do all it’s tasks. If you’ve had diarrhea as part of your flare, you may also be dehydrated. Be sure to drink plenty of fresh, clean water.

#9: L-glutamine

 

 

L-glutamine is an amino acid that your gut cells use to do repair work. Taking L-glutamine (1-5 or more grams per day) may help repair your gut lining during a flare. L-glutamine is generally well tolerated, but it’s always a good policy to start at a low dose and slowly increase to your tolerance to avoid any negative reactions.

Conclusion

 

 

You don’t have to simply wait out your IBS flare. With some attention and care, you can reduce the length and severity of a flare by trying out some of the methods shown here. If your IBS flares and attacks are an ongoing, regular occurrence, it may be time to get serious about investigating your root causes. When a client comes to me with symptoms resembling IBS, I always do a full case history, to try and identify when and why the symptoms first started. I help them do some dietary clean up and support their digestion first. If we’re not able to resolve symptoms that way, I suggest running a stool or breath test, to find out whether infections are involved. I’ve used this approach with myself as well as my clients. I’ve done so well with my IBS approach that I can’t remember the last time I had an IBS flare, let alone on my town trip day. What a relief! And though I do occasionally have a flare, they are no longer anywhere near as bad as they once were, and I’m able to resolve them quickly with a minimum of disruption of my life. My kids and my family need me, and I’d rather spend my time with them than be on my toilet. Wouldn’t you?

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Let’s get you free from symptom flares, and back to comfortable belly function! When you’re ready to dig into your underlying reasons for your IBS flares, and are ready to see the length of time between your flares increase, grab your free copy of Roadmap to Recovery, and get started right away with some easy, accessible tasks.