During IBS Awareness Month, we chat to Guts UK’s Julie Thompson about how we can look after ourselves should we experience a flare-up
You think your symptoms are under control. After all, you can’t even remember the last time you had a flare-up and your tummy feels relatively relaxed, then one day – BAM – something kicks it off and suddenly you’re dealing with excruciating stomach cramps, bloating and countless trips to the toilet, not to mention the lack of energy and headache that you’re left with as a result. Unfortunately, many of us may be struggling with symptoms reappearing or being worse than usual at the moment due to the current uncertain situation. So, what can we do to help ourselves should we experience an IBS flare-up?
This is a question I have found myself asking too many times. There is an overwhelming amount of information available as to what we should do during an IBS flare-up and even how to prevent one including using hot water bottles and altering our diet, but there seems to be very little advice on what we should be doing in the delicate time period that follows an IBS flare-up.
What should we eat afterwards?
Julie explains there’s no one-size-fits-all solution.
“Everybody is individual as to what they can tolerate and what they can’t,” she says.
After a flare-up, she recommends following first-line advice which suggests eating smaller meal sizes, avoiding eating late at night as well as limiting caffeine-containing and fizzy drinks as this could result in further fermentation and gas. However, Julie emphasises that it is important to reintroduce foods that you are able to following a flare-up and avoid cutting things out longer term.
Further, experts claim a high-protein diet will help with IBS sufferers who are experiencing diarrhoea and/or constipation. For instance, opting for chicken or fish based meals over a bowl solely containing pasta. Bear in mind, however, it’s still important to include a healthy portion of carbohydrates within your diet. Meanwhile, cooking vegetables rather than eating them raw is less likely to cause gas and bloating.
Julie also suggests considering other factors that may be contributing.
“It’s possible for it not to be diet-related,” she claims, “if you are following a really restrictive low FODMAP reduction diet and you are still having symptoms, it’s probably something else that is causing it.”
She recommends using The IBS Network’s wellness diary as an effective way to understand your condition, triggers and symptoms.
If your symptoms have been stable for a while then you experience a flare-up, Julie suggests seeking advice from your GP. Also, if there’s any change in your usual symptoms, ask your GP to check the ‘Red Flag Symptoms‘ again to rule out anything else that could be causing the flare-up, she adds. Red Flag Symptoms include bleeding from the rectum, weight loss, persistent fever and malaise and an ongoing change in bowel habit that occurs for no obvious reason.
What physical activity should we do afterwards?
“Generally, it’s advised that people try and get at least 30 minutes of physical activity per day, at least five days a week,” says Julie.
This can be particularly helpful for sufferers of IBS with constipation because it can help keep things moving and enable you to empty your bowels more regularly, she adds.
“Although, it’s not ideal at the moment as we are a bit restricted, getting out in nature can also provide benefits.”
Again, Julie stresses that all of these suggestions are not standard because everybody is different and you need to approach exercise inline with your knowledge of your own condition.
A flare-up can leave us feeling drained. How can we re-energise?
The most important thing is taking care of yourself while you’re having a flare-up and building back up gently until you feel able to cope with your normal lifestyle and routine, advises Julie.
Fatigue and lack of energy can improve for some if you start following a low FODMAP diet, she continues.
Evidence also suggests eating nutrient-dense foods such as fish, a source of B vitamins which support the conversion of food into energy, getting sufficient good quality sleep and doing physical activity can help to combat fatigue.
Why is rehydrating so important?
Julie says fluid intake can be really helpful for people with constipation-based IBS because it can help to soften stools and make them easier to pass. It’s also vital that people with diarrhoea symptoms don’t get dehydrated as it can lead to a loss of fluids.
“I would advise [drinking] eight glasses of standard caffeine-free fluid (water, diluted juice and herbal teas) per day.
“The way to tell [if you’re dehydrated] is by looking at your urine colour,” she explains, “it needs to be clear or pale yellow. If it starts getting dark, you need more fluids.”
Check out Healthline’s useful pee colour chart.
However, Julie explains for IBS sufferers with diarrhoea, the consistency generally isn’t watery and this could be a sign of other conditions such as bile acid malabsorption (BAM) or microscopic colitis. Again, check with your GP if you’re concerned.
How can we cope with a flare-up at work?
An action you can easily take should you experience a flare-up at work is to find a trusted friend or co-worker who can step in for you should you have to leave.
There are also medications available, such as Buscopan, which offer immediate relief from stomach cramps. However, the efficacy can vary per individual.
Julie claims: “It’s best to let your employer know about your condition as [IBS] is actually classed as a disability, so employers should put in reasonable steps to help you [manage your] symptoms [at work].”
The IBS Network offer advice for employers to help employees manage the condition in the workplace.
As a sufferer of IBS yourself, what is your advice for people after they’ve experienced a flare-up?
“This is probably the best advice I could give — learn as much as you can about your situation and IBS because what works for one person might not for somebody else,” explains Julie.
“Healthcare professionals can sit with you for half an hour, but they don’t necessarily understand your life. The best person who can help you is [yourself].”
The bottom line
After a flare-up, go easy on yourself. Don’t try eating anything too adventurous or large. While your abdominal cramps may have dissipated, your gut is still sensitive so start off with small regular meals if this feels right for you. Try some gentle exercise such as yoga poses for your gut. Rest and drink plenty to replace any lost fluids. Most importantly, make sure you understand your own condition, triggers and symptoms.
Julie is a registered specialist gastroenterology dietitian and information manager for Guts UK. After suffering with IBS for most of her adult life, she became a volunteer for The IBS Network.
What is IBS Awareness Month?
April was declared IBS Awareness Month in 1997 by the International Foundation for Gastrointestinal Disorders (IFFGD). It is now an annual event during which organisations, charities and health professions work to raise awareness of the condition and to improve the quality of life for sufferers.
Found this useful? What do you do after a flare-up? Get in touch.
The Gut Choice advise consulting a medical professional or dietitian before taking medication or making any alterations to your diet.