24 Hours in an IBS Flare-up: Dr Megan Rossi Explains What's Going on in Your Body

Claudia Canavan, Reviewed by Dr. Megan Rossi
·6-min read
Photo credit: Issy Muir
Photo credit: Issy Muir

Dr Megan Rossi, AKA The Gut Health Doctor, is a gut health expert, boasting a PhD in the subject. The Australia-native leads research at King’s College London, where she investigates nutrition-based therapies in gastrointestinal health – as well as being a
registered dietitian (#overachiever goals) and soon-to-be author: her upcoming book The Gut Health Doctor: Eat Yourself Healthy, an easy-to-digest guide to health from the inside out drops in September.

Photo credit: -
Photo credit: -

As part of her WH series, Never TMI, here, she walks you through your body on a 24 hour IBS flare-up. And, if you need a re-cap on IBS symptoms, what it actually is, and why it happens, keep scrolling to the bottom of the page for detail.

Over to Dr Rossi.

24 hours in an IBS flare-up

Toay, I'm going to walk you through the life cycle of diarrhoea-forward IBS flare-up (there are different types of the condition – read more about the others at the bottom of the page – but this is the one that most of us are familiar with.)

Goes without saying, but everybody is unique and this is a general overview. Exactly what goes on in your gut is snowflake-style special. Plus, if your symptoms persist, head to your GP to get checked out. The below is for illustrative purposes only – and does not sub out for in-person medical advice.

Let's start at the beginning. There are two main triggers for IBS: certain foods, or stress. (Or being stressed making you more sensitive to rapidly fermented foods.) So now, one of two things might be happening.

1. You've eaten, say, a butter bean stew, with lots of garlic and onion. Your food is making its way into the six metre long tube that is your small intestine.

2. You've barely slept, had to deliver a Zoom client presentation that went down badly and your fight or flight response has been triggered multiple times.

3. Work is crackers, you're fighting with your partner and you throw a breakfast of beans-on-toast into the mix.

Next, a few things might be at play.

1. Your food is in your small intestine, which is where nutrients are absorbed from your gut into your blood to feed your cells and keep you functioning hunky dory. But wait! The trigger food is not well-absorbed and heads into your large intestine. Here, it draws extra fluid into your gut.

The upshot? All of this liquid can overwhelm your body's ability to absorb even more, meaning you need to vacate your bowels, urgently.

2. Your unabsorbed foods are sitting in your large intestine. What happens now is that the bacteria that live there start to binge on it all. This creates extra gas and stretches your intestine a bit, which can give you nasty tummy pains.

3. Your stress has produced the hormone cortisol. This alters your gut movement, and causes pains.


Cramps, bloating, frequent dashes to the loo – it's all kicking off.

As soon as you feel an issue arising

Now, you should be avoiding large meals. Have several smaller plates rather than one huge dinner, for example, to help to ease the pressure on your gut. You should be avoiding sugar-free chewing gum and drinks, as the sweetener they contain can play with your gut, further, causing even more extra fermentation and gas.

Step away from tight clothes, so that your gut isn't restricted. If you've got intense tummy pain, try a heat pack. If your IBS is stress-related, it might help to try out a five-minute breathing exercise (I recommend Headspace or Calm).

One other tip? If you've got a load of trapped wind, try going for a walk outside and, erm, trying to deflate.

You're probably out of the woods, now. Well done. Your bacteria are full; the extra fluid has subsided; the stress messages from your gut to your brain are less frequent.

Sharp pains have chilled, you've got more control over your bowels, your tummy starts to get flatter. But know that your gut is still sensitive, so don't go and eat a massive plate of pasta. Do not push it.

You should be back to normal. Again, stay chill – no tight gym clothes, no sugar-protein bars. Try some slow yoga moves for your gut, maybe learn how to meditate.

Short story: it's a gastrointestinal disorder that involves a mix of bloating, cramping, tummy pain, trapped wind, constipation (delete as appropriate.)

The underlying mechanism with IBS appears to be a communication issue between the gut and the brain.

1. When we get stressed, that raises our cortisol and impacts the movement of our gut – the way that it pumps our food along. For the majority of people, your intestine lining won't be sensitive enough for this to trigger cramping and pain – but if you have IBS, it might.

2. The other thing that can happen? If you eat certain foods that are rapidly fermented by bacteria, like legumes (beans and pulses), garlic and onions, then excess gas can be produced, which can stretch your intestine a little bit.

Again, if you don't have IBS, then you're not going to feel any of this going on, but if you do, you might get IBS symptoms.

Although gut pain is the cornerstone feature of IBS, there are a handful of different ways that the condition can present.

  • Diarrhoea-forward (your big issue is urgent needs to go to the loo)

  • Constipation-forward (you can't go to the loo and have intense pains and bloating)

  • Mixed (you have both loose and hard poos)

  • Unspecified (your poo looks pretty normal, but when you go to the loo, it affects your symptoms- for better or worse)

This is a super pervasive condition. Two in 10 people in the UK are living with some form of IBS. So, what gives? Well, historically no one wanted to share details about bowels, so data on how many have it was an issue – so it is possible that there are just as many cases now as there were decade ago, but we're just more open now.

But it's also likely that our 2019 lifestyles are making instances spiral. More people are stressed, there's social media weighing on our minds and making us feel more self-conscious, we sit down a lot.

Plus, if you've had a lot of antibiotics or have had a gut infection in the past, you're at risk of it developing, thanks to how these two factors can play with the balance of bacteria in your gut (AKA your gut microbiota.)

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