It is important for people with IBS to understand that while pain is felt in different areas of the body, it is actually processed in the brain. Research into IBS shows that pain may be caused by oversensitive nerves in the gut. These nerves send signals to the brain, telling it to overreact to physical stimuli or tell the brain that normal digestion sensations are 'painful. Millions of nerves and neurons run between the gut and the brain, along a neural highway called the gut-brain axis.
This means that the brain can feel what's happening in the gut and that the gut can feel what's happening in the brain which is why we sometimes feel 'butterflies' in our stomach when we're nervous! The brain doesn't just receive information about pain; it can also influence the information coming from the gut.
When oversensitized nerves in the gut start miscommunicating with the brain, it may then cause the brain to overestimate or modify the information coming from the gut—causing more pain to be registered.
This explanation for increased pain is called the gate control theory of pain. Abdominal pain is a frequently reported symptom of IBS and can be accompanied by nausea, abdominal tenderness, and bloating. Abdominal pain from disordered defecation can also be caused by psychological factors , like stress or anxiety. During moments of stress, the sympathetic nervous system diverts blood flow, from the gut which slows its function. This "fight or flight'' nervous system response can also be activated when the body feels pain signals like gas pain or contraction of gut muscles , which can slow digestion, causing constipation and more pain.
IBS abdominal pain usually isn't restricted to one specific area of the gut; it may move from place to place and can vary in intensity.
Abdominal pain may occur after eating, during times of stress, or during a woman's monthly period. A buildup of gas in the gut can be extremely painful.
Gas pain is most often felt in your abdomen and can feel as mild as light cramping or as intense as a sharp stabbing pain. IBS abdominal pain may be caused by an increased sensitivity to gas rather than an increased production of gas. Contrary to what your bloating seems to be telling you, people with IBS usually do not produce more intestinal gas than people without IBS.
For people with IBS, gas can become trapped, leading to bloating and pain. A study summarized three reasons people with IBS might experience more bloating and gas pain than people without gut troubles, such as having:. Hypnotherapy for IBS has been shown to help people decrease the sensitivity of nerves in their gut and reduce gas pain and discomfort without medication or diets.
Additionally, hypnotherapy products, like Nerva , allow people to access IBS hypnotherapy programs at home for a more accessible cost than in-person hypnosis sessions. Back pain is not a symptom that many people would associate with IBS, but it commonly is experienced as a result of gas buildup and colonic spasms. While the exact cause of this pain is unknown, some experts believe that back pain from IBS may be 'referred pain.
Referred back pain in IBS means that the pain originates from another part of the body such as the gut and is felt in the back. Other examples of referred pain are when a heart attack causes pain in the jaw or when or menstrual cramps cause back pain. People with IBS may also experience back pain as they are more likely to have other conditions associated with backaches, such as rheumatoid arthritis, interstitial cystitis a painful bladder condition , and fibromyalgia a condition marked by muscle pain and stiffness.
Sometimes chest pain can be a symptom of a more serious condition, like coronary artery disease, though, for people with IBS, chest pain may be a symptom of trapped gas. While gas pains are more typically associated with discomfort in the lower abdomen, you may feel gas pains in your chest when gas becomes trapped in your stomach or in the left portion of your colon.
Another reason why people with IBS may be experiencing chest pains is that they are also four times more likely to experience gastroesophageal reflux disease GERD, also known as chronic acid reflux or heartburn.
In a study published by the World Journal of Gastroenterol ogy , Dr. Nicola de Bortoli suggests that motor abnormalities impaired muscle movements along the GI tract, including the esophagus, stomach, and intestines, might explain the overlap between IBS and GERD.
How can an irritable gut make your head irritable too? Head pain and gut pain may seem like an unlikely pair, but science shows that people with IBS also commonly experience migraines and headaches.
A study published in the Polish Journal of Neurology and Neurosurgery showed that between 23 to 53 percent of people with IBS experienced frequent headaches. The connection between the gut and the head works both ways. Just as people with IBS often have headaches, people with migraines often experience gastrointestinal symptoms associated with IBS such as nausea, vomiting, abdominal pain, or diarrhea during a migraine attack.
While the exact reason is unknown, one theory is that it's the result of the relationship between the gastrointestinal system and the central nervous system— also known as the gut-brain axis.
The vagus nerve, the longest cranial nerve in the body, connects the brain to the gut along the gut-brain axis. This nerve sends communications bi-directionally, meaning it can relay pain signals and information from the brain to the gut and vice versa.
Because the vagus nerve is involved in both migraine pain and IBS symptoms, it's often thought to be implicated in the overlapping symptoms. An upside to the gut-brain connection is that it works both ways.
So, while it's unfortunate that what happens in your gut can affect your head, there is evidence that what happens in your mind can also affect what in your gut. This is why treatments like hypnotherapy for IBS may effectively relieve IBS and headache symptoms without the need for drugs or diets. IBS can be such a pain in the The research suggests that people with IBS are at a greater risk of experiencing joint and face pain due to a higher likelihood of experiencing other centralized chronic pain conditions.
One recent study showed that people with any subtype of IBS were three times more likely to experience pain and compromised movement of the jaw joint and the surrounding muscles due to Temporomandibular disorders TMDs. When pain is chronic it takes time for it to go away. Because pain is an emotional experience, taking steps to improve emotions can lead to reduction of the harmful effects of the pain even when it is still present.
Maintaining an active role in life, engaging in physical activity, and addressing emotional and social health are important to help promote a sense of well-being, which counters negative expectations. Learn more about psychological approached in managing IBS. Here are 10 things you can do to help reach treatment goals :.
There are two levels to taking one of these agents. The second level is the neurogenesis, and that can take six months to a year or more. This is important to help prevent the pain from coming back, or relapsing.
The two effects are the physiologic effect of the pain control through the gating mechanism, and the neuroplastic effect through the brain to regrow those nerves that have been damaged by the chronic pain. A gastroenterologist who works in neurogastroenterology addressing the brain-gut axis, or a primary care doctor who knows how to work with chronic pain is usually best to treat IBS pain. They may work with a multi-disciplinary team of therapists. Finding and working with a patient-centered healthcare provider familiar with the concepts presented here will help ensure the best care for chronic pain and other symptoms of IBS.
Be on the alert for pain management clinics that use opioids as treatment, which are not a treatment for IBS and may worsen symptoms. Pain is the dominant symptom of IBS. Like all functional gastrointestinal disorders, IBS is a disorder of brain—gut interactions. This understanding of the brain—gut connection is essential, not only to the cause of the chronic pain, but also to its treatment.
There is no cure for pain in IBS. However, there are a few options that can reduce and control the pain. These include self management, psychological approaches, and medications. Opioids are not a treatment for IBS pain; there is no evidence of long-term benefit.
Finding and working with a patient-centered healthcare provider familiar with these concepts will help ensure the best available care for the chronic pain and other symptoms of IBS. Drossman, M. Adapted by Abigale Miller.
For healthcare providers Here is a video of a presentation by Douglas A. Acknowledgment We are grateful to The Allergan Foundation for a health and human services educational grant in support of this publication. IFFGD is a nonprofit education and research organization. Our mission is to inform, assist, and support people affected by gastrointestinal disorders. Our original content is authored specifically for IFFGD readers, in response to your questions and concerns.
If you found this article helpful, please consider supporting IFFGD with a small tax-deductible donation. A comorbidity is when two or more conditions or diseases are present at the same time in a patient.
For example, it is not at. The goal of taking medications to treat an illness is to make us feel better. When we are feeling ill and are looking for relief,. Many people use complementary and alternative medicine CAM in pursuit of health and well-being. The guidelines from the American College of Gastroenterology suggest trying a diet low in fermentable oligosaccharides, disaccharides, monosaccharides, and polyol carbohydrates.
A study published in March in the Journal of Human Nutrition and Dietetics found that a low-FODMAP regimen reduced abdominal pain by 62 percent, and bloating , gas, and a sense of urgency to go by half. Furthermore, the patients following a low-FODMAP diet continued to feel better nearly a year after starting the diet and drastically reduced the number of times they needed to see their doctor. Knowing exactly how to follow a low-FODMAP diet can be tricky because it eliminates so many foods that may be staples for you.
Whatever exercise you like to do is what you should do, advises Riehl. When you run, bike, swim, or simply go for a walk, you lower your levels of cortisol — your stress hormone — and you boost mood-enhancing endorphins. That combination works wonders on the tummy and helps relieve IBS symptoms. A study published in January in the Journal of Bodywork and Movement Therapies found that people with IBS who spent 30 minutes on a treadmill just three times per week improved the severity of their symptoms and their quality of life.
IBS can produce a vicious cycle of digestive symptoms that increase anxiety and anxiety that increases digestive symptoms. Tackling anxiety can help reduce other symptoms. If you have symptoms of IBS that interfere with your quality of life, visit a primary care doctor near you, who can help diagnose IBS and rule out other diseases that mimic it. IBS is diagnosed by recurrent abdominal pain for at least 6 months, combined with weekly pain for 3 months as well as some combination of pain relieved by bowel movements and changes in frequency or form of bowel movements.
Your doctor may refer you to a gastroenterologist, a specialist in digestive diseases, who can help you identify triggers and discuss ways to control your symptoms.
Lifestyle changes, such as a low-FODMAPs diet , stress relief, exercise, drinking plenty of water and over-the-counter laxatives can also help.
Identifying other trigger foods can be difficult, as these are different for each person. Keeping a diary of meals and ingredients can help identify triggers 38 , 39 , Probiotic supplements may also reduce symptoms Additionally, avoiding digestive stimulants, such as caffeine, alcohol and sugary beverages, can reduce symptoms in some people If you think you have IBS, consider keeping a journal of foods and symptoms.
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