This article is written by myself, a specialist digestive health dietitian, and I will be looking at all the scientific evidence to bring you answers.
What Causes IBS Pain?
The Nervous System
One theory is that the pain experienced by those with IBS is actually caused by nerves in the digestive system that are overly sensitive. In other words, what is going on in your digestive system may just be a normal digestive process but when you have IBS, your brain reads this as pain (1, 2).
This is not to say that your symptoms are just ‘in your head.’ What this means is that your body is incorrectly reading that there is pain when this is no the case.
When your body is under stress, it releases hormones, such as cortisol, which can lead to digestive symptoms (1).
Stress is thought to play a large role in IBS pain symptoms. It is known that chronic stress can increase gut permeability and modify how the pain signalling in the body works (3).
How To Control IBS Pain Symptoms
Using a fibre supplement in those that have constipation predominant IBS pain can help to relieve symptoms.
Not just any fibre will help this type of IBS. In fact, in studies, only Psyllium, methylcelluose, calcium polycarbophil and wheat dextrin have been shown to reduce symptoms (4).
‘FODMAPs’ stands for fermentable oligosaccharides disaccharides monosaccharides and polyols.
FODMAPs are different types of carbohydrates which can be found in various foods.
FODMAPs make they way through the gut, to the large bowel, where they are broken down by gut bacteria. This process is known as fermentation and produces gas.
Exactly how probiotics help IBS symptoms of pain is unclear at present. But, research is starting to suggest a role for gut bacteria in the the gut – brain axis (3).
For recommendations on which probiotics to try, see my previous article on probiotics in IBS.
There are a range of medications that can help with IBS pain symptoms, to get advice on these, speak to your doctor or pharmacist.
Peppermint oil is an extract from the mentha plant. It has been used for many years as a digestive aid and in more recent times, studies looking at its effectiveness in IBS have been carried out.
In one study, individuals with mild symptoms of IBS were given 180mg of peppermint oil 3 times a day for 4 weeks. This resulted in a reduction in IBS related pain (13).
It is thought that the effect of peppermint oil on IBS pain, comes from its ability to block calcium channels in the body (14).
Studies on peppermint oil capsules range from 225mg twice a day to 187mg four times a day (15). So it may be worthwhile starting with a lower dose and working your way up.
Given that there is a psychological element in IBS, it comes as no surprise that psychological therapies can help.
Cognitive behavioural therapy (CBT), hypnotherapy and mindfulness are all shown to have some benefit for those with IBS symptoms (16).
If you are experiencing pain in relation to your IBS, there are many different options for you. The most important thing is that you see a qualified professional to discuss the approach that you feel would suit you best.