Treating Irritable Bowel Syndrome (IBS) Abdominal Pain

Abdominal pain is a common symptom of irritable bowel syndrome (IBS). According to a survey of 1,966 people with IBS by the International Foundation for Functional Gastrointestinal Disorders, 80% of people with IBS report that pain is what makes their condition severe.

Pain is a serious quality of life issue, causing many people with IBS to miss work, school, and social events. Fortunately, a lot of treatment options are available to help you feel and function better.

Why Pain Happens

The abdominal pain experienced by people with IBS could be the result of intestinal contractions. The muscles in the colon contract (which is called peristalsis) to move stool along and out of the body.

For people who have IBS, these muscles may be contracting irregularly and intermittently along the length of the colon. This is a suspected cause of some of the hallmark symptoms of IBS, including abdominal pain, bloating, and gas. Pain typically occurs most commonly after a meal and may last for several hours.

Finding the Source of Pain

Keeping a food diary can help you figure out if certain foods are contributing to your abdominal pain. Recording everything you eat and including such details as where, when, and with whom meals are eaten can help you find any potential "triggers" for abdominal pain.

You can then take your food diary to appointments with your healthcare provider or nutritionist, and they may be able to help you spot patterns and root out your problem foods.

If you can't prevent abdominal pain by identifying and avoiding triggers, you have several options for coping with it.

Home Remedies

Not every IBS abdominal-pain treatment requires a healthcare provider and a prescription. Some common home remedies are peppermint oil and a heating pad.

Peppermint Oil

A natural antispasmodic, peppermint can also help reduce spasms in the colon. You can take peppermint oil in either capsule form or as a tea.

While the capsules are more effective and have even been approved for use in IBS in Germany, they can cause anal irritation. Additionally, peppermint also relaxes the muscles in the esophagus and can contribute to heartburn caused by acid reflux. Talk to your healthcare provider before taking any peppermint oil supplements.

American College of Gastroenterology guidelines published in 2021 recommend peppermint oil for alleviating abdominal pain and overall IBS symptoms. However, the authors did state that the quality of the available evidence was low and that further study is needed.

Heating Pad

A simple and inexpensive way of treating abdominal pain is with a home heating pad. Heat can help soothe cramping muscles and provide a source of comfort. Some tips to remember are:

• Never use a sports cream product (such as Icy Hot or Ben-Gay) with a heating pad as it can cause severe burns.
• Don't fall asleep with the heating pad on.
• Never use a heating pad on bare skin.

Medications

Two types of medications are commonly given for IBS: antispasmodics and antidepressants.

Antispasmodics

Antispasmodics such as dicyclomine, Levsin (hyoscyamine) and ​Donnatal (belladonna/phenobarbital) are a class of drugs that are often prescribed to treat IBS symptoms. These drugs can relax the muscles of the stomach and intestines, which could provide some relief from abdominal pain.

To be effective, antispasmodics should be taken 30 to 60 minutes before a meal. Common side effects include:

• Blurred vision
• Constipation
• Decreased sweating
• Dizziness
• Headache
• Nausea
• Urinary problems

The ACG guidelines recommend against using antispasmotics due to a lack of evidence that they're effective.

Antidepressants

Tricyclic antidepressants such as Elavil (amitriptyline), nortriptyline, and Tofranil (imipramine) are prescribed to people with IBS in order to treat abdominal pain. These drugs are recommended by the ACG 2021 guidelines.

Antidepressants seem to be more helpful when taken at night for people with diarrhea-predominant IBS (D-IBS). It may take several weeks of treatment with an antidepressant before it has an effect on abdominal pain.

A Word From Verywell

Pain is a significant problem for people with IBS. If pain is preventing you from going to work or school or doing the things you love, talk to your healthcare provider about getting it treated. There are several options available for relieving pain from IBS.

Everyone with IBS deserves relief from pain. It may take some time to figure out how to treat the pain (or prevent it in the first place), but it's worth the effort to get back to living your life.