IBS pain: triggers, location, and time to seek care


Abdominal pain is one of the best known symptoms of irritable bowel syndrome (IBS). But pain in IBS is difficult to predict. How you look and where you are can vary from person to person.

This article explores the causes and characteristics of pain in IBS. It also tells you when to contact your healthcare provider for help.

Get Medication Information / Brianna Gilmartin

The biology of pain in IBS

It is important to know what is behind the pain of IBS, including how it becomes chronic or long-lasting.

Pain in IBS is visceral in nature. It comes from your internal organs, in this case, your intestines. It is also functional, which means that there is nothing wrong with the structure of the intestines to explain pain. In other words, the pain is real even though imaging tests can show a normal bowel appearance.

In people with IBS, normal amounts of gas or bowel movements trigger pain-sensitive nerve receptors in the intestines more often than usual. These hypersensitive receptors send messages to your brain that inform you about pain.

Over time, so-called central sensitization develops. The brain begins to react sharply to pain messages. You perceive light and harmless sensations, such as digestion, as painful. This is where chronic or long-term pain in IBS comes from.

IBS is called central sensitivity syndrome . Some antidepressants , such as elavil (amitriptyline) or pamelor (nortriptyline), can be included in your treatment plan. These antidepressants can help prevent overactive nerve receptors in the gut.

These medications also reduce the anxiety that is common with IBS. Treating anxiety is very important because it can set off a cycle that will ultimately make your gut sensitivity worse.

Understanding what to expect will help you put your pain in perspective. However, it is important to speak with your doctor about any abdominal pain that persists.

If your doctor doesn't know what's going on with your pain, his or her diagnosis may be inaccurate. Your treatment plan may not be as effective.

Pain characteristics

In most cases, people with IBS say that the pain is similar to spasms. People also report pain similar to:

  • Sharp and sharp
  • Constant pain
  • Painful cramps
  • Pain when touching the abdomen.
  • Swelling discomfort


Pain in IBS ranges from mild and bothersome to severe and paralyzing. For some people, the intensity of pain can change throughout the day, making it difficult to plan daily activities.


On average, people with IBS experience pain at least one day a week. The exact frequency may vary. For some, the pain never stops. For others, it comes and goes.

Some people experience severe pain. They may have days without pain, days with mild pain, or days when the pain seems almost constant.


Pain caused by irritable bowel syndrome can occur anywhere from the chest to the pelvis, where the major digestive organs are located.

Here's a breakdown of irritable bowel syndrome pain by location:

  • Upper abdominal pain : common with bloating and may be worse after eating.
  • Pain in the middle of the abdomen : cramps can occur in the navel area.
  • Lower abdominal pain : This type of pain is likely to be relieved by having a bowel movement.

Determining where your stomach pain is can help distinguish IBS from other common digestive disorders .

For example, if you have chest pain after eating and it is worse when you bend over or lie down, it could be heartburn (acid reflux), not IBS.

If, after eating, you feel pain below the chest, but in the upper abdomen, it is most likely an upset stomach .

Keep in mind that people with IBS can have acid reflux and an upset stomach along with their usual IBS symptoms .


Stress, eating irregularly (such as skipping meals), eating certain foods (such as spicy or fatty foods), or intense exercise can cause pain with IBS.

Having a bowel movement can also make IBS pain worse in some people.

You may be surprised to learn that the pain caused by irritable bowel syndrome can be worse when you have a bowel movement. After all, the Rome III criteria that were used to classify functional gastrointestinal disorders say that IBS pain "subsides with bowel movements."

However, the updated Rome IV diagnostic criteria state that abdominal pain is simply "associated with defecation." This means that when you have a bowel movement, the pain may lessen or lessen.

Other symptoms

IBS can also cause symptoms such as:

When to call your healthcare provider

If you experience abdominal pain associated with loss of appetite, malnutrition, or weight loss, it is very important that you contact your healthcare professional immediately.

Pain that gets worse over time or wakes you up from sleep may not be IBS. If your pain progresses, you should have a medical exam right away.

Also, if your pain is unusually severe and doesn't feel like normal IBS pain, you may need immediate medical attention.

Some signs that you need to go to the hospital right away include:

  • Your belly is very hard or tender to the touch.
  • You have rectal bleeding or bloody diarrhea.
  • You have trouble breathing or chest pain.
  • You cough or vomit blood.
  • You have severe pain in your neck or between your shoulder blades.
  • You can't stop vomiting.

Irritable Bowel Syndrome Doctor Discussion Guide

Get our printable guide to your next doctor's appointment to help you ask the right questions.


The pain caused by irritable bowel syndrome varies from person to person. Long-term pain is caused by overly active nerve receptors that send pain messages from the gut to the brain, even when your body is doing its normal digestive activities. Over time, the brain becomes very sensitive to these pain signals.

Where the pain is, how strong it is, how often it occurs and what causes it, can vary from person to person. Your own symptoms can also change from day to day.

It is important to notice changes because other medical conditions can cause abdominal pain. If the pain becomes severe, does not feel like a normal symptom, or is accompanied by bleeding, vomiting, or breathing problems, you should seek immediate medical attention.

Get the word of drug information

If you find out about your pain, you will be able to cope better. If pain affects your quality of life or interferes with your daily activities, talk to your doctor.

The good news is that there are many treatments for IBS, including diet changes and medications that can relieve symptoms. Cognitive behavioral therapy is another good option. It can help you manage pain and other symptoms of IBS.

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