IBS Flare or Something More? Irritable Bowel Syndrome Symptoms and Warning Signs

Irritable bowel syndrome (IBS) is a long-term condition where the gut is extra sensitive, causing belly pain or cramping, bloating, and diarrhea, constipation, or both, that come and go. Pain often improves after a bowel movement. IBS doesn't damage the bowel, and many people manage it with diet changes, stress management and medicine. But some symptoms don't fit IBS: blood in the stool, weight loss, fever, symptoms that wake you at night, or new symptoms after age 50 all need to be checked.

Common IBS symptoms

• Belly pain or cramping, often in the lower belly, that eases after a bowel movement
• Bloating and gas
• Diarrhea, constipation, or alternating between the two
• Mucus in the stool
• A feeling of not fully emptying

IBS is often described by type: IBS with diarrhea, IBS with constipation, or mixed.

Common flare triggers

• Certain foods: for many people, high-FODMAP foods like onions, garlic, beans, wheat, some fruits, dairy and artificial sweeteners
• Fatty or fried meals, caffeine and alcohol
• Stress and anxiety
• Hormone changes around a period
• A stomach bug, which can set off IBS symptoms for weeks afterward

What helps

• Keep a food and symptom diary to find your triggers
• Eat regular, smaller meals, and slow down
• Adjust fiber: soluble fiber, like psyllium or oats, often helps; too much insoluble fiber can worsen bloating
• Drink enough water, especially in Denver's dry climate
• Move: regular exercise helps the gut
• Manage stress: therapy, relaxation techniques and sleep all help
• Ask about a low-FODMAP plan, ideally with a dietitian
• Over-the-counter options: loperamide for diarrhea, fiber or a gentle laxative for constipation, and peppermint oil capsules for cramping. Our constipation post has more.

Prescription medicines are available when these aren't enough. A primary care provider or gastroenterologist manages IBS long term.

Symptoms that aren't IBS

These need to be checked, because they can point to another cause, such as inflammatory bowel disease, celiac disease, infection or, rarely, cancer:

• Blood in the stool, or black, tarry stool
• Unintended weight loss
• Fever
• Symptoms that wake you from sleep
• Ongoing vomiting
• Anemia
• New bowel changes after age 50
• A family history of colon cancer, celiac disease or inflammatory bowel disease

What urgent care can do

For a bad flare, a clinician can examine you, check for dehydration or infection, and help with symptom relief. For new or changing symptoms, or red flags, you'll be pointed to a primary care provider or gastroenterologist for testing. Our post on lower belly pain covers other causes of pain.

At an AfterOurs clinic, a standard self-pay visit is $175, and a self-pay in-clinic visit never costs more than $330. We contract with all major commercial and government plans, including Colorado Medicaid and Medicare. See our abdominal pain page and the cost and insurance page.

Go to the ER or call 911 if you have severe or worsening belly pain, a hard or swollen belly, a lot of blood in your stool or black stool, vomiting blood, a high fever with belly pain, or signs of serious dehydration such as dizziness, confusion or no urine for 8 hours.

Where to find us

Four clinics across metro Denver, all ages welcome, se habla español:

• Hampden (Southeast Denver): 8 AM–11 PM daily
• Littleton: 8 AM–11 PM daily
• Thornton: 8 AM–11 PM daily
• Highlands: Mon–Fri 5–11 PM, Sat–Sun 8 AM–11 PM

Walk in, or book online.