Understanding IBS Pain Location, Triggers, and Treatments

Abdominal pain is one of the best known symptoms of irritable bowel syndrome (IBS). But IBS pain can be hard to predict. What it feels like, how it's triggered, and exactly where it's located can vary from person to person. Additionally, studies show that the severity of IBS symptoms a woman experiences may be influenced by female sex hormones.

This article explores the causes and characteristics of IBS pain and cramps. It also explains when you should see a healthcare provider for care.

Causes of IBS Pain

It's important to know what's behind IBS pain, including why it can be chronic, or long-lasting.

The pain of IBS is visceral. It comes from your internal organs—in this case, your intestines.

It is also functional, meaning there is nothing wrong with the structure of the gut to explain the pain. In other words, the pain is real even though your imaging tests may show nothing abnormal.

Central Sensitization

Over time, something called central sensitization develops. The brain begins to overreact to pain messages. It perceives mild, non-harmful sensations like digestion as painful. That's where the chronic or long-lasting pain of IBS comes from.

IBS is called a central sensitivity syndrome.

Some antidepressants, such as Elavil (amitriptyline) or Pamelor (nortriptyline), may be included in the treatment plan. These antidepressants can help keep the nerve receptors in the gut from becoming too active.

These medications also reduce anxiety, which is common in IBS. It's important to treat anxiety because it can start a cycle that ends up making gut sensitivity worse.

Understanding what to expect can help you put your pain in perspective. Even so, it's important to talk to your doctor about any abdominal pain that doesn't go away.

If your doctor doesn't know what's going on with your pain, your diagnosis might not be accurate. Your treatment plan might not be as effective as it could be as well.

What Does IBS Pain Feel Like?

Most of the time, people with IBS say the pain feels like cramps. People also report that the pain:

• Feels sharp and stabbing
• Is like a constant aching
• Is like painful spasms

Tenderness when the abdomen is touched and discomfort from bloating can also occur.

Severity

IBS pain ranges from mild and nagging to severe and crippling. For some people, pain intensity can change throughout the day, making it hard to plan daily activities.

Frequency

People with IBS have pain at least one day per week, on average. Exactly how often can vary. For some, the pain never stops. For others, it comes and goes.

Some people experience pain in spurts. They may have pain-free days, mild-pain days, or days when the pain seems almost constant.

Location

IBS pain can occur anywhere from your chest down to your pelvis, where your main digestive organs are located.

• Upper abdomen pain: This often occurs with bloating and may be worse after meals.
• Middle abdomen pain: Cramps can occur around the area of the belly button.
• Lower abdomen pain: This type of pain is more likely to be eased by a bowel movement.

Identifying where your abdominal pain is located can help tell the difference between IBS and other common digestive disorders.

For instance, if you have pain behind your chest after you eat, and it gets worse when you bend or lie down, it may be heartburn (acid reflux) rather than IBS.

If you have pain after meals below your chest but at the top of your abdomen, is likely to be indigestion.

Bear in mind that people with IBS may have acid reflux and indigestion along with IBS.

What Triggers IBS Pain?

Stress, irregular eating habits (for example, skipping meals), eating certain foods (like spicy or fatty foods), or exercising intensely can trigger IBS pain.

In the past, diagnostic criteria noted that IBS pain was "improved with defecation." However, updated criteria note that abdominal pain is simply "related to defecation." So, IBS pain could either get better or worse with a bowel movement.

Other IBS Symptoms

IBS pain and cramps can be accompanied by other symptoms, including:

• Constipation
• Diarrhea
• Mixed bowel habits (going from constipation to diarrhea)
• Passing mucus during a bowel movement
• A feeling that you haven't passed all your stool
• Bloating of the abdomen
• Looser or more frequent stools

How Women Are Affected by IBS Pain

Although symptoms of IBS can vary from person to person, the condition can affect women differently than men. Not only is IBS more common in females, but they are more likely to report severe abdominal pain and symptoms related to constipation.

It's also common for women to have more frequent and severe IBS symptoms during certain phases of their menstrual cycle, particularly during their periods. This may include worsening abdominal pain, loose stools, and bloating.

In contrast, those who are pregnant or who have completed menopause may notice improvements in their IBS symptoms.

Research suggests that female sex hormones (progesterone and estrogen) may explain this, as they can influence bowel function, pain perception, and gut flora.

How Can I Relieve IBS Pain?

If you have IBS, it's important to monitor your symptoms, daily bowel habits, and any factors that may be affecting your condition. Treatments for IBS pain may include:

• Dietary changes: This means avoiding foods that can cause gas or indigestion. Increasing fiber intake may also be beneficial.
• Medication: Certain medications such as anticholinergic drugs and low-dose antidepressants may help with IBS pain. Depending on your symptoms, other drugs may provide pain relief, such as lubiprostone, linaclotide, alosetron and eluxadoline.
• Psychosocial therapy: Cognitive behavioral therapy (CBT) or hypnotherapy can be an effective way to help individuals cope with unpleasant IBS symptoms.

When to Call Your Healthcare Provider

If you have abdominal pain with a loss of appetite, malnutrition, or weight loss, it is vital that you contact your healthcare provider right away.

Pain that gets worse over time or wakes you up from sleep may not be IBS. If you have pain that is progressing, you need a prompt medical evaluation.

Moreover, if your pain is unusually severe and does not feel like your typical IBS pain, you may need to seek immediate medical attention.

Some signs that you need to get to a hospital immediately include:

• Your abdomen is extremely hard or tender to the touch
• You have rectal bleeding or bloody diarrhea
• You are having trouble breathing or chest pain
• You are coughing up or vomiting blood
• You are having severe pain in your neck or between your shoulder blades
• You can't stop vomiting

IBS Doctor Discussion Guide

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

Download PDF

Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life.

Email Address

Sign Up

You're in!

Thank you, {{form.email}}, for signing up.

There was an error. Please try again.

Summary

IBS pain varies from one person to the next. Long-term pain is caused by over-active nerve receptors sending pain messages from your intestines to your brain—even when your body is just carrying out its normal digestive activities. Over time, the brain becomes very sensitive to these pain signals.

Where the pain is, how severe it feels, how often it happens, and what triggers it can be different in different people. Your own symptoms can also change from day to day.

Seek immediate medical care if your pain becomes severe, doesn't feel like your usual symptoms, or comes with bleeding, vomiting, or breathing problems.