The chronic pain (pain lasting 6 months or longer) in IBS can be felt anywhere in the abdomen (belly), though is most often reported in the lower abdomen.
SYMPTOMS ALL OVER THE BODY IN IBS
For example, four studies that have asked IBS patients about a wide variety of body symptoms(1-4) all found headaches (reported by 23-45% of IBS patients), back pain (28-81%), and frequent urination (20-56%) to be unusually common in individuals with IBS compared to other people.
IBS pain is often described as cramping. It can also be burning, stabbing, or aching in nature. One of the important aspects of typical IBS pain is related to bowel movement (defecation or passing gas). Typically, the pain would improve with a bowel movement, but it can worsen with a bowel movement or passing gas.
Abdominal pain in IBS is protean, but may have the following characteristics: Pain frequently is diffuse without radiation. Common sites of pain include the lower abdomen, specifically the left lower quadrant.
Patients with IBS typically present with abdominal pain and cramping. The pain can be located in the upper quadrants (right and/or left) of the abdomen or it can be diffuse in nature. Patients often have a difficult time describing the pain quality.
IBS attacks can strike anytime, but usually and with greater intensity after a meal. The average duration of an IBS flare-up is two to four days, however, they can last anywhere between a few hours to a couple of months at a time.
Your Stomach Hurts Often
In addition to stomach pain, you may notice your chest appearing bloated and full under your ribs. Your abdomen may feel very tender to the touch and may gurgle and make ample noise as your body struggles to work through the digestion of food intake.
As well as the main symptoms described above, some people with IBS experience a number of other problems. These can include: a lack of energy (lethargy) feeling sick.
The symptoms of IBS may be constant, or they can come and go. There may even be times when it seems your tummy woes have disappeared. Then IBS symptoms flare up again.
Pain is a common feature of IBS. This can appear in the stomach, the lower abdomen as well as in the back and can be related to several factors. These include levels of gas being produced in the gut, bowel movements (eg constipation) as well as the functioning of the diaphragm and sleep quality.
Pain in IBS can arise almost anywhere below the rib cage.
Pain below your ribs can be caused by your GI tract, like GERD, indigestion, gallbladder disease, or constipation, or problems with your lungs, like pneumonia. You may also have nausea, bloating, chest pain, coughing, or pain that's worse when you breathe in.
Pain arising from the abdominal muscles is frequently overlooked as a prime cause for abdominal pain. There is an interesting link between IBS and Trigger Points in the Abdominal Muscles. The same nerves that supply the small and large intestines also supply the abdominal muscles.
Linaclotide (Linzess®) and Plecanatide (Trulance®) work by increasing fluid secretion and gut movement. Both have also been shown to reduce abdominal pain by decreasing activity of pain sensing nerves. Both drugs treat overall IBS-C symptoms and are FDA approved for the treatment of IBS-C and CIC.
Generally, a flare up of irritable bowel syndrome can last from a few hours to several days. However, it is not uncommon for some people to experience symptoms for weeks or even longer.
In people with IBS, the colon muscle tends to contract more than in people without the condition. These contractions cause cramps and pain. People with IBS also tend to have a lower pain tolerance. Research has also suggested that people with IBS may have excess bacteria in the GI tract, contributing to symptoms.
Conventional analgesic drugs, such as paracetamol, non-steroidal anti-inflammatory drugs and opiates are unlikely to relieve pain in IBS, and some have the potential to exacerbate gastrointestinal symptoms.
“I sometimes tell patients to stay away from ibuprofen (like Advil® or Motrin®) and naproxen (like Aleve®) because they can cause stomach discomfort,” says Dr. Tosch. “Over long periods of time, they can cause ulcers. If you need something for pain, Tylenol® (acetaminophen) is the best option.”
As many as half of people with IBS experience fatigue or exhaustion. A 2016 review found that fatigue occurred alongside other IBS symptoms, including bowel-related symptoms, psychological distress, and health-related impacts on quality of life. It was also found to be more common among younger females.
A definitive diagnostic lab test for IBS does not exist. IBS cannot be seen on an ultrasound, CT scan, MRI, or colonoscopy. Patients who see a gastroenterologist for abdominal pain will often have testing and imaging (most commonly an ultrasound or a CT scan) completed to rule out other causes of abdominal pain.