This is an excerpt from a recent article I authored for the IFFGD. It appears here with permission.

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Pain, by definition, is the dominant symptom experienced by patients with irritable bowel syndrome (IBS). Three out of 4 people with IBS report continuous or frequent abdominal pain, with pain the primary factor that makes their IBS severe. Importantly, and unlike chronic pain in general, IBS pain is often associated with alterations in bowel movements (diarrhea, constipation, or both).

The standard general definition for pain is, an unpleasant sensory and emotional experience that’s associated with actual or perceived damage to the body. Pain that is shortlived is termed acute, while pain that lasts 6 months or longer is termed chronic. Chronic pain may be constant or recurring frequently for extended periods of time.

The chronic pain in IBS can be felt anywhere in the abdomen, though is most often reported in the lower abdomen. It may be worsened soon after eating, and relieved or at times worsened after a bowel movement. It is not always predictable and may change over time. People with IBS use different descriptors to explain how the pain feels; some examples include cramping, stabbing, aching, sharp or throbbing. IBS is a long-term condition that is challenging both to patients and healthcare providers. It affects 10–15% of adults. Less than half of those see a doctor for their symptoms. Yet patients with IBS consume more overall health care than those without IBS.

The primary reason people with IBS see a clinician is for relief of abdominal pain. Standard diagnostic test results are normal in people with IBS; diagnosis is based on certain symptoms that meet defined (Rome IV) criteria. How can IBS be so painful when nothing irregular shows up on tests? The answer is that IBS is a condition where the symptoms relate to alterations in normal gastrointestinal function; that is, dysregulation of brain and gut affecting both pain signals and motility (movement of the bowels). The aim of this publication is to explain this relationship between the brain and the gut in order to help those affected understand why and how pain in IBS occurs, and how it can be confidently managed.

Ten Steps for Self-Management – What You Can Do to Help Reach Your Treatment Goals:

  1. Acceptance: Accept that the pain is there. Learn all you can about your condition and it’s management; knowledge is therapeutic
  2. Get Involved: Take an active role in your care. Develop with your provider a partnership in the care. Understand your provider’s recommendations and maintain an open dialogue .
  3. Set Priorities: Look beyond your symptoms to the things important in your life – do what is important. Eliminate or reduce what is not important.
  4. Set Realistic Goals: Set goals within your power to accomplish. Break a larger goal into small manageable steps. Take the time to enjoy the success of reaching your goals.
  5. Know Your Rights with your Healthcare Provider: You have the right to be treated with respect; To ask questions and voice your opinions; To disagree as well as agree; To say no without guilt.
  6. Recognize and Accept Emotions: Mind and body are connected. Strong emotion affects pain. By acknowledging and dealing with your emotions you can reduce stress and decrease the pain.
  7. Relaxation: Stress lowers pain threshold and increases symptoms. Relaxation helps reclaim control over your body and reduces pain.Examples of relaxation options to consider (taught or guided by an expert):
  • Deep breathing exercises
  • Progressive relaxation
  • Gut-directed hypnosis
  • Yoga and Meditation


8.  Exercise: Diverts attention from your symptoms. Increases your sense of control in life. Helps you feel better about yourself.

9.  Refocus: With these steps your symptoms are no longer the center of your life. Focus on abilities not disabilities. You will then see you can live a more normal life.

10. Reach Out: Share your thoughts and feelings with your provider. Interact with family and friends in healthy ways. Support others and seek support from them as well.

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About The International Foundation for Functional Gastrointestinal Disorders (IFFGD)
The International Foundation for Functional Gastrointestinal Disorders(IFFGD) is a nonprofit education and research organization. Our mission is
to inform, assist, and support people affected by gastrointestinal (GI) disorders. Visit our websites at and or
phone 414-964-1799.

Opinions expressed are an author’s own and not necessarily those of the International Foundation for Functional Gastrointestinal Disorders (IFFGD). IFFGD does not guarantee or endorse any product in this publication nor any claim made by an author and disclaims all liability relating thereto. This article is in no way intended to replace the knowledge or diagnosis of your doctor. We advise seeing a physician whenever a health problem arises requiring an expert’s care.