When you haveirritable bowel syndrome(IBS), you may think your abdominal pain under the ribs is from trapped intestinal gas. But some of it may come from other sources.
Intestinal gasresults from the activity of gut bacteria on food. An aspect of IBS calledvisceral hypersensitivityheightens pain in your digestive tract. That means the pressure from gas can become quite painful.
However, trapped gas isn’t the only thing that causes abdominal pain in IBS.This article looks at other causes, how to tell gas from other IBS pain, and what to do about it.
Verywell / Cindy Chung
Causes of IBS Pain
The causes of abdominal pain in IBS aren’t well understood. What’s clear is that your brain and your gut work together in a complex way.
That interaction can cause visceral hypersensitivity even when you don’t have gas. That’s especially true if you’re under a lot ofstress.
Another key factor in IBS ismotility dysfunction—colon contractions that are too fast or too slow. That leads to diarrhea (too fast) and constipation (too slow).
Motility dysfunction can also cause painful cramping or spasms in the large intestinal muscles.Complicating matters, pain from deep inside the body can radiate away from the original site. So it may not be clear where your pain is coming from.
When Is Constipation Considered an Emergency?
Causes of Gas Pain
Foods
Some types of carbohydrates—sugars, starches, and fiber—aren’t fully digested in the stomach and small intestine. Some containfermentable oligosaccharides, disaccharides, monosaccharides, and polyols(FODMAPs). These undigested carbohydrates will pass to your large intestine, where bacteria break them down and create gas.
Foods that are more likely to cause gas include:
Medications
Although less common, gas can be a side effect of certain medications and supplements, including antibiotics, antacids, Questran (cholestyramine), Xenical (orlistat), and supplements (fiber, iron, and multivitamins).
Health Conditions
Along with IBS, there are other health conditions that may cause gas, including:
Is It Trapped Gas or IBS?
One way to distinguish gas pain and other types of IBS pain is to look at symptoms and causes.They can be fairly distinct.
If you’ve eaten gassy foods, are constipated, passing gas, or pain moves around, it’s likely gas. Other IBS pain tends to hit when you’re stressed, cover wider areas, and have a cramping feel to it.
GasPain shifts (from upper abdomen to chest or rib cage, for example)Constipation/infrequent bowel movementYou’re passing windYou recently ate gassy foodsIBSPain is widespread—as if large parts of your colon are hurtingPain radiates upwardCramps/feeling like your colon is spasmingYou’re anxious or under stress
GasPain shifts (from upper abdomen to chest or rib cage, for example)Constipation/infrequent bowel movementYou’re passing windYou recently ate gassy foods
Pain shifts (from upper abdomen to chest or rib cage, for example)
Constipation/infrequent bowel movement
You’re passing wind
You recently ate gassy foods
IBSPain is widespread—as if large parts of your colon are hurtingPain radiates upwardCramps/feeling like your colon is spasmingYou’re anxious or under stress
Pain is widespread—as if large parts of your colon are hurting
Pain radiates upward
Cramps/feeling like your colon is spasming
You’re anxious or under stress
Managing IBS and Gas Pain
Once you know the source of your pain, you can take steps to alleviate it.
When to See a Healthcare Provider
You should talk with a healthcare provider if you have:
Summary
Not all IBS pain comes from trapped gas. Visceral hypersensitivity, motility dysfunction, and intestinal muscle spasms also cause pain.
Gas paintends to be food-related. It involves shifting location, passing wind, and constipation or infrequent bowel movements. Other IBS pains tend to be stress-related, widespread, radiate upward, and feel crampy.
To relieve IBS pain, don’t sit on the toilet for long spells, don’t strain, try a low-FODMAP diet, learn to relax, and look into anti-spasmodic medications or peppermint supplements.
9 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Seo AY, Kim N, Oh DH.Abdominal bloating: pathophysiology and treatment.JNeurogastroenterol Motil. 2013;19(4):433-53. doi:10.5056/jnm.2013.19.4.433Farzaei MH, Bahramsoltani R, Abdollahi M, Rahimi R.The role of visceral hypersensitivity in irritable bowel syndrome: Pharmacological targets and novel treatments.J Neurogastroenterol Motil. 2016;22(4):558-574. doi:10.5056/jnm16001Cleveland Clinic.Irritable bowel syndrome (IBS).National Institute of Diabetes and Digestive and Kidney Diseases.Symptoms and causes of gas in the digestive tract.Harvard Medical School.Flatulence (gas).Lacy BE, Gabbard SL, Crowell MD.Pathophysiology, evaluation, and treatment of bloating: hope, hype, or hot air?.Gastroenterol Hepatol (N Y). 2011;7(11):729-39.Capili B, Anastasi JK, Chang M.Addressing the role of food in irritable bowel syndrome symptom management.J Nurse Pract. 2016;12(5):324-329. doi:10.1016/j.nurpra.2015.12.007Grundmann O, Yoon SL.Complementary and alternative medicines in irritable bowel syndrome: an integrative view.World J Gastroenterol. 2014;20(2):346-62. doi:10.3748/wjg.v20.i2.346Alammar N, Wang L, Saberi B, et al.The impact of peppermint oil on the irritable bowel syndrome: a meta-analysis of the pooled clinical data.BMC Complement Altern Med. 2019;19(1):21. doi:10.1186/s12906-018-2409-0Additional ReadingFashner J, Gitu AC.Common gastrointestinal symptoms: Irritable bowel syndrome.Family Practice Essentials. 2013;413:16-23.
9 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Seo AY, Kim N, Oh DH.Abdominal bloating: pathophysiology and treatment.JNeurogastroenterol Motil. 2013;19(4):433-53. doi:10.5056/jnm.2013.19.4.433Farzaei MH, Bahramsoltani R, Abdollahi M, Rahimi R.The role of visceral hypersensitivity in irritable bowel syndrome: Pharmacological targets and novel treatments.J Neurogastroenterol Motil. 2016;22(4):558-574. doi:10.5056/jnm16001Cleveland Clinic.Irritable bowel syndrome (IBS).National Institute of Diabetes and Digestive and Kidney Diseases.Symptoms and causes of gas in the digestive tract.Harvard Medical School.Flatulence (gas).Lacy BE, Gabbard SL, Crowell MD.Pathophysiology, evaluation, and treatment of bloating: hope, hype, or hot air?.Gastroenterol Hepatol (N Y). 2011;7(11):729-39.Capili B, Anastasi JK, Chang M.Addressing the role of food in irritable bowel syndrome symptom management.J Nurse Pract. 2016;12(5):324-329. doi:10.1016/j.nurpra.2015.12.007Grundmann O, Yoon SL.Complementary and alternative medicines in irritable bowel syndrome: an integrative view.World J Gastroenterol. 2014;20(2):346-62. doi:10.3748/wjg.v20.i2.346Alammar N, Wang L, Saberi B, et al.The impact of peppermint oil on the irritable bowel syndrome: a meta-analysis of the pooled clinical data.BMC Complement Altern Med. 2019;19(1):21. doi:10.1186/s12906-018-2409-0Additional ReadingFashner J, Gitu AC.Common gastrointestinal symptoms: Irritable bowel syndrome.Family Practice Essentials. 2013;413:16-23.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Seo AY, Kim N, Oh DH.Abdominal bloating: pathophysiology and treatment.JNeurogastroenterol Motil. 2013;19(4):433-53. doi:10.5056/jnm.2013.19.4.433Farzaei MH, Bahramsoltani R, Abdollahi M, Rahimi R.The role of visceral hypersensitivity in irritable bowel syndrome: Pharmacological targets and novel treatments.J Neurogastroenterol Motil. 2016;22(4):558-574. doi:10.5056/jnm16001Cleveland Clinic.Irritable bowel syndrome (IBS).National Institute of Diabetes and Digestive and Kidney Diseases.Symptoms and causes of gas in the digestive tract.Harvard Medical School.Flatulence (gas).Lacy BE, Gabbard SL, Crowell MD.Pathophysiology, evaluation, and treatment of bloating: hope, hype, or hot air?.Gastroenterol Hepatol (N Y). 2011;7(11):729-39.Capili B, Anastasi JK, Chang M.Addressing the role of food in irritable bowel syndrome symptom management.J Nurse Pract. 2016;12(5):324-329. doi:10.1016/j.nurpra.2015.12.007Grundmann O, Yoon SL.Complementary and alternative medicines in irritable bowel syndrome: an integrative view.World J Gastroenterol. 2014;20(2):346-62. doi:10.3748/wjg.v20.i2.346Alammar N, Wang L, Saberi B, et al.The impact of peppermint oil on the irritable bowel syndrome: a meta-analysis of the pooled clinical data.BMC Complement Altern Med. 2019;19(1):21. doi:10.1186/s12906-018-2409-0
Seo AY, Kim N, Oh DH.Abdominal bloating: pathophysiology and treatment.JNeurogastroenterol Motil. 2013;19(4):433-53. doi:10.5056/jnm.2013.19.4.433
Farzaei MH, Bahramsoltani R, Abdollahi M, Rahimi R.The role of visceral hypersensitivity in irritable bowel syndrome: Pharmacological targets and novel treatments.J Neurogastroenterol Motil. 2016;22(4):558-574. doi:10.5056/jnm16001
Cleveland Clinic.Irritable bowel syndrome (IBS).
National Institute of Diabetes and Digestive and Kidney Diseases.Symptoms and causes of gas in the digestive tract.
Harvard Medical School.Flatulence (gas).
Lacy BE, Gabbard SL, Crowell MD.Pathophysiology, evaluation, and treatment of bloating: hope, hype, or hot air?.Gastroenterol Hepatol (N Y). 2011;7(11):729-39.
Capili B, Anastasi JK, Chang M.Addressing the role of food in irritable bowel syndrome symptom management.J Nurse Pract. 2016;12(5):324-329. doi:10.1016/j.nurpra.2015.12.007
Grundmann O, Yoon SL.Complementary and alternative medicines in irritable bowel syndrome: an integrative view.World J Gastroenterol. 2014;20(2):346-62. doi:10.3748/wjg.v20.i2.346
Alammar N, Wang L, Saberi B, et al.The impact of peppermint oil on the irritable bowel syndrome: a meta-analysis of the pooled clinical data.BMC Complement Altern Med. 2019;19(1):21. doi:10.1186/s12906-018-2409-0
Fashner J, Gitu AC.Common gastrointestinal symptoms: Irritable bowel syndrome.Family Practice Essentials. 2013;413:16-23.
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