What Does IBS Feel Like? IBS Pain And Symptoms Explained

Irritable bowel syndrome (IBS) affects between 7% and 16% of the population in the US¹. Although the disease is not associated with significant mortality, it can be debilitating, challenging, and severely impact the lives of people who suffer from it.

IBS is linked to numerous symptoms, and yet it affects everyone who suffers from it differently. It can be unpredictable and confusing. If you think you are experiencing IBS, you likely have many questions - such as “what does IBS pain feel like?” and “what are the symptoms of IBS?”. In addition to understanding IBS symptoms, you also need to know when to see a doctor about IBS.

Read on to find out what IBS pain feels like and other symptoms to be aware of.

IBS pain explained

IBS can cause significant pain and discomfort. Not all the mechanisms for how it causes pain are understood, but we do know some of the contributing factors.

IBS pain is visceral pain. That means that it arises from an organ — in this case, the intestines and colon.

Visceral pain can be triggered by pressure, inflammation, or injury. Chronic low-grade inflammation of the colon is thought to lead to immune cell activation along the colon wall. Activated immune cells interfere with the release of serotonin in the gut, which normally regulates sensation and the contractions that transfer waste.

When serotonin levels are unregulated, the gut becomes hypersensitive to impulses, and normal gut activity is disrupted. This means that if you have IBS, you may perceive “normal” bloating and peristalsis (contractions of the intestine’s muscles that move waste along) as painful. It might also take more or less time for waste to move through your colon, leading to diarrhea or constipation, respectively².

On top of this, IBS is often associated with increased gas production. Diets rich in high-FODMAP foods can cause excessive gas production as fermentable fiber is broken down by bacteria. In people who are already hypersensitive, the bloating caused by excess gas can go from causing discomfort to causing pain³ ⁴.

But there may be another contributing factor that explains why the pain from IBS is so debilitating.

IBS is classified as a central sensitivity syndrome. This is a group of syndromes in which central sensitization can occur and includes IBS, fibromyalgia, and chronic headaches⁵.

Central sensitization (CS) is a condition of the nervous system associated with chronic pain. When CS occurs, the nervous system becomes hyper-reactive. This state of hyper-reactivity lowers your pain threshold and increases your sensitivity to pain. In the case of IBS, it may be normal gut peristalsis that feels like painful cramps or normal bloating that makes you feel as if you are in severe pain⁶.

What does IBS pain feel like?

Although pain is a subjective experience and how you feel your pain will be different from how another person experiences theirs, some characteristics appear to be typical of IBS pain⁷.

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.

IBS pain also typically comes and goes. If you have IBS, you will experience less pain on some days and more severe pain on others. To fit the criteria for an IBS diagnosis, you would experience pain on at least one day per week.

Pain resulting from IBS is also often related to eating certain types of food. You may find that some foods trigger pain.

If you have IBS, you can feel pain in different parts of your abdomen. The most common place to feel IBS pain is in your lower abdomen, but it can also be felt in your central abdomen, around your belly button. IBS pain is not usually experienced in the upper abdomen or stomach area.

If you experience pain in both your upper and lower abdomen, you may have IBS and indigestion or heartburn, which are usually experienced in the upper abdominal area.

IBS pain can worsen with menstruation in women.

Another trigger for IBS pain can be stress, so if your pain typically worsens with stressful events, this is a fairly typical symptom of IBS.

Other symptoms

If you think that you have IBS based on what your pain feels like, you may want to see if any of your other symptoms are consistent with IBS.

Diarrhea, constipation, or both

With IBS, it’s typical to experience altered bowel habits. This can present as constipation, diarrhea, or alternating bouts of both.

With IBS, what you eat can affect your symptoms, so you may find that you develop worse diarrhea or constipation after eating certain foods. Typically, high-FODMAP foods can exacerbate the symptoms of IBS⁸.

If you have IBS, especially if you struggle with constipation, you may feel that your bowels haven’t emptied after going to the toilet. It may also be painful to pass stool if your stool is very hard.

IBS can cause mucus to be passed with stool, so if you find that you have whitish mucus on or in your stool, that can be suggestive of IBS. Note that it is not normal for IBS to cause blood in your stool⁹.

When to see your doctor

Some of the symptoms of IBS can be confused with other, more serious illnesses. If you experience any of the following signs or symptoms, it is unlikely that they are linked to IBS. In this case, you should see your doctor for a full examination and investigation.

• Diarrhea at night

• Blood in your stool or black, tarry stool

• A hard and very tender abdomen

• Persistent pain that isn't relieved by passing gas or a bowel movement

• Pain that wakes you up at night

• You have unintended weight loss

It’s also important to note that if you are over the age of 50 and develop symptoms for the first time, these are unlikely to be related to IBS. If this applies to you, see your doctor as soon as possible to exclude a more serious illness.

The lowdown

Although IBS pain is different for everyone, some characteristics are typical of IBS. 

Pain is usually cramping, burning, or aching in nature and, most notably, gets better or worse with a bowel movement. IBS pain is generally felt in the mid and lower abdomen and is often variable, feeling worse one day and better the next. Typical triggers of IBS pain include specific types of foods, stress, and menstruation. 

Other symptoms typical of IBS are changing bowel habits (diarrhea, constipation, or a combination of both) and bloating.

Make sure you are familiar with symptoms that suggest a more serious condition than IBS. If you experience any of these, you must see your doctor for a definitive diagnosis.