IBS pain is thought to come from a mix of an oversensitive gut, spasm of the gut muscle and changes in how the bowel moves. Antispasmodic medicines relax that muscle,[1] and they and peppermint oil are the options with the most trial evidence. Other steps calm the nervous system or take pressure off your digestion. None works instantly for everyone, so it helps to know which are backed by trials and which are simply low-risk comfort measures.
What stops IBS pain and cramps fast?
| Measure | Evidence | Good to know |
|---|---|---|
| Peppermint oil capsules | Better than placebo for overall symptoms and abdominal pain in a meta-analysis of 10 trials, but the evidence is of very low quality[2] | Heartburn (reflux) is a common side effect[3] |
| Antispasmodics, such as hyoscine | Better than placebo in a meta-analysis of 22 trials; hyoscine and otilonium showed the most consistent benefit[4] | Can cause dry mouth, blurred vision and dizziness[1] |
| Loperamide, if diarrhea dominates | NICE's first-choice antidiarrheal for IBS; the BSG says it may be effective for diarrhea[5][3] | Side effects include constipation, bloating and abdominal pain[3] |
| A laxative, if constipation dominates | NICE recommends considering laxatives for constipation in IBS; polyethylene glycol (PEG) may help[5][3] | NICE advises against lactulose, which can cause bloating[5][1] |
| A heat pack on your abdomen | Suggested by Monash University's dietitians; a comfort measure, not a tested treatment[6] | Keep it warm, not hot |
| A gentle walk | Light exercise helped clear trapped gas in a small lab study[7] | Regular activity also reduces symptoms over weeks[8] |
| Slow breathing or relaxation | A comfort measure; guidelines encourage making time to relax[5] | Psychological therapies such as CBT and gut-directed hypnotherapy have trial evidence for longer-term relief[9] |
| Small, plain, low-FODMAP meals | Expert advice for flares rather than a tested treatment[6] | Lower in fat and FODMAPs, with plenty of fluids |
Do peppermint oil and antispasmodics work?
They're the options with the most trial evidence, though the trials measured symptoms over at least a week of treatment rather than minutes after a dose.[4] A 2022 meta-analysis of 10 randomized trials (1,030 patients) found that peppermint oil beat placebo for overall IBS symptoms and abdominal pain, although side effects were more common and the quality of evidence was very low.[2] The largest single trial, from the Netherlands, missed its main goal, but small-intestine-release capsules still reduced abdominal pain more than placebo on secondary measures.[10] Antispasmodics relax the smooth muscle of the gut, and in a meta-analysis of 22 trials they were more effective than placebo overall.[4] The British Society of Gastroenterology (BSG) says that peppermint oil and certain antispasmodics may be effective for overall symptoms and abdominal pain,[3] and NICE advises taking antispasmodics as needed, alongside diet and lifestyle advice.[5]
Products, strengths and availability vary by country, so ask a pharmacist which one suits you,[11] especially if you're pregnant, take other medicines or have another health condition. Ordinary painkillers such as acetaminophen (paracetamol), NSAIDs and opioids are unlikely to relieve IBS pain, and some can make gut symptoms worse.[1]
Do heat, walking and breathing help an IBS attack?
These are comfort measures rather than proven treatments, but they're safe for most people:
- Heat: Monash University's dietitians include a heat pack in their tips for getting through a flare.[6]
- Gentle walking: in a small lab study of people with bloating, most of whom had IBS, light pedaling roughly halved the amount of gas held in the gut and eased symptoms.[7] Over the longer term, a 12-week program to increase physical activity reduced IBS symptom scores compared with usual lifestyle.[8]
- Slow breathing and relaxation: NICE encourages people with IBS to make time for relaxation.[5] Everyday stress and IBS symptoms are linked, so it's a logical step, even though its direct effect on symptoms is uncertain.[1] For lasting relief, cognitive behavioral therapy and gut-directed hypnotherapy have the largest evidence base among psychological treatments.[9]
What should I eat to calm a flare?
Keep meals small, regular and plain, and lower in fat and FODMAPs. Monash's dietitians suggest returning to a stricter low-FODMAP diet for a short time, then easing back to your usual diet as symptoms improve.[6] After a FODMAP overload, symptoms should settle within one to three days.[12] Our guide on what to eat during an IBS flare-up has a meal-by-meal list.
How do I fix IBS for good?
IBS symptoms are often long-lasting, so the realistic goal is good control rather than a one-off fix.[1] The BSG recommends regular exercise and first-line dietary advice for everyone with IBS, soluble fiber such as psyllium (ispaghula), and a low-FODMAP diet supervised by a dietitian as a second-line option.[3] Medicines are chosen according to your main symptom,[5] and cognitive behavioral therapy and gut-directed hypnotherapy can help people whose symptoms persist.[9] See how IBS is treated.
If flares keep coming back, note what happened in the day before each one and which measures helped. IBS Clue keeps your meals and symptoms in one place and can export a PDF report to take to your doctor.
When is an IBS flare-up an emergency?
Call emergency services or go to the emergency room if abdominal pain starts suddenly and is severe, if you vomit blood or something that looks like coffee grounds, if you pass a lot of blood or black, sticky stool, if you can't pass stool or gas at all, or if you're struggling to breathe.[13] Get an urgent appointment if your pain suddenly gets much worse, there is blood in your stool, you're pregnant, or diarrhea or vomiting hasn't gone away after a few days.[13]
See your doctor promptly for warning signs that IBS doesn't explain, such as unexplained weight loss, fever, anemia, symptoms that wake you at night, or a lump in your abdomen.[14] More in IBS red flags, and see how long an IBS flare-up lasts.