Trapped Gas Pain and Other IBS Abdominal Pain Sources

When you have irritable 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 gas results from the activity of gut bacteria on food. An aspect of IBS called visceral hypersensitivity heightens 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.

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 of stress.

Another key factor in IBS is motility 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.

Causes of Gas Pain

Gas pain can be caused by certain foods, medications, and health conditions.

Foods

Some types of carbohydrates—sugars, starches, and fiber—aren't fully digested in the stomach and small intestine. 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:

• Cruciferous vegetables (cabbage, Brussels sprouts, broccoli, cauliflower)
• Pulses, including beans and lentils
• Dairy products
• Foods high in fructose. which can include figs, dates, prunes, pears, grapes, soft drinks, fruit drinks, cookies, and cakes
• Sorbitol. a sugar alcohol that is added to many sugar-free gums and candies and some medications
  

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:

• Lactose intolerance
• Dietary fructose intolerance
• Small intestinal bacterial overgrowth (SIBO)
• Celiac disease
• Constipation
• Gastroesophageal reflux disease (GERD)
• Gastroparesis
• Intestinal pseudo-obstruction (the intestine is unable to contract to move food and waste)
• Bowel obstruction or blockage of the digestive tract

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.

Managing IBS and Gas Pain

Once you know the source of your pain, you can take steps to alleviate it.

• Toilet habits: Don't sit on the toilet for long stretches trying not to "trap in" any gas. That can cause anxiety and feelings of incomplete evacuation. Excessive straining increases your risk of hemorrhoids.
• Gas-related pain: Gas-related likely means food-related. Certain foods are more likely to cause gas. For severe pain, you may want to try a low FODMAP diet. For milder pain, over-the-counter gas relievers might be enough.
• Hypersensitivity/motility: Relaxation is key for relieving pain from visceral hypersensitivity and motility problems. Mind/body approaches (relaxation exercises, yoga, meditation) may help.
• Muscle spasms and cramps: Antispasmodic medications, peppermint tea, or enteric-coated peppermint capsules can relax the muscles.

When to See a Healthcare Provider

You should talk with a healthcare provider if you have:

• Persistent gas symptoms that are painful, bother you, or disrupt your daily activities
• Symptoms that change or worsen suddenly
• Multiple symptoms, such as abdominal pain, constipation, diarrhea, or weight loss, along with gas symptoms

Summary

Not all IBS pain comes from trapped gas. Visceral hypersensitivity, motility dysfunction, and intestinal muscle spasms also cause pain.

Gas pain tends 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.