Irritable bowel syndrome (IBS) often includes a host of uncomfortable symptoms. Severe symptoms, such as extreme pain or intense cramping, or non-GI-related symptoms, such as dizziness, might be a sign to get more immediate care.

When you have irritable bowel syndrome (IBS), experiencing any symptoms, even mild ones, can affect your quality of life.

If you’re living with IBS, you likely know, or a healthcare professional has likely told you, that there are times when your symptoms can get worse. Sometimes, other severe symptoms may occur that you think are related to your IBS but are really caused by another condition.

Finding the right doctor is the first step toward building a supportive patient and doctor relationship. Having a good relationship with your doctor can make it easy to ask questions about IBS, including learning when it’s necessary to call your doctor about IBS-related circumstances and symptoms.

Because your doctor knows your unique health history, they can establish guidelines in advance to help you answer the questions “Is this expected?” and “Is this worth calling my doctor about?”

Read on for specific instances and occasions that warrant picking up the phone and calling your doctor’s office.

While doctors don’t exactly know what causes IBS, many factors can contribute.

One contributing factor is your gastrointestinal (GI) tract is more sensitive to the effects of bacteria, gas, and bloating. Hormonal changes, stress, and anxiety can also aggravate the digestive tract, as can eating certain foods known to contribute to GI upset. All these factors can come together to cause IBS symptoms.

You may go through periods where you have no IBS symptoms at all. Then, you may experience severe symptoms. Over time, those with IBS tend to learn their symptoms and their triggers.

Generally, if you experience any symptoms that are not typical for you, appear with other concerning symptoms, or are more severe than usual, call your primary healthcare professional or a gastroenterologist.

Worrisome symptoms can include:

  • Abdominal pain and cramping: While you may experience occasional abdominal pain, having severe pain and cramping is a warning sign that immediate medical care is needed. Extreme pain is pain that you would rate a 7 or higher on a scale of 1 to 10, with 10 being the worst pain ever. Similarly, acute abdominal pain that comes on suddenly may be from health complications other than your IBS.
  • Mucus in your stool: When your gastrointestinal tract has irritation, your colon may sometimes start releasing mucus. People with IBS can produce large amounts of mucus. Other intestinal infections could also cause excessive amounts of mucus accompanied by diarrhea.
  • Severe diarrhea or constipation: While diarrhea and constipation may be symptoms of your condition, any symptoms out of the ordinary for you, such as an extended time of either symptom, can or show cause for concern. New bowel movement patterns or a worsening of your typical patterns can interfere with your daily routine and be a cause for concern.

Most people with IBS are familiar with their habits and symptoms. If you have new symptoms or a worsening of usual symptoms that begin to affect your daily life, talk with your doctor.

If you’ve recently started new medications related to your IBS, you may also wish to call your doctor and ask if any new symptoms are related to your medications. For example, some medications to stop intestinal spasms and cramping can cause constipation or problems urinating.

However, you should not stop taking your medications unless your doctor advises you to do so.

If your symptoms do not seem to be improving with a new treatment, it’s a good idea to reach out to your doctor. Generally, when symptoms do not improve within 3 months of starting a new treatment or worsen during that time, it’s important that you talk with your healthcare professional.

You sometimes may have abdominal symptoms you think are related to your IBS but are actually symptoms of another condition.

If you notice any of the following, you should get medical attention right away:

  • blood in the stool that’s either bright red or dark red
  • tarry stools that are black and sticky in consistency
  • unusually foul-smelling stools

Blood in your stool or black, tarry stools could indicate the presence of a GI bleed, where an area of your intestine or stomach is bleeding. Blood in the stool is not a typical symptom associated with IBS.

Other symptoms you may experience that do not typically occur with IBS include:

  • feeling dizzy
  • joint, skin, or eye discomfort
  • pain that is getting progressively worse
  • acute or sudden onset pain
  • significant lack of appetite
  • sudden weight loss
  • symptoms that occur only at night and cause you to wake up frequently
  • fever
  • symptoms of anemia such as weakness, pale skin, fast heartbeat, and shortness of breath

If you have a family history of serious gastrointestinal disorders and experience any of the above-mentioned symptoms, contact your doctor right away. Examples of these disorders include inflammatory bowel disease, celiac disease, or cancer.

Severe pain is often part of an IBS attack. Even though you work hard to avoid your triggers, IBS attacks can still occur, bringing with them severe pain. Treating IBS pain often requires a multifaceted approach. You may want to try the following:

  • Apply heat: Heat can be a quick way to decrease abdominal pain. A hot water bottle or heating pad placed across your abdomen may help ease cramping, improve circulation, encourage the smooth muscles of the colon to relax, and provide a relaxing sensation.
  • Consider using certain medications with your doctor’s approval: Antispasmodic medications can help relieve cramping associated with gas and bowel movements. Depending on which type of IBS you have, your healthcare professional may recommend laxatives to relieve constipation or antidiarrheals to address diarrhea.
  • Try peppermint oil: Peppermint oil taken in capsules can help with IBS pain, according to a 2019 review. Peppermint oil relaxes the colon’s muscles while decreasing sensation, essentially numbing the gastrointestinal tract.
  • Enjoy IBS-friendly teas: Many GI teas include peppermint oil, as well as other beneficial herbs, such as turmeric or ginger, that can help relieve and manage IBS symptoms. Other common teas that typically will not trigger IBS symptoms include green tea, white tea, or black tea. Sipping calming blends such as chamomile may also help you relax while experiencing IBS pain.
  • Engage in calming exercises: IBS flares are often as mentally exhausting as they are physically. Relaxing through deep-breathing exercises, meditation, or guided imagery can help you focus less on the pain and more on calming your mind.

While these techniques can be effective in helping you manage severe pain caused by IBS attacks, long-term steps to avoid triggers and manage your symptoms may help reduce the number of attacks. Keeping a food and symptom diary, altering your eating pattern, and adjusting your lifestyle may help decrease the likelihood of painful flares.

If you experience changes in your symptoms, your doctor will likely order tests to find out what may have caused these changes. First, your doctor will ask you questions about your symptoms. They may ask questions, such as:

  • When did you first notice your symptoms?
  • How long have the symptoms been going on?
  • Do you notice anything that makes your symptoms worse or better?
  • Are you taking any new medications, or have you changed your eating pattern recently?

Your doctor will use your answers to these questions as a starting point to determine a likely cause. Depending on your symptoms, your doctor may order a blood test to ensure your blood levels are at an expected range.

If your doctor thinks that inflammation or bleeding somewhere in your intestinal tract may be the cause, they may recommend a colonoscopy or other imaging tests to view the inner lining of your colon for any irregularities.

Get medical treatment as soon as possible when you experience a change in your IBS symptoms. This can help your doctor determine if the change necessitates a change in your treatment plan or is a sign of another condition.

Remember, anything that worries you is worth calling your doctor about.

Can IBS cause excruciating pain?

IBS pain can vary from person to person and even from attack to attack, ranging from mild to excruciating. Any severe or acute pain is a reason to call your doctor, even if you believe it to be IBS-related.

How do you deal with severe IBS pain?

You can sometimes manage severe IBS pain due to a flare at home by taking antispasmodic medications, applying heat to the abdomen, and practicing relaxing activities such as sipping IBS-friendly teas.

Typically, the best way to manage IBS pain is to learn your triggers and adjust your eating pattern and lifestyle activities to help avoid flares.

Can the hospital do anything for IBS pain?

If you’re experiencing IBS pain, it’s always better to get medical attention than to try and tough it out or treat your pain at home. Healthcare professionals can often provide treatment to ease your symptoms, making them more bearable. They can also evaluate your symptoms to determine whether they’re the result of another possibly more serious condition.

Pain is often a common symptom of IBS. Do not take severe IBS pain lightly.

People with IBS generally become familiar with their symptoms. Discuss any new or worsening symptoms with your doctor to rule out other complications and help you manage your pain.

Severe pain, alongside other symptoms such as dizziness, fever, lack of appetite, or changes in your skin, requires immediate medical attention.

If your doctor believes your pain can be managed pain at home, they will advise you of steps you can take to ease your discomfort, such as applying heat and using peppermint oil.

But for many people with IBS, prevention and trigger avoidance is the best way to reduce the chances of a painful IBS attack.