How to Manage IBS Flares and Advocate for Yourself With Your Doctor

Irritable bowel syndrome (IBS) is one of the most common gastrointestinal conditions in the United States, affecting an estimated 2.4 million to 3.1 million Americans. Yet despite how widespread it is, IBS remains chronically underdiagnosed, frequently misunderstood and often undertreated — leaving millions of people to manage unpredictable, disruptive symptoms largely on their own.

IBS is characterized by recurring abdominal pain, bloating, cramping and changes in bowel habits, including diarrhea, constipation or both. Symptoms can range from mild and occasional to severe and daily, and because they are invisible to others, the condition carries a burden that extends well beyond the physical. Many patients spend years cycling through appointments, testing and treatments before finding a care approach that works — and many more never feel truly heard by their providers at all.

Ronen Arai, M.D., a gastroenterologist with Baptist Health South Florida, is working to change that. We sat down with him to discuss practical strategies for managing IBS day to day, how to build a productive relationship with your health care provider, and why the connection between gut health and mental health is central to any meaningful treatment plan.

IBS symptoms can be unpredictable and disruptive. What practical strategies can patients use in their day-to-day lives to better manage flares and maintain quality of life?

Ronen Arai, M.D.: Patients should understand that IBS is a functional gastrointestinal disorder, also described as a disorder of gut-brain interaction, that responds and is often affected by external factors, such as stress and diet. Thus, I recommend that patients do everything they can to maximize their underlying health status. This includes reduction of stress, getting adequate rest and sleep, eating healthy foods, exercising regularly, and avoiding triggers that may negatively affect their health, such as smoking and excessive alcohol.

What advice would you give to help patients advocate for themselves and feel more confident in conversations with their health care provider?

RA: Patients should expect that their health care provider will understand that IBS is not just an internal problem originating in their brain and under their control. Once they find the right provider who will listen to their complaints and help them find ways to manage their symptoms and flares, they will feel more confident that they have a health care provider who is truly a partner in their journey toward improvement.

IBS often impacts mental health as well as physical health. How can patients recognize when stress or anxiety is affecting their symptoms, and what support options are available?

RA: The connection between IBS and mental health works in both directions, meaning that IBS flares can negatively impact mental health and that mental health challenges can negatively affect IBS and lead to flares. Patients should understand that stress and anxiety/depression are often seen in IBS, and that proper IBS therapy will always include effective stress reduction and treatment of anxiety/depression, and that effective therapy may require counseling/therapy and often pharmaceutical agents to treat the underlying mental health issues.

If you are living with IBS and feel that stress, anxiety or depression may be playing a role in your symptoms, raising that conversation with your gastroenterologist or primary care provider is an important next step. Effective, integrated care — care that treats the whole person rather than the symptom in isolation — is available, and it can make a meaningful difference.