bowel flare ups

Overview

A bowel flare-up is a period when your normal bowel symptoms get noticeably worse for a while. It can include tummy pain, bloating, diarrhoea, constipation, or an urgent need to use the toilet. Flare-ups often happen in people who have a long-term bowel condition, such as irritable bowel syndrome (IBS) or inflammatory bowel disease (IBD).

Yes. Bowel flare-ups are very common, especially among the roughly 1 in 5 people in the UK who experience IBS-like symptoms, and among people living with IBD. Even people without a diagnosed condition can get a temporary flare-up after a tummy bug or a course of antibiotics.

Bowel flare-ups can happen to anyone at any age. They are more often reported in women than men, and they are especially common in young adults and people who have had a previous gut infection. In children, flare-ups are also quite common, often linked to stress or a slight virus, but they can also signal a food intolerance.

Symptoms

Common symptoms

• Cramping or gripping pain in your belly, often around the tummy button
• Bloating and a feeling of fullness
• Diarrhoea, sometimes with sudden urgency to get to the toilet
• Constipation – stool might be hard, 'pebbly', or mixed with mucus
• Wind or excessive gas
• A feeling that you haven't fully emptied your bowel after a toilet trip
• Nausea or feeling queasy
• Fatigue, tiredness and feeling generally unwell

Symptoms in children

• Tummy cramps that come and go, often around the belly button
• Changes in poo – either very loose, watery stools or hard, pellet-like stools
• Unexplained crankiness, especially in very young children
• Loss of appetite or eating less than usual
• Bloating or excess wind
• Tiredness or wanting to sleep more

Symptoms in older adults

• Changes in bowel habit that last longer than a few weeks
• Diarrhoea or constipation, sometimes with mucus
• Stomach pain, especially after eating
• Unexplained weight loss or poor appetite
• Fever, night sweats or chills may also occur if there's an infection
• Confusion or increased falls in frail older people due to dehydration

Causes

Main causes

• Irritable bowel syndrome (IBS) – a common condition affecting how your gut works
• Inflammatory bowel disease (IBD) – including Crohn's disease and ulcerative colitis, which cause inflammation in the gut lining
• A bowel infection (gastroenteritis) – from viruses, bacteria, or parasites
• Food sensitivities or intolerances, for example to lactose, gluten, or artificial sweeteners
• Certain medicines – for example antibiotics or some painkillers (discuss with a pharmacist/doctor before changing anything)
• Stress and anxiety – the gut is very sensitive to your emotions
• Changes in routine – like travelling, lack of sleep, or eating very differently than usual

Risk factors

• Having IBS or IBD
• Previous gut infection, especially if it was severe
• Stressful life events, like exams, grief, or a new job
• Use of antibiotics or other medicines that affect the gut
• Hormone changes in women, especially around a period
• Eating a diet very high in refined foods and low in fibre (for some people)

When to see a doctor

See a doctor urgently if:

• Blood or mucus in your poo (unless you've had it before and it's normal for you – but when in doubt, check)
• Frequent, ongoing vomiting or inability to keep fluids down
• High fever or signs of dehydration
• Severe pain that is not easing or changing
• New or different symptoms from your usual flare-ups – especially in people over 50

Book a routine appointment if:

• Your flare-up does not improve after a couple of days
• Your normal bowel pattern changes and doesn't go back within a few weeks
• You need frequent time off work or school
• You want advice about adjusting your diet or managing symptoms
• You are under 50 and have new persistent symptoms lasting more than 6 weeks

Diagnosis

Your doctor will begin with a detailed chat about your symptoms, your bathroom habits, your diet, your family history, and any medicines you take. They will also gently feel your belly. Based on that, they may arrange tests or suggest simple first steps.

Tests that may be done

• Stool sample to check for infection, inflammation, or blood
• Blood tests to check for anaemia, inflammation markers, or coeliac antibodies
• Breath tests for lactose intolerance or bacterial overgrowth
• Colonoscopy or flexible sigmoidoscopy – a thin, flexible tube with a camera to see the inside of your bowel
• Imaging, like an ultrasound or CT scan, if more detail is needed

What to expect at your appointment

Diagnosing a bowel condition can take time. You might be asked to keep a symptom and food diary. If you need a camera test, you'll be given full instructions about how to prepare, including a special diet and laxatives to clear your bowel. The procedures aren't usually painful – you can have sedation if you want it – and you can usually go home the same day.

Treatment

Treatment depends on whether your flare-up is due to an infection, IBS, or IBD. In mild flares, self-care is often enough. In moderate to severe flares, you may need prescription medicines to calm inflammation, control symptoms, or treat an infection. The aim is to return your bowel to its normal rhythm and improve your quality of life.

Self-care at home

• Drink plenty of fluids (water, clear broths) to replace what you lose – a pharmacist or GP can advise on rehydration salts
• Go gentle on your gut – try plain foods like rice, toast, bananas or applesauce if you can eat, in small portions
• Take time to rest – allow your body to recover
• Use a hot water bottle or a warm bath for tummy cramps
• Keep a diary of food, stress, and stool pattern before and during the flare
• Wash your hands carefully, avoid sharing towels, and prepare food safely to reduce spreading infection if you have gastroenteritis

Medical treatments

Depending on the cause, doctors may recommend antispasmodics for cramping, things to slow down or loosen stool, or anti-inflammatory drugs to reduce gut swelling. For IBD, immune-modulating medicines can be used to keep the immune system from overreacting. Antibiotics may be needed if there is a bacterial infection. Always discuss all over-the-counter and prescribed treatments with your healthcare professional – do not change doses or stop treatments on your own.

When is surgery considered?

Surgery is not usually needed for a simple flare-up. But if you have IBD and develop a blockage, a tear (perforation), an abscess, or severe bleeding that doesn't settle, surgery may be recommended. It may involve removing a short segment of affected bowel. Any operation is a big decision, and your team will explain the benefits and risks thoroughly.

Living with this condition

A flare-up can be exhausting and sometimes embarrassing. You can make things easier by keeping a bag with wet wipes, a change of underwear, and emergency toilet paper. Plan your journeys so you know where public toilets are. It may feel hard, but carrying on with your life as much as possible actually helps your wellbeing.

Lifestyle tips

• Find your personal trigger foods by keeping a diet diary and checking for patterns over a few weeks
• Practice a simple breathing exercise (breathe in slowly for 4 seconds, hold for 4, out for 4) when you feel cramping
• Aim for 7-9 hours of sleep a night – poor sleep makes your gut more sensitive
• Stay gently active – a short daily walk can reduce bloating and stress
• Consider talking therapies like cognitive behavioural therapy (CBT) if anxiety drives your flares
• Build a routine around your bowel – for example using the toilet at quieter times if that feels more comfortable

Diet and exercise

There isn't one 'flare-up diet' that suits everyone. In general, eat small meals, chew well, and drink enough throughout the day. Some people benefit from a low-calorie or low-FODMAP diet, but you should only do this under the guidance of a qualified dietitian. Gentle movement like yoga, swimming, or walking is fine and actually helps maintain muscle mass and mental wellbeing. Avoid high-intensity exercise until the flare settles.

Mental health and emotional wellbeing

It is completely normal to feel anxious, low, or embarrassed about bowel flare-ups. You might worry about being far from a toilet, or that people will judge you. These feelings are very common in people with bowel conditions. If your anxiety is constant, or you are avoiding leaving your house, please reach out to a mental health professional. Talking about it can genuinely help you feel more in control.

Prevention

Flare-ups can't always be prevented, but their frequency and severity can often be reduced. If you have IBD, staying on your maintenance treatment (if prescribed) is crucial. If you have IBS, learning to manage stress and identifying foods that trigger you can make a big difference. Keeping a stable routine with regular meals, sleep, and exercise helps your gut stay calmer.

Vaccines

Some infections that cause flare-ups can be prevented by vaccination. For example, flu, COVID-19, and in some countries gastroenteritis vaccines are available. Talk to your GP or pharmacist about vaccines recommended for you, especially if you have a chronic condition or are over 65.

Screening programmes

If you have long-term inflammatory bowel disease, you may need regular colonoscopies to check for early changes. You may also be eligible for bowel cancer screening based on your age and country – your doctor or local health service can tell you when and how. Screening tests are quick and often done at home.

Complications

If left untreated

• Repeated inflammation can cause the bowel wall to thicken or narrow, leading to blockages (strictures).
• A collection of pus (abscess) or a tear (perforation) in the bowel wall can happen in severe IBD.
• Frequent severe diarrhoea can cause dangerous dehydration, especially in children and older adults.
• Small, unnoticed amounts of blood in poo over time can lead to iron deficiency anaemia.
• On rare occasions, chronic bowel inflammation can increase the risk of bowel cancer.

Long-term outlook

The outlook for most bowel flare-ups is very good. They tend to settle with a little time, rest, and the right treatment. Even people with long-term conditions like IBD often have long periods without flares. The key is to work together with your healthcare team, stay on top of your routine, and speak up early when things change. Most people can enjoy a full life, a normal diet, and meaningful work and family activities.

Find support

External links open third-party websites. Ruqelo Health is not responsible for external content. Listing an organisation does not imply endorsement.