A dejected-looking woman sits in a dark room while the guilt of what she did to cause her flare-up weighs on her from above.

Whose Fault is it Anyway?

I had a major abdominal pain flare-up last night, and I’m still reeling from it today. Though physically I feel better, I remain a bit shook. Besides the pain itself, what I feel most is, oddly, guilt.

There’s an award-winning Amazon Prime series popular right now called “The Marvelous Mrs. Maisel.” In one scene, the daughter announces to her parents that her husband has left her. Her slightly overbearing mom’s instant reaction: “Why? What did you do?”

Feelings of guilt

That’s pretty much what I say to myself. Why did this happen? What did I do? What didn’t I do? What did I eat? I must have done something WRONG. It’s my fault somehow for sure.

After tossing and turning literally for hours, I find myself sitting on the living room couch in a silent house at 3 a.m., because sitting up hurts less than lying on my side or my back (and lying on my belly is right out). My confused old cat snuggles by my side, wondering why I’m awake at this hour, and rocking side to side in an effort to soothe my screaming gut.

I haven’t experienced this much abdominal pain since my original diagnosis of IBS-M in 2011. And it came on so suddenly, so unexpectedly, after an otherwise great day.

What did I do to cause the pain?

I’m mentally ransacking the previous 24 hours. What did I eat? Yes, there was Texas barbecue, but I used almost none of the spicy sauce (a newish trigger for me) and cut off the fattiest bits. I had tortilla soup for dinner. Too much acid from tomatoes over the day?

Or maybe it’s work stress. I just had a crazy week of travel. Thinking about being stressed makes me feel stressed – and the pain briefly intensifies. I take deep breaths to re-center myself.

Did I follow my regular daily regimen: Antidepressant medications, probiotics, fiber supplements, vitamins? Yes. Water intake? OK, but too much Diet Coke. I really need to quit that stuff.

Could it be related to the deep tissue massage I had that day, trying to manage some chronic back pain? I can’t see how. I worked out in the morning, but nothing crazy.

Try everything to help the pain

I try some tricks that sometimes help. Lying in different positions, hoping to find an angle that offers relief. Pepto-Bismol. Cool compress to my abdomen. Tylenol. (An NSAID would be a BAD idea.) Nibbling on candied ginger. Then sipping ginger tea. Graham crackers. Meditating (with cat). Listening to classical music. Distracting myself by perusing the subreddits on Reddit with cute animals. (It helps!) I even take an extra dose of generic Cymbalta, hoping it might do something.

I get on Google and search for new ideas, new answers. I almost hope that the pain is a symptom of something acute, that I can go to the ER to get fixed.

Because beneath the guilt that I’ve done something wrong to cause this flare-up is another emotion, one I don’t want to get too close to: fear. What if my regimen no longer works? What if the antidepressants have pooped out? What if this is how it’s going to be from now on? What if I have to start over? I try not to panic.

Pain ebbs

At about 4:30 a.m., the pain begins to ebb. I don't know why; was it one of my usual tricks, or on its own. It’s been 8 long hours. Will it come back? (Spoiler alert: Yes, though not as badly.) I creep back into bed, taking care not to jar my gut and re-wake the beast. Afraid to lie flat, I prop myself up with extra pillows. I don’t know what caused the flare-up -- does it matter whose fault it is? I'm just grateful it was a short one. I put on my CPAP mask, and fade into sleep.

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