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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.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.


  • ExplodingGuts
    11 months ago

    First, stop beating yourself up. Then consider a Bowen therapist for your back. A good one can kick-start your healing process. Typically just two sessions are sufficient, too. I’ve had great success with lower back and shoulder trauma, so i speak from experience.

    My therapist now a pal recommended a couple weeks ago to drink a tbsp of apple cider vinegar in a glass of water an hour or so before meals. It’s so foul I don’t want to eat for hours afterward but hey, presto! My guts have mostly stopped exploding. Not entirely but mostly. Another few weeks and I may be able to resume workouts.

    Until the vinegar just walking across the park to the library had me running to the bathroom as soon as I arrived. Yes, I had all the relevant tests and scripts – colonoscopy, dexilant and endless sand-like concoctions – my life as a beach. They helped a bit but not enough to justify the price and inconvenience, so no solution.

    The vinegar, however gag-worthy, is strangely effective. Eventually. First it makes my stomach hurt like hell. I feel as if I’m getting a bad flu. Then in a few minutes when the pain and nausea subside, all is well. I feel as if I could climb a mountain. Really.

    Gastroenterologist tried a million ways to get me to admit to stress. Not really, I thought. In my case, a tough patch in the marriage – long over now – was the game changer. I had for a long time put my stress in my stomach, but that tough patch was when my IBS really flared. It then became my body’s new default position.

    The trick now, if there is one, is to re-educate the mind-body response. Easier said than done but do-able. I work at it every day.

    I’ve been trying to be more ‘mindful,’ as they say. I realize I do have stress and that it requires management. But how?

    When I stopped being able to take long walks and work out regularly b/c of IBS, I lost 2 major stress busters. Living in a city with few public washrooms is a significant and unanticipated challenge. There is nowhere to walk here without risking an embarrassing explosion. It’s made me hate where I live, but moving is not yet an option.

    I finally found a place at the beach with washrooms where I now walk almost daily with spouse. Sanity! It’s not much of a walk for someone used to walking many miles, but it’s something.

    I also test myself several times a day for stress and apply relaxation meditation and breathing just sitting at the typer. It works. I learned this from a dentist who taught me how to cure TMJ w/o drugs. Took about two weeks but it worked.

    Changing food and drink does nothing. I do all my own cooking – healthy cooking – bake my own bread – rarely eat out b/c mine’s better. My IBS is immune to diet and drink. I often feel great after several cocktails the night before on an empty stomach. Other times, a vegetable stir-fry nearly kills me. There is no logic to it so I stopped looking.

    Slowly but surely, I find that for the first time in years as if I might get my life back. I’m no genius so I bet you will, too.

    Ultimately, I think it DOES matter whose fault the flare-up is. If you’re stressing about an unnamed conflict, name it. Fearlessly. Discuss even just with yourself strategy to address it.


    Life too often requires us to turn ourselves inside out to digest figuratively what is not only unpalatable but in many cases patently poisonous. It would be unusual if we didn’t experience digestive problems. Try to figure out what poisons you might eliminate and keep looking for ways to help you tolerate those you can’t avoid. That has been working for me.

  • Holly5757
    11 months ago

    I feel I could have written this. Word for word. After a bad flareup I start doing mind inventory of everything I could have done “wrong” to cause such pain. But more often than not I come up with nothing out of the ordinary and they just hit me with gusto for no reason. Which makes it that much worse because I cannot do things different to stop the flareups from hitting.
    So in the meantime I am sitting up at 3am watching old 60s sitcoms to try to take my mind off of the pain.

  • Lisa Carr author
    11 months ago

    Thanks, Holly — It really is frustrating when you realize that you can do everything “right,” and still get a flare-up, isn’t it? It’s just human that we want a reason. Take care of yourself! 🙂 — Lisa

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