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Even if you experience good results from the FODMAP diet, symptoms can suddenly flare up—even when you know your triggers and follow a diet that usually works. This may be due to other factors, such as stress, sleep quality, and hormonal fluctuations that can affect our digestion. Here, we provide common causes of symptom worsening and offer some tips on how to manage them.

Possible Causes of IBS Flare Ups

1) Stress and Anxiety

The brain and gut are closely connected, and many have experienced that stress and anxiety can cause digestive issues. When we're stressed, the brain doesn't distinguish between serious and minor situations—it activates the same response. This means that non-essential functions, like digestion, are deprioritized. The result can be bloating, pain, cramps, or altered bowel movements. Breathing techniques, physical activity, yoga, and meditation can help calm the nervous system and support digestion—especially during challenging periods.

2) Physical Activity

Regular movement is important to keep digestion functioning. Prolonged sitting can contribute to constipation and bloating. Try to be active every day, for example, by taking walks, doing light strength training, or other activities you enjoy.

3) Fiber Intake

Both too much and too little fiber can trigger discomfort. Fiber contributes to regular bowel movements and good stool consistency. On a low FODMAP diet, you can include many fiber-rich foods, such as spinach, broccoli, berries, nuts, seeds, oats, lentils, beans, and psyllium husks (be mindful of portion limits and your own tolerance). If you're getting too little fiber but experience symptoms when increasing intake, try gradually increasing your intake over time.

4) Hormonal Cycle

Hormones affect digestion, and many experience variations in symptoms throughout the menstrual cycle. Bloating and constipation are common in certain phases, while loose stools occur for many during menstruation. Tracking your cycle can provide valuable insight into how hormones affect your symptoms. The diary in the app can be used for this purpose.

5) Sleep Quality

Sleep affects both stress levels and digestion. Poor sleep can worsen IBS symptoms. Good routines—such as going to bed at the same time each night and avoiding screens right before bedtime—can make a big difference for your gut health.

6) Dietary Triggers

Even foods that are low in FODMAPs can cause symptoms. Very fatty or spicy foods, carbonated drinks, and caffeine are common triggers for many. Try to limit the intake of caffeinated beverages to a maximum of three per day and avoid caffeine in the hours before bedtime.

7) Meal Calmness and Eating Habits

Eating slowly, chewing well, and avoiding stress during meals give your digestion the best possible working conditions. Eating too quickly or too much at once can cause discomfort.

8) Irregular Routines

Digestion likes predictability. Eating at approximately the same time every day and having regular meals can contribute to better symptom control.

9) Illness

When the body is working to fight off illness, digestion can be affected. This can lead to temporary changes in your symptoms. Make sure to give your body rest during these periods.

10) Stacking

"Stacking" refers to symptoms that occur when multiple "green" servings (i.e., amounts that are low FODMAP) are consumed in the same meal or within a short period of time

Even if each food is consumed within the low FODMAP limit, the total amount of FODMAPs can become too high for some—even if the foods don't contain the same FODMAP group. To avoid stacking, it's recommended to wait 2–3 hours between meals. Other measures that can help include eating smaller and more regular meals, keeping a food diary to track what is tolerated—and being aware that some individuals are more sensitive than others.

Understanding what triggers your IBS symptoms isn't just about diet—it's often an interplay between food, stress, sleep, and activity. Keeping a symptom diary and experimenting with small adjustments can be useful tools for gaining better control in everyday life. Also, remember that tolerance can change over time so testing your tolerance regularly is advised.

If you find that your symptoms persist over a longer period, we recommend contacting your doctor to investigate whether there are other underlying causes. If appropriate, consider scheduling an appointment with a clinical dietitian to help manage worsening IBS symptoms.