your friend should definitely see a doctor. period. that amount of pain = he/she needs to rule out things that others have suggested. diverticulosis <sp) is the 'diverts' that exist and will get seeds and stuff stuck in the holes then get infected. my brother has this and the doctor gives antibiotics (which wrecks his gut flora)- less, though, since he was diagnosed with celiac and adheres strictly to gluten-free diet. so, they should check that, as well...
funny thing - i had been having the exact thing happening every now and again. the last time my husband was home and he rushed me to the e.r. (i was crying bc pain was so bad. i don't cry. he knows this.) they did bloodwork and a c.t. scan - everything ok. sent me home with a pocket full of scripts and i followed up with my g.i. doc. he said either i got glutened OR i had an intestinal spasm. made sense to me - i was nauseas and puking, nothing could move, i couldn't even keep water down!) one of those magical drugs (i don't take the others he gave me - don't need 'em) was called dicyclomine - it's an anti-spasmodic. at the first sign of it, i try to drink a ton of water and sometimes i can get it to move along. but, i have the dicyclomine that i will take and it works like a charm, just makes me really sleepy and my day will be spent close to the bed and bath (not beyond <haha see what i did there
ask your friend if, after these episodes, their stool looks bright yellow (like you could see it from outer space) bc my g.i. doc told me that your body will try to make soft stool to try to move things past the spasm.
definitely they should go to the doc to rule out other potential separate problems, but this is something i really never heard of and it helps not to panic when i know what to do about it. i hope they get some relief. you are a good friend. everybody forgets but i'll quote dr. fasano: "your digestive system is a VITAL ORGAN." and if ya had a heart attack, ya wouldn't put off prioritizing the problem. it's the same with your guts. you need them!! every. day.