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IBS and Stress

Irritable Bowel Syndrome (IBS) is a common disorder that affects the digestive system, causing symptoms such as abdominal pain, bloating, and changes in bowel movements. Many factors can trigger IBS flare-ups, and among them, stress has been found to play a significant role.

Many people with IBS report a correlation between periods of increased stress and anxiety and the exacerbation of their symptoms. Scientific studies have also shown a link between stress and IBS, although the exact mechanisms behind this connection are still being explored. However, it is believed that chronic stress can impact the gut-brain axis, causing changes in gut motility, sensitivity, and inflammation, which can ultimately contribute to IBS symptoms.

In this blog post, we will delve into the relationship between IBS and stress, plus offer practical strategies to manage stress effectively and reduce the likelihood of IBS flare-ups. By exploring the IBS-stress relationship and discovering stress management techniques, you can take a proactive approach to managing your symptoms and improving your overall well-being.

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IBS and Stress: A Prevalent Association

Studies have consistently shown a strong association between the two. Research indicates that up to 60% of individuals with IBS report experiencing high levels of stress, compared to about 20% in the general population (ACG Clinical Guideline, 2021). 

Furthermore, stress has been found to increase the severity and frequency of IBS symptoms in affected individuals. This post aims to shed light on the reasons behind this relationship and offer strategies to help readers manage stress and minimize stress-related IBS symptoms.

A man in a button up with a pencil in his hands, looks down at his desk with a look of worry or stress and holds his hands up to his temples

Can Stress Cause IBS?

While stress and IBS often coexist, it is essential to understand the complex relationship between the two. Stress can have a profound effect on the body, triggering various physiological changes. When stress occurs, the body releases stress hormones, such as cortisol, which can disrupt normal digestive processes. 

Chronic stress can lead to increased gut sensitivity, altered gut motility, and changes in the gut microbiota, potentially contributing to the development or exacerbation of IBS symptoms.

While stress exacerbates IBS symptoms, current evidence does not suggest it causes IBS. 

IBS and Stress Connection (The Influence of Gut-Brain Axis)

The gut-brain axis, a bidirectional communication system, serves as a crucial link between the central nervous system and the gut. The enteric nervous system (ENS), often referred to as the “second brain,” facilitates independent gut functioning while being modulated by stress and emotional states.

Research has shown that mental health conditions like stress, anxiety, and depression can significantly impact gut health, altering gut motility, immune responses, and gut microbiome composition. This intricate interplay between the brain and the gut highlights the importance of addressing stress for effective IBS management.

A woman in a chunky sweater sits curled up on the floor with one hand to her head, looking uncomfortable or in pain

Stress-Induced IBS Symptoms

The impact of stress on IBS can manifest in various ways, leading to a range of symptoms. Some common stress-induced IBS symptoms include:

  • Abdominal pain or discomfort
  • Bloating and distension
  • Altered bowel movements (diarrhea, constipation, or both)
  • Nausea and vomiting
  • Urgency or the feeling of incomplete bowel movements

Stress-Induced IBS Treatment Strategies

Managing stress effectively can significantly reduce symptoms and enhance overall well-being. 

Here are some strategies to help alleviate stress and reduce the likelihood of IBS flare-ups.

A woman in athletic wear and a ponytail holds one arm across her chest as she holds the other up to her nose to do a breathing technique

1. Respiratory Vagal Activation Techniques: Harnessing the Power of Breathing

One promising stress reduction technique that can benefit individuals with IBS is respiratory vagal activation. 

The vagus nerve, a key component of the parasympathetic nervous system, plays a vital role in regulating various bodily functions, including digestion and stress responses. By utilizing specific breathing exercises, we can stimulate the vagus nerve, inducing a state of relaxation and activating the body’s natural healing mechanisms.

Scientific research has highlighted the effectiveness of respiratory vagal activation techniques in reducing stress and improving gastrointestinal symptoms. Techniques such as diaphragmatic breathing, paced breathing, and coherent breathing have shown positive outcomes in alleviating IBS symptoms by promoting relaxation, reducing inflammation, and improving gut-brain communication.

Here are 5 ways to stimulate your vagus nerve and improve your gut-brain connection. ⁠
  • Deep breathing (including techniques such as diaphragmatic breathing, paced breathing, and coherent breathing).
  • Cold showers and quiet alone time.
  • Humming or gargling to activate your vagus nerve. ⁠
  • Singing to relax and lift your mood.
  • Laughing can help you literally laugh the pain away but also help you take your mind off all your IBS troubles.⁠

Follow me on Instagram @ibs.dietitian for additional strategies to improve your gut-brain connection and find relief from IBS symptoms.

A yoga class mid-practice doing a yogic squat variation

2. Stress-Relieving Practices, like Yoga or Meditation

In addition to respiratory vagal activation techniques, adopting a holistic approach to stress reduction can significantly benefit individuals with IBS. Engage in activities like meditation, yoga, or mindfulness to help calm the mind and relax the body. These practices have been shown to reduce stress and promote a sense of well-being.

A woman sleeps soundly amidst clean, white sheets

3. Sleep, Rest, and Self-Care

People with IBS may experience pain, discomfort, frequent trips to the bathroom, and heightened sensitivity to their surroundings, all of which can make it hard to achieve a night of restful and uninterrupted sleep.

But sleep has a direct connection to your gut, and not getting enough restful sleep can worsen IBS symptoms. On the other hand, a good night of sleep allows you to relax and not be so stressed, easing your body and enhancing your gut-brain connection. A healthy sleep cycle also helps the body reduce stress hormones and increase gut microbiome diversity for better health.

If you struggle to get a restful night of sleep, here are 4 strategies to try for better sleep.
  • Take a bath before bed and enjoy some solo quiet time.
  • Stay off the screen an hour before bed. Blue light stimulates our brain and can make it difficult to fall asleep. 
  • Don’t be caffeinated when you go to sleep. Know your body and have a cut-off time for caffeine. 
  • Turn everything off (and the AC on). Having a room that is cool, dark, and quiet can help calm your mind and allow you to get better quality sleep.⁠

Sleeping better not only reduces our stress but is crucial to our gut health. Ensure you are getting sufficient sleep and rest to allow your body to recover and rejuvenate. Adequate rest plays a crucial role in reducing stress levels and maintaining optimal gut health.

Aim for 7-9 hours of quality sleep each night. 

A person receives acupuncture therapy

4. Alternative Medicine

Some individuals find relief from stress-induced IBS symptoms through complementary therapies, such as acupuncture, aromatherapy, or herbal supplements. However, it is important to discuss these options with your healthcare provider before incorporating them into your routine.

A woman rests on her couch and journals in a notebook

5. Journaling

Writing down your thoughts and feelings in a journal can serve as a therapeutic outlet for stress. This practice can help identify triggers, track symptoms, and provide a sense of emotional release.

In addition, practicing gratitude daily has shown to improve mood, reduce stress and anxiety. Try to incorporate gratitude practice and journaling into your daily practice. 

A young man waves hello and smiles to his phone while he is on a video call

6. Professional Help

If stress becomes overwhelming or unmanageable, it may be beneficial to consult a mental health professional. They can provide guidance and support, offering coping strategies tailored to your individual needs.

Conclusion:

The relationship between IBS and stress is undeniable, with stress often exacerbating IBS symptoms and vice versa. By recognizing this connection and implementing stress reduction techniques, IBS patients can take proactive steps to manage stress effectively, ultimately reducing symptoms and improving their overall quality of life. 

While living with IBS can be challenging, you’re not alone, and there are many resources available to help you manage your symptoms and improve your quality of life. Click here to learn more about IBS Freedom, a dietitian-led holistic program to help you manage IBS and get relief from symptoms like gas, bloating, pain, reflux, and irregular bowel habits once and for all.

For a daily stress-reduction technique to try right now, and for more on the relationship between stress and IBS, watch my FREE IBS Masterclass here

3 mistakes to avoid on the low fodmap diet for IBS freedom

Summary:
  1. Irritable Bowel Syndrome (IBS) is a chronic gastrointestinal disorder characterized by uncomfortable bowel symptoms, such as abdominal pain, bloating, and changes in bowel movements.
  1. Stress does not cause IBS, but is a significant factor in triggering IBS symptoms and flare-ups, and studies have shown a strong association between stress and worsening IBS symptoms.
  1. The gut-brain axis plays a crucial role in the connection between IBS and stress, with chronic stress affecting gut motility, sensitivity, and inflammation.
  1. Respiratory vagal activation techniques, including diaphragmatic breathing and paced breathing, can stimulate the vagus nerve, promoting relaxation and improving gut-brain communication.
  1. Other stress reduction strategies, such as mindfulness, yoga, and meditation, can help manage stress and alleviate IBS symptoms.
  1. Adequate sleep and self-care practices are important for reducing stress levels and improving gut health in individuals with IBS.
  1. Alternative therapies, such as acupuncture and aromatherapy, may provide relief for stress-induced IBS symptoms, but consultation with a healthcare professional is recommended.
  1. Practicing gratitude daily and journaling can serve as a therapeutic outlet for stress and help identify food triggers(link to FODMAP post) and track symptoms.
  1. Seeking professional help from a mental health professional is advised if stress becomes overwhelming or unmanageable.

References:

American College of Gastroenterology. (2021). ACG Clinical Guideline: Management of Irritable Bowel Syndrome. American Journal of Gastroenterology, 116(1), 17-44.

Fond, G., Loundou, A., Hamdani, N., Boukouaci, W., Dargel, A., Oliveira, J., … & Boyer, L. (2014). Anxiety and depression comorbidities in irritable bowel syndrome (IBS): a systematic review and meta-analysis. European Archives of Psychiatry and Clinical Neuroscience, 264(8), 651-660.

Lackner, J. M., & Gudleski, G. D. (2019). Cognitive behavior therapy for irritable bowel syndrome. Gastroenterology Clinics, 48(3), 409-431.

Palsson, O. S. (2015). Self-help treatments for irritable bowel syndrome. Nature Reviews Gastroenterology & Hepatology, 12(10), 571-582.

Seers, K., Cade, J. E., & Marshall, P. (2020). Psychological interventions for irritable bowel syndrome: a systematic review and meta-analysis. Journal of Gastrointestinal and Liver Diseases, 29(3), 351-366.

Yoon, S. L., Grundmann, O., & Koepp, L. (2020). Mindfulness-based interventions for chronic pain and irritable bowel syndrome: a systematic review and meta-analysis. Evidence-Based Complementary and Alternative Medicine, 2020, 6725310.

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