Irritable bowel syndrome might be linked to stress, suggest studies

Irritable bowel syndrome (IBS) is a digestive disorder that affects about 20% of people around the world. It’s the most common gastrointestinal diagnosis and the second most common cause of absence from work.

IBS is a chronic condition that you’ll need to manage long term. Although it doesn’t lead to severe disease, it can have a big impact on your everyday life, so finding ways to manage it is key.

While the cause of IBS remains unclear, it’s widely accepted that there is a strong link between gut health and mental health, as a result of what’s known as the gut-brain axis. By learning to manage your anxiety and stress levels, you may be able to minimise your IBS symptoms too.

What causes IBS, and who is likely to have it?

The exact cause of IBS is unknown, but possible causes include over-sensitive nerves in the gut or immune system, food passing through the gut too quickly or too slowly, stress, or a family history of IBS.

Post-infectious IBS is caused by a previous bacterial infection in the gut, which can then lead to the syndrome.

You’re more likely to have IBS if:

• You’re under 50 years of age
• You’re female
• You have a family history of IBS
• You have a history of anxiety, depression or other mental health problems

What are the symptoms of IBS?

IBS is a chronic gastrointestinal disorder characterized by co-occurring symptoms, such as abdominal pain or discomfort, and disturbances in bowel movements, including constipation and diarrhea.

Depending on the prevalence of symptoms of diarrhea, constipation, or both, IBS can be categorized into four main subtypes:

• IBS with diarrhea (IBS-D)
• IBS with constipation (IBS-C)
• undefined IBS (IBS-U)
• IBS-mixed (IBS-M)

IBS-mixed is characterized by symptoms of both constipation and diarrhea, whereas the symptoms associated with IBS-U tend to vary.

Despite the uncomfortable symptoms, individuals with IBS do not show signs of structural damage to the digestive tract, such as ulcers.

Some of the potential mechanisms contributing to these symptoms include altered gut motility and heightened pain sensitivity of internal organs.

Cramping, abdominal pain, bloating, gas, etc. are also some common symptoms of IBS.

How does stress and anxiety affect the gut?

Together, the brain and the nerves that control your body are called the central nervous system. This system operates on internal controls that seemingly run on autopilot. It’s usually divided into two parts: the sympathetic and parasympathetic nervous systems. Some classify it as having a third part, the enteric nervous system, which controls most of the activity of the gastrointestinal system.

The sympathetic and parasympathetic systems usually work in tandem. The parasympathetic system is known as the “rest and digest” system. It controls body functions like urination, defecation, digestion, tear production, and saliva production — in short, many of the functions your body does in going through the activities of daily life.

The sympathetic nervous system is your “fight or flight” side. Stress and anxiety activate this system. They set off a chain reaction of hormone release that increases how fast your heart beats, pumps more blood to your muscles, and slows or even stops digestive processes in your stomach.

According to an article published in the World Journal of Gastroenterology, having IBS results in disturbances in the balance between your brain and gut. The result is that stress and anxiety sometimes trigger over-activity of your gut. This causes the diarrhea and stomach churning that those with IBS know well. In others, the brain signals are under-active, and their gut may slow down, resulting in constipation, gas, and abdominal discomfort.

How can stress trigger IBS?

The body’s goal is to maintain homeostasis, or a steady state of being. After a stress response, fluctuating hormones are meant to return to normal levels. However, when people experience chronic stress and anxiety, their bodies can’t achieve homeostasis. This is often the case when a person has IBS.

Stress can wreak havoc on your gut. It causes the release of many hormones, including corticotropin-releasing factor (CRF). This hormone is linked to the gut’s healthy bacteria, which maintains bowel function. The extra CRF also activates your body’s immune response. While that may sound like a good thing, immune activity can have adverse effects, as is the case when a person has a strong allergic response to a healthy food.

Chronic stress can cause your intestinal bacteria to be imbalanced, a condition known as dysbiosis. According to an article in the World Journal of Gastroenterology, stress-induced dysbiosis may play a key role in a person developing IBS.

Treating the stress and IBS connection

Some people know the source of their stress, while others have a hard time recognizing it. One of the ways to start treating your stress and its connection to IBS is to keep a journal.

In this journal, you can write about the patterns of your day and the state of your symptoms. No detail is too small. Abdominal pain, constipation, and gas are all symptoms that you may be able to link back to worsening IBS. You may have to keep the journal for a while — major life events and stressors could trigger a flare-up a few weeks or months later.

Once you’ve identified the stressors in your life, you can take steps to both remove them and teach yourself to cope with the stress these situations can create.

Here are some tips for coping with stress to reduce IBS:

• Take up a stress-relieving practice, such as meditation or yoga. Through learning deep breathing and focusing your thoughts, you may be better able to handle stress.
• Make efforts to sleep at least seven to eight hours a night. Getting plenty of sleep can provide you with the energy you need to go through your day. Going to sleep at a regular bedtime, avoiding use of electronic devices in bed, and keeping your bedroom cool and dark can all promote a better night’s sleep.
• Seek professional help from a psychiatrist. While it may be difficult to talk about your IBS symptoms with another person, a psychiatrist can help you learn skills to manage stress. For example, they may help you learn cognitive-behavioral techniques to identify stress.
• Participate in an IBS support group. Social support from others can be a key factor in managing stress and controlling IBS symptoms.
• Try complementary medicine techniques such as acupuncture, massage, or reiki. These have helped some people with IBS reduce their symptoms.
• Continue journaling as a means to identify how your methods of managing stress are improving and ideally how your symptoms are getting better.

While stress can be a contributing factor to IBS, it usually isn’t the sole factor. Focusing on stress reduction, as well as taking medications and managing your diet to lower risk of symptom triggers, can help you reduce IBS symptoms whenever possible.