Irritable bowel syndrome (IBS) is a syndrome that causes a collection of symptoms such as abdominal pain, gas, bloating, diarrhea, and constipation. These symptoms range in severity for those affected and can greatly impact a person’s emotional, social, or professional life. In fact, there are strong correlations between emotional and mental health and IBS. Stress and anxiety are often found together in those with IBS. Though it’s not yet clear how they’re related or even which one comes first, they certainly seem to each exacerbate the others. Those with IBS have a more sensitive gut that reacts, not only to certain foods, but also to stress. This makes the effects of stress on those with IBS more severe than those without IBS.
The Gut-Brain Connection
Everything is connected, and this is clearly seen in the human body. Perhaps the connection that seems the most “unconnected” is the link between our emotional centers of the brain and the functioning of our gut. This is called the gut-brain connection (or gut-brain axis), and describes the nerve-signaling between the central nervous system (including our brain) and the enteric nervous system (which is found in our gut). This “gut” nervous system is composed of 100 million nerve cells that line our digestive tract, from esophagus to rectum. It controls things such as swallowing, digesting, releasing enzymes, and communicating back and forth with our central nervous system (which includes our brain). In this way, our gut has the power to influence our brain’s reaction to stimuli. This connection becomes more pronounced and has heightened responses during moments of stress. When our brain experiences stress, so does our gut.
IBS and Anxiety
For those with IBS, irritation to the gastrointestinal tract launches a stress response which signals the central nervous system to trigger large emotional shifts, such as anxiety and depression. These emotional shifts tend to be stronger in those with IBS due to their heightened stress response. The prevalence of anxiety in those with IBS is quite strong. Around 60% of people with IBS develop anxiety or depression, with generalized anxiety disorder as the most common mental disorder in that population.
Types of Stress
Not only is mental health more affected in those with IBS but the stress response is also heightened. Stress is any event (perceived or actual) that disrupts the balance between our mind and body. Stress can be acute or chronic and includes daily inconveniences, life-threatening trauma, and everything in between. Lastly, stress can be physical or psychological in nature. Physical stress includes things such as surgery, infection, and working out, while psychological stress is what we’re more accustomed to and includes emotional reactions, relationship problems, job loss, financial struggles, etc.
IBS and Stress
In someone with IBS, stress of any kind can exacerbate IBS symptoms. Depending on which type of IBS a person has, their stress response can trigger abdominal pain, diarrhea, or constipation. Gut motility, for example, is affected to a greater extent during a stress response in those with IBS than it is for those without IBS. Motility in this context means the movement of the large intestine that causes rhythmic contractions to push digested food through our digestive tract.
In response to stress, those with IBS can experience either a speeding up or a slowing down of gut motility. Having faster motility leads to diarrhea while slower motility leads to slow gastric emptying and constipation.
Another item about impaired motility is that it can affect the natural balance of our gut bacteria and actually cause an overgrowth. This overgrowth is what characterizes SIBO (small intestine bacterial overgrowth) and is why those with IBS often develop SIBO or are greatly helped by following a low FODMAP diet. Interestingly enough, chronic stress alone is enough to set our gut bacteria off-balance and cause dysbiosis (even without the help of slowed motility).
Ways to Cope
With all the communication that takes place between our gut and our brain, it’s important to make sure that only healthy messages are being sent. By this I mean that a healthy brain translates to a healthy gut (this goes for anyone with a gut and a brain, not just those with IBS!!). The good news is research shows that stress management can help prevent IBS symptoms (or ease any flare-ups). The following tips can help you formulate a stress management plan to get your brain and your gut on the same wavelength.
Cognitive Behavioral Therapy (CBT) is a mind-body therapy that helps alter the way we think and respond to stress. It provides new perspectives while helping us regain control and confidence with effective coping strategies.
Keep a symptom journal. Document your symptoms on a daily basis to help you make connections between which thought processes or events may be triggering your IBS symptoms. Once you understand your specific stressors, take steps to spot them coming and avoid them.
Mindful eating. Help soothe your gut by practicing mindfulness during mealtimes. Create a peaceful eating environment where you can sit away from daily distractions. Focus on how your meal will nourish you and eat slowly, chewing thoroughly.
Gratitude. Take control over your stress or anxiety by practicing daily gratitudes. Focus on what you’re grateful for each day while letting go of any negative thoughts, to-do lists, worries, or busy schedules. Many people opt for a gratitude journal to remind themselves of past thoughts of thankfulness.
Relax. Relaxation will look different for everyone. Sometimes it’s a hobby, sometimes it’s taking a walk, listening to music, or maybe even the act of washing dishes. The important thing is to set aside time to do what you enjoy. This activity should also be relaxing for you. Aim to relax in this way at least twice a week and notice how your attitude, emotions, and overall well being brightens up.
Daily movement. Those with IBS would do best with gentle activities that don’t trigger symptoms. Such movements support the gut-brain connection while lowering stress. Walking, yoga, bike riding, and swimming are all great options.
Acupuncture. Many people with IBS report that acupuncture helps minimize stress and anxiety. In fact, acupuncture can be effective in a variety of gastrointestinal disorders and symptoms from nausea to ulcers, Crohn’s disease to IBS. Importantly, acupuncture can also help relax an overstimulated fight or flight response (stress response).
Those with IBS usually have several triggers that bring on symptoms. Not all of them are food related though. Stress and anxiety are strongly related to IBS and can affect IBS symptoms. The communication channel between our gut and our brain is what allows our gut health to affect our brain health (and the other way around). Lowering stress and anxiety triggers will go a long way towards alleviating or even preventing IBS symptoms. Call our team at Healthy Connections for a free discovery call to get started on a gut healing plan for your IBS.