How Stress Affects Irritable Bowel Syndrome (IBS) And Other Digestive Problems
Remember as a child when you felt nervous and excited the night before the first day of school? You may have told your parents, “I have a stomach ache.” Were you suddenly sick? Or was it something else?
Could it be that there is a relationship between your emotions and your gastrointestinal (GI) tract or gut? Does it explain why feeling anxious causes IBS symptoms to flare up in some people? Or, does it make sense that in a period of increased stress, constipation develops in others?
Actually, it all fits together when you understand the brain-gut connection.
What Is The Brain-Gut Connection?
To add to the complexity, the pathway between the brain and organs (autonomic nervous system), endocrine glands, and gut bacteria (microbiota) are also involved.
Although we still have much to learn, this system helps explain the relationship between your stress level and emotions, your brain function, and your GI tract. In other words, your emotions and stress affect your GI tract and your GI tract affects your emotions. It’s a two-way street.
What Are Functional Gastrointestinal Disorders (FGID)? And Why Is Stress A Trigger?
Abnormal movement of food through the intestines
Heightened sensitivity of the nerves in the intestines
Changes in brain processing
Altered GI tract lining (mucosa) and immune functioning
Changes in gut bacteria (microbiota)
Is Stress Affecting Your IBS Symptoms?
Now that you know that IBS is a functional disorder - i.e. it is related to the brain-gut connection, it makes sense that “irritable” is part of its name. Not only can feeling stressed or irritated affect IBS, but the GI tract itself is also irritated - i.e you have GI symptoms. You may have worsening abdominal pain, diarrhea, or constipation, for example.
You may also feel more stressed when your symptoms worsen. This creates a continuous cycle of stress - symptoms - stress - and so on.
How Are FGIDs Diagnosed?
With functional GI conditions, there aren’t actual changes to the structures of the GI tract. That means findings on such tests are usually normal - despite the presence of mild-to-severe disease.
IBS and other FGIDs are usually diagnosed by discussing your symptoms with your doctor. Diagnostic tests may be done to exclude other causes for your symptoms.
What Are The Other Functional Gastrointestinal Disorders (FGID)? And How Is Stress Related?
These FGIDs may affect the esophagus, stomach and small intestine, large intestine, gallbladder, anus and rectum.
Some examples are:
Functional dysphagia (affects the esophagus). This is trouble swallowing without actual changes in the esophagus.
Functional dyspepsia (affects the stomach and small intestine) is indigestion without a known cause.
Functional gallbladder disorder. This disorder causes a problem with the way the gallbladder functions.
Functional constipation (affects the large intestine). Here, we see difficult or infrequent bowel movements.
There are also FGIDs that are more common in infants and toddlers, like colic, and in children and adolescents, e.g., various abdominal pain disorders.
Which Other Health Problems Occur With FGIDs? And Are They Also Affected By Stress?
They include fibromyalgia, chronic fatigue syndrome, chronic back pain, chronic headache, chronic pelvic pain, and temporomandibular joint (TMJ) dysfunction.
Additionally, depression, anxiety, and other mental health conditions are very common among those with IBS or other FGIDs.
What Are Common Treatments For IBS And Other FGIDs? And Do They Address Stress?
Prescriptions, Over-the-Counter Medicines, and Supplements
Treatment for IBS, as well as other FGIDs, may include prescription and over-the-counter (OTC) medicines and supplements for symptom relief.
For example, it may be recommended that a person with IBS take certain prescription medications like:
Antispasmodics to lessen cramping
Antidepressants to relieve pain and improve symptoms in general
The Brain-Gut Connection -- Again
We already know that FGIDs are linked to abnormal brain-gut functioning. And we know the symptoms of these disorders are related to several factors, including increased sensitivity of the nerves in the intestines and changes in brain processing. So how does an antidepressant help? By decreasing the sensitivity of the nerves in the intestines and supporting brain processing - all while decreasing psychological stress.
OTC medicines for IBS may include osmotic laxatives (those that draw water into the GI tract), such as polyethylene glycol (Miralax) to help with bowel movements and loperamide to slow the movement of food through the GI tract.
Guar gum and fiber, like psyllium, are recommended for IBS-C since they increase the consistency of stool and the frequency of bowel movements (see also soluble fiber-rich foods below). Peppermint oil is another supplement that generally improves IBS symptoms. And probiotics can help lessen overall IBS symptoms, as well as abdominal pain.
Diet and Nutrition
To lessen IBS symptoms, dietary recommendations include the following:
A food diary to help identify and avoid dietary triggers (foods that worsen symptoms)
Soluble fiber-rich foods (like whole-grain foods; nuts and seeds; berries, apples and pears; and peas, broccoli, and squash)
Since IBS and other FGIDs are related to an abnormal brain-gut connection, it makes sense that mind-body therapies are a significant part of treatment. Evidence supports the effectiveness of mind-body methods, -such as mindfulness meditation - in reducing stress, improving mood, and increasing overall quality of life.
Some mind-body therapies are:
Cognitive behavioral therapy involving intentional changes in thoughts and behaviors can help improve the function of the brain-gut connection
Relaxation methods such as progressive muscle relaxation (PMR) and guided imagery can reduce stress.
Yoga reduces the body’s reaction to stress through its impact on the brain-gut connection, in particular, the autonomic and enteric nervous systems and immune functioning (see above).
Exercise and physical activity can positively impact both IBS symptoms and emotional health. Much research supports the benefits of exercise for anxiety, depression, and other mental health conditions, as well as overall stress reduction. Exercise can also help prevent GI symptoms and regulate the movement of food through the intestines.
Goodpath’s Integrative Approach
Take the Goodpath IBS Assessment if you want to know what program we recommend for you.