IBS and Stress: Is There a Link?

Written by: Dr. Maitreyi Raman, MD, MSc, FRCPC

Updated: April 3rd, 2023

Have you ever heard anyone tell you that your symptoms of IBS are all in your head? In 2023, there is an evolving body of medical literature that describes a strong connection between the brain and the gut, and in turn the gut and the brain. The bi-directional connection and communication between the brain and the gut is the latest and most comprehensive description that explains IBS.

Several factors such as early adverse childhood events, depression, anxiety and stress create changes in the brain. Did you know that the brain is highly “plastic”? It is not made of plastic of course, but refers to neuroplasticity – meaning that the structure and the function of the brain has the ability to change! Through exposures in the environment, the processing of stress and emotions, and the practice or implementation of specific lifestyle behaviours, certain areas of the brain may grow or shrink, and neural connections may increase or decrease.

Ultimately, the novel understanding of brain “neuroplasticity” provides a tremendous understanding and foundation for both why IBS may occur, and may offer a wide array of therapeutic interventions for its relief. As if this isn’t complex enough, the entire digestive system is lined with a mesh-like body of neurons which is referred to as the ‘Enteric Nervous System.’ Our brains are connected to the gut and the rest of the body through something called the vagus nerve. The vagus nerve is responsible for the human ‘fight or flight’ response to external stimuli, in particular stress. While the cause of IBS may not be in everyone’s head, it is likely to be a contributing factor to many, and stress is a big factor to the brain and vagus nerve.

Stress’ Impact on IBS

Stress is a major risk factor for IBS. Individuals with IBS may frequently report symptom flares during periods of higher stress. Common examples of life stressors include periods of transitions (death of loved ones, loss of employment, new employment, retirement), financial insecurity, illness of loved ones, aging of parents. Even positive life events such as birth of a new child and a new promotion may result in positive stress otherwise referred to as eustress. Stress can impact the structure and function of the brain; it can also result in the liberation of stress hormones, and other chemicals liberated through the nervous system to affect how the gut functions. Stress can alter the movement (motility) in the intestine by either speeding up the bowel transit or slowing it down, physically affect the contractions and movement of your gastrointestinal system, sometimes causing pain and other bowel symptoms such as diarrhea, constipation or both.

Research studies have confirmed that stress management can have positive results upon the symptoms of IBS, such as abdominal pain, bloating and diarrhea and constipation. Stress management strategies can reverse the stress-induced changes in the brain, and alter the signalling between the brain and the gut. While we may have heard of the need to manage stress, what tools do you have in your toolbox to practically implement stress reducing strategies on a day-to-day basis?

Many mind body interventions have demonstrated effectiveness to improve stress. Mind body interventions are lifestyle behaviours that can impact the brain as well as the body, and they have been shown to improve happiness, wellness, stress, depression, anxiety, and yes, IBS as well! Examples of mind body interventions include yoga, yogic breathing, mindfulness, gut hypnosis, relaxation, cognitive behavioural therapy (CBT), physical activity, Tai Chi and even listening to music. These can be learned from a yoga instructor, a yoga therapist, psychologist, and even through digital health and virtual tools.

Practical Strategies to Manage Stress

Quite a lot can be involved in a full stress management plan, and everything should be tailored to individual needs. Many stress management techniques can be added quite simply to your day-to-day life. As always, it is important to discuss any changes you make to your routine with your health care provider.

Deep Breathing

Even just 5-10 minutes of deep breathing per day can help you cope with stress. Taking a moment to focus on your breathing can help keep your mind from wandering to external stressful events or internal emotions. There are hundreds of breath practices that can positively impact the vagus nerve and its function. Belly breathing, alternate nostril breathing and breath watching practices are three popular breathing practices that can be readily learned through a beginner class for yoga, or even online through meditation and breathing applications. The LyfeMD application (www.lyfemd.com) is one such application that is available to use at no cost if you have IBS and live in Canada. Concentrating on your breathing and listening to your body helps you focus on doing something positive for your well-being.

Mindfulness

Our minds are fascinating things. But oftentimes our minds wander – causing us to overthink and ruminate on situations that cause us stress. Mindfulness practices are those that help us to focus on being fully present in the moment we are currently in. When we are truly focused on being present we are consciously not allowing our minds to wander to stressful situations and emotions.

Mindfulness might sound easy, but it can be tough as we need to train our brains to focus only on the present. The good news is that mindfulness practice is free and available to all of us. Being mindful can be as simple as sitting in a comfortable chair, closing your eyes and focusing on your breathing. But you can also practice mindfulness while doing physical activities like yoga and tai chi, or while following guided or non-guided meditation. Anything that helps us to focus on the present rather than letting our mind unconsciously wander to the past or future allows is to enjoy the gift of the present moment.

Choose the mindfulness technique, or techniques, that work best for you that fit into your lifestyle. Remember that mindfulness takes practice, and its normal to find your mind wandering back to stressful thoughts even while practicing mindfulness. When you notice your mind drifting to other thoughts, try to consciously return your thoughts to your breathing and focus on being present in the moment. Try the mindfulness practices in the LyfeMD application for IBS.

Practice Gratitude

Sometimes when we are overcome with stress it is challenging to think of the positive in our lives. By consciously remembering what we have to be thankful for, we help ourselves to put the current situation that is causing us stress into perspective. It’s especially important when we are stressed to remember that this moment will pass and that there are many things we have to be grateful for. Also, sometimes it is helpful to write down thoughts of gratitude. The act of writing down your thoughts can be cathartic in and of itself, and you can return to these writings again in the future to help provide yourself perspective.

Speak with Someone

If you are struggling with stress it can be helpful to speak to someone about what you are feeling. Talk to a family member, friend, your doctor, or anyone you trust is a good way to help you talk through your concerns. You can even talk to yourself – but be sure to focus on being positive. Negative self-talk is often the source of our stress, so be aware of your negative emotions and try to change the negative thoughts to more positive ones. Remember that everyone struggles with stress at times. Be compassionate and kind to yourself. Cognitive Behavioural Therapy (CBT) is an effective solution to retrain one’s thoughts, which in turn will alter the emotional response and ultimately behaviours. CBT is among the most effective therapies for IBS symptoms. Talk to your doctor about your interest in CBT, if you struggle with negative self-talk, fear, or anger which may affect your IBS symptoms.

What to Expect

Using stress management to treat IBS symptoms is certainly not an overnight cure. It requires consistency and commitment in order to see tangible, long-term results. It’s important to consult with your doctor for guidance and medical advice throughout your personal journey, and to be better informed on when you can expect to see a difference, what you should notice, etc.

We recommend that you try to commit to whatever stress management technique(s) you decide on for at least three weeks and log your findings in the myIBS app. If you are having trouble with a particular stress management technique, try another option before giving up entirely. If you are looking to start any stress management techniques, the LyfeMD application (www.lyfemd.com) is one such application that is available to use at no cost if you have IBS and live in Canada.

Remember that stress is a part of everyone’s life, and finding strategies to help you manage stressful times can reap lifelong benefits not just for your IBS symptoms but also your overall well-being.

Looking for more information on treatment options for IBS? Check out more resources:

CDHF’s myIBS App

MyIBS is our FREE and easy-to-use tracking app for Irritable Bowel Syndrome (IBS). Journal your symptoms, poop, food, sleep, stress and more with this flexible tool that helps you better understand and manage your IBS. Download it today on the App Store, or on Google Play!

LyfeMD App

LyfeMD empowers people to take control of their wellness through an easy-to-use application. The LyfeMD app provides personalized health coaching to those with chronic digestive and inflammatory diseases. Learn more about the LyfeMD App today!