Stress-Induced IBS: The Gut-Brain Axis at Work

Irritable bowel syndrome (IBS) is a digestive condition that affects millions of people around the world. It can be very frustrating to diagnose, as many cases are determined primarily by ruling out other conditions. 

There can be many symptoms of IBS that vary depending on the individual. But one thing that many people with IBS will report experiencing is how much their mood and physical symptoms go together. Let’s unravel the gut-brain connection between stress and IBS. 

Understanding IBS: Symptoms and Impact

IBS is a functional digestive disorder. Its common symptoms include abdominal pain, bloating, and changes in normal bowel patterns. Some people experience constipation more frequently while others struggle with diarrhea, and many people fluctuate between the two. 

There are various factors thought to be involved in the development of IBS and fluctuations of its symptoms. For instance, it may be influenced by genetics, sleep disorders, exposure to medications like antibiotics (especially in early life), smoking, disrupted immune function, and disturbances in gut bacteria. There is also a growing spotlight on IBS and stress.

Regardless of how IBS manifests, it can understandably take a toll on your quality of life and ability to perform daily tasks as normal. It can be painful at times, inconvenient, and annoying to struggle with IBS symptoms. Furthermore, while there are ways to help certain symptoms with the hope of putting IBS into remission, there’s currently no cure for the condition.

The Role of Stress in IBS

Think about the last time you were preparing to speak or perform in front of a crowd of people or initiate a conversation with a stranger you thought was attractive. You might remember the feeling of having “butterflies in your stomach” that are often associated with nervousness. This is a prime example of how your gut and brain talk to each other. When your nerves calm down, the butterflies also go away. 

Along these same lines, stress can be a trigger — and exacerbator — of IBS symptoms. If you have IBS, you might notice that your symptoms tend to worsen when you’re feeling overwhelmed or anxious AKA stress-induced IBS.

The gut-brain connection has always been there but we continue to learn more about how closely these two parts of the body talk to and impact one another. The “gut-brain axis” is a term that describes the bidirectional communication pathways between your brain and your digestive system. 

Researchers have found that mental stress can alter the balance and makeup of your gut microbiome, the community of trillions of microorganisms that live in your digestive system and influence your wellness. When the communication between your gut bacteria, digestive system, and brain is imbalanced, it can negatively influence the regulation of your emotions and digestive function. 

IBS is considered a stress-sensitive disorder. There’s plenty of evidence that being stressed out can significantly impact your intestinal motility, permeability, and sensitivity. Scientists believe this is because psychological stress can alter the neuro-endocrine-immune pathways that act on the gut-brain axis and lead to symptomatic IBS flare-ups.

Furthermore, studies have shown that people who suffer from IBS are more likely to experience depression and anxiety compared to those who do not have IBS. This may be related to how much back and forth there can be between mental health and gut health symptoms and the toll it can take on everyday life.

Stress Management and IBS

If you have stress-induced IBS, you’re probably wondering what you can do to better manage your symptoms. A helpful first step is to identify how certain types of stressors physically impact you. Implementing stress management practices can benefit both your mental load and how it manifests as digestive symptoms. 

A recent review examined the effects of stress management techniques on typical physical symptoms among adults with IBS. The authors concluded that intentionally practicing stress management can offer short-term mental and physical benefits for IBS but long-term effects are unclear. 

Still, stress management has been shown to help slow down your heart rate, lower blood pressure, slow breathing rate, support normal blood sure levels, and improve digestion. 

If you’re not sure where to begin with stress management, here are some practices to try on: 

• Mindfulness: Mindfulness is the practice of acceptance as well as learning to be present in the moment and more closely connected to your body and mind. One study conducted over 8 weeks found that mindfulness-based stress reduction training was associated with significant improvements in digestive symptoms and related problems among participants with IBS.
• Meditation: This is the art of training your attention and awareness, with the goal of reaching a calm, stable, and mentally clear state of mind. Some research has found that practicing meditation can help improve reported quality of life and reduce subjective pain among people with IBS. This may also incorporate the use of breathing techniques, which have been shown to help reduce feelings of stress by calming your respiratory and central nervous systems. 
• Exercise: Being physically active offers countless benefits for your body and mind. One randomized controlled trial among 109 sedentary women with IBS found that adding 24 weeks of low-to-moderate intensity exercises was helping in alleviating certain symptoms compared to those who remained sedentary. This is thought to be due to the antioxidative and anti-inflammatory effects of exercise on the body. 
• Cognitive behavioral therapy (CBT): CBT is a form of therapy that focuses on uprooting negative or irrational beliefs that are interfering with achieving optimal health and function. When CBT is used among people with IBS, it may be effective in reducing feelings of anxiety as well as associated physical symptoms. Some researchers believe that improving access to CBT among people with IBS could offer long-term benefits. 

In addition to stress management practices, it’s important to fuel your body well. A poor diet can further promote a gut bacterial imbalance that adds to IBS symptoms.

Aim to adopt an overall diet pattern that includes plenty of fruits and vegetables, healthy fats, and lean proteins. This also includes identifying whether certain foods trigger IBS symptoms and eliminating them. Pro tip: work with a gut health dietitian to help you identify triggers and make an individualized nutrition plan. 

Can Stress Cause IBS?

Researchers believe an association exists between IBS and stress, largely because of how stress influences the balance of our gut bacteria. Therefore addressing underlying stressors and personal triggers is an integral piece of IBS management. It’s best to take a comprehensive approach to IBS care that takes into account both physical and mental aspects. A team of qualified health professionals, including a mental health therapist and a gut health dietitian, can be enormously beneficial. 

References

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Amanda Sauceda, MS, RDN

Amanda is a pizza loving registered dietitian nutritionist specializing in mindfulness and gut health. She quickly realized that gut health goes beyond the gut; it is also about honoring our gut feelings. She is the creator of The Mindful Gut™ which uses science and strategy to help people improve their gut health.