Can irritable bowel syndrome (IBS) be caused by stress?

 

Although stress does not cause IBS, it is now widely accepted as a disorder of the gut-brain axis (GBA). Understanding what the GBA is and how it operates is key to understanding the link between IBS and stress.

Firstly, the gut has its own nervous system called the enteric nervous system (ENS), also known as ‘the second brain’. This is connected to the brain or central nervous system (CNS) via a two-way highway and allows messages to be carried from the brain to the gut and vice versa. The gut and the brain are in constant communication with each other via the GBA.

Secondly, the enteric nervous system together with the sympathetic and parasympathetic nervous systems make up the autonomic nervous system (ANS), and this controls most of the processes that happen unconsciously in the body including digestion and breathing. The ENS also acts on messages it receives from these two branches of the ANS.

This is where the link between stress and IBS comes into the equation.

The sympathetic nervous system controls the body’s stress or ‘fight or flight’ response whilst the parasympathetic nervous system is responsible for the ‘rest and digest’ state. So, what happens in the body when we experience a stressful event or threat, whether real or perceived? The stress response, activated by the sympathetic nervous system, is only concerned with keeping you alive in that moment and prepares the body accordingly. Blood flow and energy is directed away from non-essential processes such as the gut and digestion and is shunted toward the muscles and heart allowing you to ‘fight or flight’.

We know that changes in gut motility resulting in constipation and/or diarrhoea are a feature in IBS, and this is thought to be driven and worsened by stress via the gut-brain axis. In other words, stress experienced in the brain has a direct effect on the functioning of the gut. We also know that the gut is far more reactive in an IBS sufferer than in those who do not have IBS.

But not all stress is bad, and it is an unavoidable part of life. The problem is not stress itself but rather our perception of it. In contrast to our ancestors who had to react to real physical threats like being chased by a lion, most of the stress we experience now in our daily lives is psychological in nature or perceived threats.

Unfortunately, the body’s stress response does not know the difference between real or perceived stress and reacts in the same way regardless. And the body is not designed to stay in the stress response for prolonged periods of time.

The good news is that you can control how you choose to react to different stressors. The clue is in your perception of the stressor. Your brain is constantly taking cues from your external environment through the different senses of sight, smell, touch, hearing, and taste but your thoughts have a big role to play also.

Here are some techniques you can use to help you deal with stress better

 

1. Meditation

  • A regular meditation practice can make you less reactive to stressful events that happen in your daily life.
  • I recommend starting with one of the many free apps like Insight Timer, Calm or Headspace.
  • Try just a few minutes a day, it doesn’t have to be a big commitment.

2. Deep breathing

  • Allows the body to tap into the parasympathetic nervous system which controls the ‘rest and digest’ state.
  • There are lots of different deep breathing techniques like the 4-4-4 or box breath, 4-7-8 or alternate nostril breathing. Find the one that works best for you and do that.

3. Journalling

    • The simple act of writing down what is causing you stress or worry can help to give you perspective and to find solutions rather than having fearful or negative thoughts running around in your head.
    • A lot of what we stress about never actually happens!

    4. Yoga

      • Gentle exercise like yoga can help to calm the nervous system and activate that ‘rest and digest’ state.
      • There are lots of free yoga classes you can access online any time.

      5. Prioritising sleep

        • The ability of the body and mind to deal with stress is severely impaired when we do not get enough or have poor quality sleep.
        • Getting outdoors in the morning for 10-15 minutes can help to regulate your sleep-wake cycle.
        • Avoiding caffeine past midday to avoid it interfering with your sleep.
        • Moving your body daily can help with your sleep drive.

        How you react to stress is largely under your control and using the techniques above can help you to form a healthier relationship with stress.

        In answer to the question can IBS be caused by stress? No, although IBS is not specifically caused by stress it can trigger a flare up of symptoms for many patients.

        IBS is so unique to everyone and what works for someone else will be different to what works for you. There are many factors that contribute to IBS; your nutrition, sleep, movement, stress management and when you work with me, we address all aspects of your diet and lifestyle to find the solution for you.

        If you know that stress is a major trigger for your IBS and would like more support, then you might be interested in my ‘Flare Up Rescue Power Hour’ package. You can find the details here.

        If you want to discuss your options further then you can book a free 15 minute clarity call.