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A Two-Way Street: The Connection Between Stress and IBS

Irritable Bowel Syndrome (IBS) is a common gastrointestinal disorder characterized by abdominal pain, bloating, and altered bowel movements. While the exact cause of IBS is not down one specific factor, stress is believed to play a significant role in the development and maintenance of the condition.

Stress is the body's natural response to perceived threats or challenges. When we are stressed, our body releases hormones such as cortisol, which helps to regulate our body's stress response. Although stress can be beneficial in small doses, chronic stress can have negative effects on the body, including the digestive system.

The relationship between the two is multifaceted, but research suggests that stress may trigger and exacerbate IBS symptoms [1]. This is because stress activates the body's "fight or flight" response, which can disrupt digestion and lead to gastrointestinal symptoms. Activation of the “fight or flight” response affects the way the brain and gut interact. The gut has a large number of nerve cells that communicate with the brain; these signals regulate gut movements and ensure the digestive system is functioning in a regular manner. Unfortunately for us, stress wreaks havoc with the body and so the communication between the brain and gut can be disrupted, leading to symptoms such as abdominal pain and diarrhoea.

Stress can also alter the balance of the gut microbiome (the community of bacteria that lives in digestive tract). The gut microbiome plays a crucial role in the functioning of the digestive system, and changes in the microbiome can lead to digestive problems (e.g. inflammation and discomfort). Research shows that chronic stress is associated with reduced gut microbiome diversity [2] and therefore an imbalance of gut bacteria.

In addition to these physiological effects, stress can also worsen IBS symptoms by increasing anxiety and negatively impacting an individual's coping mechanisms. For example, individuals who are under a lot of stress may be more likely to turn to unhelpful behaviours, such as avoiding foods or going to the toilet more regularly, which can further irritate the digestive system.

Where it can get tricky to navigate is when a vicious cycle starts to form. You’re stressed which impacts on symptoms, but because the symptoms are worsening, you start to feel stressed out about them. The relationship is essentially a two-way street; stress impacts symptoms and symptoms feed back into stress. All sorts of feelings and emotions can come up and add things into the mix – worry, guilt, shame, embarrassment, anger, upset – and it can all feel overwhelming and difficult to untangle.

While it's not always possible to avoid stress and in small doses it can be helpful, there are strategies out there that can help reduce and manage stress to improve IBS symptoms. This may involve setting boundaries, finding ways to relax and recharge, and seeking support from friends and loved ones. It may take some trial and error to find the techniques that work best for you.

If you are someone who has IBS or know someone who does, you may like to enquire about our CBT for IBS services which include an online 8-week therapy group (next starting 26th Jan 2022!), individual CBT for IBS therapy or guided self-help, using the evidence-based programme from the ACTIB trial.

[1] Qin, H. Y., Cheng, C. W., Tang, X. D., & Bian, Z. X. (2014). Impact of psychological stress on irritable bowel syndrome. World journal of gastroenterology, 20(39), 14126–14131.

[2] Geng, S., Yang, L., Cheng, F., Zhang, Z., Li, J., Liu, W., ... & Zhang, J. (2020). Gut microbiota are associated with psychological stress-induced defections in intestinal and blood–brain barriers. Frontiers in microbiology, 10, 3067.


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