IBS and Stress Can Both Be Managed
Whether you’ve recently been diagnosed with irritable bowel syndrome or have long been affected by the condition, then you’ll have been told that stress and anxiety play a major role.
Evidence from multiple studies suggests that people suffering with IBS have higher sensitivity to stress, and frequently suffer from anxiety and depression.
While there’s no known specific cause for IBS but research into the link between the brain and the gut is strong: stress and anxiety can trigger over- or underactivity in your gut, resulting in diarrhea and stomach cramps or constipation and discomfort.
The good news is:
You can use this knowledge to begin treating your IBS as a symptom of your stress and anxiety, and work on healing yourself by changing your thinking.
Stress, Anxiety and Your Gut
Given how closely the gut and brain interact, it becomes easier to understand why you might feel nauseated before giving a presentation, or feel intestinal pain during times of stress.
That doesn’t mean, however, that functional gastrointestinal conditions are imagined or “all in your head.” Psychology combines with physical factors to cause pain and other bowel symptoms.
Psychosocial factors influence the actual physiology of the gut, as well as symptoms. In other words, stress (or depression or other psychological factors) can affect movement and contractions of the GI tract, make inflammation worse, or perhaps make you more susceptible to infection.
Psychology combines with physical factors to cause pain and other bowel symptoms.
In addition, research suggests that some people with functional GI disorders perceive pain more acutely than other people do because their brains are more responsive to pain signals from the GI tract. Stress can make the existing pain seem even worse.
Connecting IBS and Stress
You might expect that at least some patients with functional GI conditions might improve with therapy to reduce stress or treat anxiety or depression.
And sure enough, studies bear this out.
Psychological therapies reduce GI symptoms in adults with IBS. These effects remained significant and medium in magnitude after short-term and long-term follow-up periods.
A 2016 review and meta analysis published in the journal Clinical Gastroenterology and Hepatology concluded that:
“Psychological therapies reduce GI symptoms in adults with IBS. These effects remained significant and medium in magnitude after short-term and long-term follow-up periods.”
In a prospective cohort study looking at almost 600 people whose gastroenteritis was caused by the bacterium Campylobacter, researchers found that the patient’s ability to handle stress before the infection was a pivotal factor in whether they went on to develop IBS.
Those with higher levels of perceived stress, anxiety, and negative illness beliefs at the time of infection were at a greater risk to develop IBS. By contrast, depression and perfectionism did not seem to increase the risk of IBS.
A 2017 study which analyzed 50 patients between the ages of 18 and 65 who were diagnosed with IBS concluded that “The high prevalence of psychiatric comorbidities such as anxiety and depression in IBS samples in our study provides evidence in favor of proper screening for these disorders in gastrointestinal clinics. Recognition and treatment for these comorbidities can improve the quality of life as well as overall outcomes.”
A meta analysis which analyzed 220 studies found that:
“IBS symptoms are often exacerbated during stressful events and the psychiatric treatment has a positive effect on gastro-intestinal symptomatology.”
Symptoms of Stress
Watch for these other common symptoms of stress and discuss them with your doctor. Together you can come up with strategies to help you deal with the stressors in your life, and ease your digestive discomforts.
Physical Symptoms of Stress
- Stiff or tense muscles, especially in the neck and shoulders
- Sleep problems
- Shakiness or tremors
- Recent loss of interest in sex
- Weight loss or gain
Behavioral Symptoms of Stress
- Grinding teeth
- Difficulty completing work assignments
- Changes in the amount of alcohol or food you consume
- Taking up smoking, or smoking more than usual
- Increased desire to be with or withdraw from others
- Rumination (frequent talking or brooding about stressful situations)
Emotional Symptoms of Stress
- Overwhelming sense of tension or pressure
- Trouble relaxing
- Quick temper
- Poor concentration
- Trouble remembering things
- Loss of sense of humor
Stress And Digestive Problems: Beyond IBS
Unreasonable deadlines. Being stuck in traffic. Having too much to do and not enough time to do it in.
Most of us are familiar with these kinds of daily stresses that get our heart racing, our breath quickening, and our stomach churning.
Of course, just having a digestive condition can be a source of anxiety in itself.
Studies show that a major stressful event long-since passed could still be affecting your gut even now.
Plus, being stressed-out also causes many of us to overeat and drink too much alcohol, both of which affect our gut.
What is the real effect of stress on our gut?
Many studies show that stressful life events are associated with the onset of symptoms, or worsening of symptoms, in several digestive conditions, beyond IBS including inflammatory bowel disease (IBD), gastroesophageal reflux disease (GERD), and peptic ulcer disease.
Many studies have shown that stressful life events precede the onset (or worsening) of several digestive conditions.
Inflammatory Bowel Disease
This study identified a variety of mechanisms by which stress affects both the systemic and gastrointestinal immune and inflammatory responses.
Gastroesophageal Reflux Disease
However, in practice, chronically anxious patients were more likely to notice worsening of their symptoms during a stressful event.
In other words, their attitude affected their perception of symptom severity.
Peptic Ulcer Disease
Most ulcers result from infection with bacteria called Helicobacter pylori (H. pylori). Contrary to old beliefs, neither eating spicy food nor living a stressful life cause stomach ulcers.
H. pylori bacteria weaken the protective mucous coating of the esophagus, stomach, or duodenum, which then allows acid to get through to the sensitive lining beneath.
Both the acid and the bacteria irritate the lining and cause a sore, or ulcer. However, evidence suggests that ongoing stress leads to mucosal lining inflammation, thereby allowing gastric juices to irritate the sensitive stomach lining underneath.
Evidence suggests that ongoing stress leads to mucosal lining inflammation.
Other Digestive Issues
Stress increases gut motility and fluid secretion. This is why you might get a bout of diarrhea or repeated urges to urinate during or following a stressful event.
Stress can both delay emptying stomach contents and speed up passage of material through the intestines. This combination of activity leads to abdominal pain and altered bowel habits.
Additionally, acute psychological stress decreases a person’s pain threshold.
Anxiety and Stress Management
The two extremes are that some people can handle major upsets without batting an eye, while others become distressed at the slightest deviation from their normal routine.
It’s important to remember that in small doses, stress can be a good thing. It can give you the push you need, motivating you to do your best and to stay focused and alert. Problems accumulate only when stress is constant.
Problems accumulate when stress is constant.
The specific signs and symptoms of stress vary from person to person, but the potential to harm your health, emotional well-being, and relationships with others is real.
Stress affects the mind, body, and behavior in many ways apart from the digestive tract, including weight fluctuations, head and muscle aches, mood changes, and altered mental function.
You’ll probably have to experiment to find the best way(s) of dealing with life’s stressors.
By understanding how you deal with stress, you can make lifestyle changes that will lower your stress level, help you better cope with stress, and recover from stressful events more quickly.
Treat Anxiety to Treat IBS
Because there is a close association between anxiety and IBS, techniques currently being implemented to treat anxiety are likely to lessen the symptoms of your IBS.
Reducing stress can help also reduce the severity and frequency of IBS symptoms.
Cognitive Behavioral Therapy
Dozens of studies show that cognitive behavioral therapy (CBT) is effectiveness in IBS patients. Harvard University researchers reviewed 13 of them in a meta-analysis.
The patients who tried psychological-based approaches had greater improvement in their digestive symptoms compared with patients receiving only conventional medical treatment.
One of the most compelling studies came out in 2018 It was the largest federally funded non-drug clinical trial for irritable bowel syndrome and included over 400 IBS patients
The study found that more than 60% of the patients reported substantial improvement in their GI symptoms in just four or fewer visits to the psychologist, plus doing the work at home. They practiced deep breathing and worked on changing their self-talk so as not to catastrophize events and other known triggers.
Meditation is training in awareness and getting a healthy sense of perspective.
You’re not trying to turn off your thoughts or feelings. You’re learning to observe them without judgment. And eventually, you may start to better understand them as well.
Learning to meditate is like learning any other skill. Think of it like exercising a muscle that you’ve never really worked out before. It takes consistent practice to get comfortable. And it’s usually easier if you have some guidance.
Recommended: Relax: Guided Meditations to Ease Stress & Anxiety
There are several mechanisms in yoga that have an effect on stress levels, meaning there are multiple ways that yoga can minimize your stress levels.
Studies show that yoga is associated with improved regulation of the sympathetic nervous system and the hypothalamic-pituitary-adrenal system.
By simultaneously getting us into better moods, enabling us to be more focused on the present moment, and by encouraging us to give ourselves a break, yoga is a very effective stress reliever.
Recommended: Levoit Premium Yoga Set Kit
This fantastic 8 piece set contains everything you need to learn and practice yoga in your own home.
- 1 yoga mat
- 2 yoga blocks
- 1 yoga mat towel
- 1 yoga hand towel
- 1 stretch strap
- a professional DVD teaching video
- smart-looking carrying case.
This set has excellent user reviews.
If you’re looking for a way to reduce stress, consider tai chi. Originally developed for self-defense, tai chi has evolved into a graceful form of exercise that’s now used for stress reduction and a variety of other health conditions.
Often described as meditation in motion, tai chi promotes serenity through gentle, flowing movements.
When learned correctly and performed regularly, tai chi can be a positive part of an overall approach to improving your health.
The benefits of tai chi include:
- Decreased stress, anxiety and depression
- Improved mood
- Improved aerobic capacity
- Increased energy and stamina
- Improved flexibility, balance and agility
- Improved muscle strength and definition
A study published in the medical journal Psychiatric Clinics of North America concluded that tai chi is an “evidence-based approach to improve health-related quality of life, and … may be effective in reducing depressive symptoms, stress, anxiety, and mood disturbances.
Recommended: Tai Chi Fit In Paradise (2018)
This is a beginner-friendly whole-body workout, filmed in beautiful Hawaii.
Enjoy a tai chi vacation and get into the flow, that feeling you get when all the moves are connected, continuous, and harmonious. This workout will help you find inner peace through moving meditation.
The purchaser reviews for Tai Chi Fit In Paradise are fantastic. Customers say this DVD is easy to follow, “flowing and mellow,” with a beautiful and relaxing background.
There is a growing body of literature that recognizes the positive effects of exercise on mood states such as anxiety, stress and depression, through physiological and biochemical mechanisms.
A large cross-sectional study published in The Lancet Psychiatry in 2018 found that “… exercise was significantly and meaningfully associated with self-reported mental health…”
Exercise Pumps Your Endorphins
Physical activity helps bump up the production of your brain’s feel-good neurotransmitters, called endorphins.
Although this function is often referred to as a runner’s high, a rousing game of tennis or a nature hike also can contribute to this same feeling.
Exercise is “Meditation in Motion”
After a fast-paced game of racquetball or several laps in the pool, you’ll often find that you’ve forgotten the day’s irritations and concentrated only on your body’s movements.
As you begin to regularly shed your daily tensions through movement and physical activity, you may find that this focus on a single task, and the resulting energy and optimism, can help you remain calm and clear in everything you do.
Exercise Improves Your Mood
Regular exercise can increase self-confidence, it can relax you, and it can lower the symptoms associated with mild depression and anxiety.
It can also improve your sleep, which is often disrupted by stress, depression and anxiety.
All of these exercise benefits can ease your stress levels and give you a sense of command over your body and your life.
Hypnosis can be used for stress management in two ways:
First, you can use hypnosis to get into a deeply relaxed state, fighting tension and triggering your relaxation response. This will help to prevent health problems due to chronic stress.
Second, hypnosis can help you achieve various healthy lifestyle changes that can reduce the amount of stress you encounter in your life.
Autogenic Training (Self-Hypnosis)
Autogenic Training is a form of self-hypnosis which was developed in the 1930’s by German physician Dr. Johannes Shultz.
It allows you to attain a state of profound relaxation and peace.
The process is completely passive and indirect. In other words, rather than thinking consciously about making a particular change occur, you induce specific body changes, such as warmth or heaviness, by concentrating on visual imagery, sounds, or parts of your body.
It’s related to visualization, sensory imagery techniques, and meditation.
Autogenic training is not complicated, but the lessons follow a specific progression and take a good deal of time and discipline to master.
Success requires consistent, regular practice!
There are six basic steps which are taught in series, one step per session. Sessions always start at step one and continue in sequence, adding the latest step at the end of practice.
The goal of the activity is passivity and observation, rather than trying to force a particular sensation to occur. The exercise takes place while the trainee is sitting or lying comfortably.
Autogenic Training Script
1. Inducing the sensation of heaviness
1.1. Think of your right arm as being very heavy. (Begin with your left arm if you are left handed.) Repeat to yourself six times, “My right (left) arm is very heavy.”
1.2. At the end of the sixth repetition, say to yourself once, “I am completely calm.”
1.3. Repeat steps 1.1 and 1.2 five or six times. Try to disregard all thoughts except those involved in the training.
1.4. Repeat steps 1.1 through 1.3 for each arm and leg.
2. Inducing a sense of warmth
2.1. Do step 1 in its entirety.
2.2. Using the same format as in step one, repeat to yourself six times: “My right (left) arm is very warm.” Then say, “I am completely calm” once.
2.3. Repeat the heaviness routine followed by “My right (left) arm is very warm.” Do this six times, ending each repetition with “I am completely calm,” Repeat this entire sequence several times.
2.4. Continue as above, repeating the heaviness and warmth routines for each arm and leg.
3. Heartbeat practice
3.1. After a complete repetition of the previous steps, begin heartbeat practice by thinking, “My heartbeat is calm and regular.” Repeat this six times, followed by “I am completely calm” once.
3.2. Repeat the entire series, beginning with “My right/left arm/leg is very heavy” and ending with “I am completely calm.” Do this several times.
4. Breathing practice
4.1. Following the repetition of all prior steps, begin breathing practice by repeating to yourself, “My breathing is calm and regular.” Repeat this six times, followed by “I am completely calm” once.
4.2. Repeat the entire series beginning with, “My right/left arm is very heavy” several times.
5. Solar plexus (abdominal) practice
The solar plexus is a large network of neurons (cells in our brain and nervous system) that regulates the function of the abdominal organs. It lies midway between the breastbone and the navel and is part of the autonomic nervous system.
5.1. Following repetition of all prior steps, begin work on the solar plexus by repeating, “My solar plexus (abdomen) is warm” six times, followed by “I am completely calm” once.
5.2. Repeat the entire series, beginning with the heaviness routine, several times.
6. Head practice
6.1. Begin by thinking “I am very calm.” Repeat all of the previous steps. Complete each step six times, beginning and ending with “I am very calm.”
6.2. When you have repeated all the earlier steps, begin head practice by thinking, “My forehead is cool” six times, followed by “I am very calm” once.
6.3. Repeat the entire program, from the heaviness routine through head practice, several times.
Antidepressants, particularly the selective serotonin reuptake inhibitors (SSRIs), are widely used to treat and prevent a variety of anxiety disorders.
Examples of SSRIs that are commonly used to treat chronic anxiety include citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac), paroxetine (Paxil), and sertraline (Zoloft).
The antidepressants duloxetine (Cymbalta) and venlafaxine (Effexor), SNRIs (serotonin and norepinephrine reuptake inhibitors) which act on the brain chemicals serotonin and norephinephrine, and some of the tricyclic antidepressants like imipramine (Tofranil), may also help.
Antihistamines (such as hydroxyzine) and beta-blockers (such as propranolol) can help mild cases of anxiety as well as performance anxiety, a type of social anxiety disorder.
Antidepressants such as SSRIs or SNRIs or tricyclics need to be taken daily whether or not you have anxiety on that particular day, as prescribed by your health care provider.
Antihistamines or beta-blockers are usually taken only when needed for anxiety, or immediately before an anxiety-provoking event (for example, taking propranolol shortly before giving a speech).
Finally, certain anticonvulsant medicines, such as gabapentin (Neurontin) and pregabalin (Lyrica), are also beginning to show value in treating some forms of anxiety in initial research studies.
Speak to your doctor if you feel you may benefit from an antidepressant.
Anxiety Protocol: Natural Anxiety Treatment By A Psychiatrist
Written by a psychiatrist who has specialized in mental health for over 15 years, Anxiety Protocol by Dr. Carlo Caradang is the system I recommend if you suffer with generalized anxiety disorder.
Not to be confused with General Anxiety which is quite a normal life reaction, people who suffer from Generalized Anxiety Disorder will experience exaggerated worry and tension.
They often expect the worst when there is no reason to.
It starts slowly, during your teen or young adult years.
The symptoms may get better and worse, but it will manifest itself more during times of stress.
If the symptoms are mild, you can hold a normal job and function socially, but if symptoms are severe one can have difficulty carrying out the simplest of daily activities.
General Anxiety Disorder (GAD) Symptoms
- Can’t Relax
- Startle Easily
- Difficulty Concentrating
- Trouble Sleeping (falling asleep and/or staying asleep)
- muscle tension
- muscle aches
- difficulty swallowing (or feeling a “lump” in your throat)
- trembling or twitching
- having to go the the bathroom frequently
- feeling out of breath
- hot flashes
This isn’t a simple technique; it’s a collection of multiple techniques that have taken Dr. Caradang years to write and compile.
Many anxiety programs have only 1 simple technique that is supposed to be the cure-all for anxiety, but you can’t really use the same thing for everybody.
Some people need meditation, some people need exercise.
This protocol will provide you with the guidance to explore proven techniques that will empower you to ease your anxiety (and likely heal your IBS) for good.
The Relaxation & Stress Reduction Workbook
A New Harbinger Self Help Workbook – 7th Edition
Now in its seventh edition—with more than one million copies sold worldwide—The Relaxation and Stress Reduction Workbook remains the go-to resource for stress reduction strategies that can be incorporated into even the busiest lives.
The Relaxation and Stress Reduction Workbook broke new ground when it was first published in 1980, detailing easy, step-by-step techniques for calming the body and mind in an increasingly overstimulated world.
Now in its seventh edition, this fully revised and updated workbook—highly regarded by therapists and their clients—offers the latest stress reduction techniques to combat the effects of stress and integrate healthy relaxation habits into every aspect of daily life.
This new edition also includes powerful self-compassion practices, fully updated chapters on the most effective tools for coping with anxiety, fear, and panic—such as worry delay and “defusion”, two techniques grounded in acceptance and commitment therapy (ACT)—as well as a new section focused on body scan.
In the workbook, you’ll explore your own stress triggers and symptoms, and learn how to create a personal action plan for stress reduction. Each chapter features a different method for relaxation, explains why the method works, and provides on-the-spot exercises you can do when you feel stressed out.
The result is a comprehensive yet accessible workbook that will help you to curb stress and cultivate a more peaceful life.
The Mindful Self-Compassion Workbook: A Proven Way to Accept Yourself, Build Inner Strength, and Thrive
Are you kinder to others than you are to yourself?
More than a thousand research studies show the benefits of being a supportive friend to yourself, especially in times of need.
This science-based workbook offers a step-by-step approach to breaking free of harsh self-judgments and impossible standards in order to cultivate emotional well-being.
In a convenient large-size format, the book is based on the authors’ groundbreaking eight-week Mindful Self-Compassion (MSC) program, which has helped tens of thousands of people worldwide.
It’s packed with guided meditations (with audio downloads); informal practices to do anytime, anywhere; exercises; and vivid stories of people using the techniques to address relationship stress, weight and body image issues, health concerns, anxiety, and other common problems.
The seeds of self-compassion already lie within you–learn how you can uncover this powerful inner resource and transform your life.
Although the exact nature of the relationship between IBS and anxiety is still largely unknown, anxiety relief techniques have proven to be an efficient method to manage symptoms of IBS.
Hopefully, future studies will provide more insight into the relationship between IBS and anxiety and help researchers discover preventative measures for symptoms of IBS.
In the meantime, knowing that your psychological state plays a major role in IBS is the first, important step toward relief.
You’ll probably have to experiment to find the best way(s) of dealing with life’s stressors.
By understanding how you deal with stress (and which management techniques work best for you), you’ll be able to make lifestyle changes to lower your stress level, help you better cope with stress, and recover from stressful events more quickly.
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4. Naliboff BD, Mayer M, et al. The effect of life stress on symptoms of heartburn. Psychosomatic Medicine 2004;66:426-434.
5. Mayer, EA. The neurobiology of stress and gastrointestinal disease. Gut 2000;47;861-869.
6. Mawdsley JE, Rampton DS. Psychological stress in IBD: News insights into pathogenic and therapeutic implications. Gut 2005;54:1481-1491.