If you have irritable bowel syndrome (IBS) and feel an urgent need to run to the bathroom every time your boss pings you, your mother-in-law texts, or your friends change plans at the last minute, it’s time to focus on the stress that could be triggering your symptoms.
For some people with IBS, the condition can be exacerbated by an imbalance in the signals that the brain sends to the gut and the gut sends back to the brain, and this bodily response can be worsened by stress.
“Stress increases the hormone cortisol, and it can impact our digestive system,” says Megan Riehl, PsyD, a gastrointestinal psychologist at University of Michigan Health in Ann Arbor. “People with IBS have trouble downregulating digestive distress. They may feel the digestive process with some gurgling or discomfort, and that sets off stress signals and a fear that they will need the bathroom urgently.”
Here, find out more about the stress response in IBS and what experts say you can do to lessen its impact.
The IBS-Stress Connection
One research review found that stress and anxiety were significantly more common in people with IBS than in those without the condition.
“Behavioral treatments for IBS are needed as a complement to medicine to get patients over the finish line,” says Brennan Spiegel, MD, a gastroenterologist and the director of health services research at Cedars-Sinai in Los Angeles. “Patients need to develop skills and train their brain to overcome the symptoms of IBS, and that means combating stress.”
So if you’re living with IBS, make sure that you’re not neglecting to manage stress, as it can significantly impact your gastrointestinal symptoms.
Here are three ways to reduce IBS-related stress.
1. Exercise to Relieve Stress With IBS
You don’t have to be a member at a CrossFit box or a fancy gym to reap the mental health benefits of physical activity. Moderate exercise like walking, jogging, swimming, and cycling is enough to reduce stress in the general population.
And a review that included research on physical activity in people with IBS notes that one study found it can have a significant effect on symptom relief. Two other studies included in the review — in which people with IBS engaged in moderate- to high-intensity exercise like walking, cycling, and aerobics three to five times a week for 20 to 60 minutes each session — showed beneficial effects on symptoms and well-being, as well as reduced depression and anxiety, when compared with a control group.
Another review found that studies on
yoga improved IBS symptom severity, mood-related symptoms, and quality of life, compared with a control group. And in the general population, yoga has been found to reduce stress.
“Exercise helps boost our endorphins and lower cortisol levels, which means we feel happier and less stressed,” says Dr. Riehl. “That’s when the brain and gut send much more favorable signals to each other.”
An exercise habit increases
norepinephrine, a hormone and
neurotransmitter that helps protect your brain from stress. Exercise also trains the nervous system to better respond to stress.
2. Breathe Deeply to Help Manage Stress and IBS Symptoms
Deep breathing is one of Riehl’s go-to techniques when teaching her patients to reduce stress.
“Stress makes for shallow, short breaths,” she says. “When we slow our breathing down, we kick-start the parasympathetic system that calms us down and gives a nice massage to the digestive organs. That reduces spasming and urgency.”
One technique that she is particularly fond of is diaphragmatic breathing. It involves slow and deep belly breathing, affecting the brain as well as the cardiovascular, respiratory, and gastrointestinal systems. A small study of people with constipation-predominant IBS found that slow, deep breathing at a rate of six breaths per minute for 30 minutes, at least five days a week for six weeks, improved symptoms and rectal sensitivity in the group that did the breathing exercise intervention, compared with a control group.
Another small study found that just five minutes of breath work per day improved mood and reduced anxiety. The researchers found cyclic sighing, which uses a double inhale and emphasizes prolonged exhalations, to be the most effective form.
3. Try Gut-Directed Hypnosis
Gastrointestinal psychologists have found that
gut-directed hypnosis is extremely effective at
reducing stress and improving IBS symptoms. In this technique, a trained therapist guides a patient into a focused state of awareness and deep relaxation. Through suggestions and imagery, gut-directed hypnosis aims to calm the digestive tract and steer attention away from physical discomfort. Self-directed apps like
Nerva also offer such programs.
One research review notes that of the available brain-gut behavioral therapies, gut-directed hypnosis and cognitive behavioral-based interventions have the most evidence for both short-term and long-term success.
“Oftentimes, when people with IBS fail to find relief with other strategies, they tend to have success with gut-directed hypnosis, as long as they’re open to trying it,” says Riehl.
“We can develop the skills to stop the brain from [ruminating] on gastrointestinal-specific worries,” she says. “For example, we can start to retrain the mind when someone is always imagining that they will have a bowel accident in public. It’s how we identify and think about IBS in our day-to-day life that can make symptoms better or worse.”
Additional reporting by Ashley Welch.
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