The Connection Between IBS, Stress, and Anxiety
Dr. Paul Deglmann
Meghan Feir Walker
IBS and stress are commonly interwoven conditions. If you’ve ever been nervous about a big project, social interaction, or another nerve-wracking situation, you’ve probably experienced some digestive distress along with it.
While many doctors wrongly assume all their patients’ digestive symptoms are caused by anxiety when there are other potential causes they didn’t test, it’s important to realize what a pivotal role mental health can have on your gut—and vice versa! There are times when anxiety is the cause of your digestive distress. However, gut problems can cause anxiety. It sometimes feels like a “chicken or the egg—which came first” type of scenario.
Read on to learn more about IBS and stress and the practical strategies you can implement to reduce stress-related IBS.
How stress impacts IBS
Have you been to various doctors and specialists to discover why you have chronic digestive symptoms? Perhaps you’ve had various tests done, only to rule out one condition after another. This is often when doctors diagnose chronic digestive symptoms as IBS. IBS is a functional gut condition that can’t be tested for and doesn’t have a known cause. It’s the diagnosis patients commonly get when doctors have no idea what’s causing their digestive distress.
One of the most common things patients hear from doctors is that their digestive problems are caused by anxiety. So is IBS caused by stress? The answer is sometimes, but not always. Even if stress isn’t the root cause of why you developed IBS, it can majorly contribute to symptoms.
The gut-brain connection is so strong that whatever is happening in the gut can affect how the brain functions. For example, the gut produces up to 95 % of the body’s serotonin. When neurological problems occur, this can affect how the gut functions as well. Stress affects the gut, and gut problems can cause stress. These physiological responses are all a part of what’s called the gut-brain axis.
Stress and anxiety increase the sympathetic/fight-or-flight response in the body, which negatively affects the gut and contributes to symptoms. This effect happens via the brain-gut axis. Gut motility problems, sensitivities, and inflammation can be worsened by stress.
Slow motility/constipation
A chronic stress response can cause slow motility and constipation by decreasing migrating motor complex (MMC) activity. MMC activity is a cyclical pattern of muscle contractions in the small intestine and stomach that happens when you fast. It helps send leftover food particles, bacteria, and other unwanted bits to the large intestine. This helps prevent bacterial overgrowth. When this isn’t working properly, constipation and slow motility can lead to other problems, such as SIBO (link to SIBO article).
Fast motility/diarrhea
Other people may experience diarrhea. For example, acute stress and high amounts of stress can cause diarrhea.
Types of stress triggers:
Any of these stressors can lead to IBS flares or an increase in symptoms.
- Work stress
- Financial stress
- Relationships
- Major life changes/events
- Low blood sugar
- Inflammation
- Pain
- Illness
- Infection
- Anxiety
- Depression
The role of stress and anxiety in IBS
It’s normal to experience occasional stress or periods of life where stress happens more frequently. However, there’s a difference between short-term stress and ongoing anxiety.
It’s common for people with IBS to have clinical anxiety. As explained earlier, gut problems can cause anxiety, and anxiety can cause gut problems.
Many people have more anxiety because of their gut symptoms. Imagine all your gut problems went away. How much less anxious would you feel? Obviously, it can be hard to know the extent of what caused what, but it’s still a good question to ask. There are many situations where IBS symptoms make life much more stressful.
The digestive symptoms that come along with IBS can make it difficult to want to go out to eat with loved ones and friends. These symptoms may make you apprehensive about going to someone’s house for dinner because you don’t know how you’ll react. This additional stress creates more anxiety, and the anxiety often increases the very IBS symptoms they were hoping to avoid (gas, bloating, abdominal pain, constipation and/or diarrhea, etc.).
This vicious cycle impacts the brain-gut axis and gut-brain axis.
When it seems likely that the main cause of these problems begins in the gut, you need to address the gut first. This potentially can reduce anxiety.
Symptoms of IBS related to stress and anxiety
Anxiety and stress can bring on various gut symptoms.
Here are the most common symptoms related to anxiety and stress:
- Bloating/gas
- Abdominal pain
- Constipation
- Diarrhea
- Belly pain, bloating, and cramping related to constipation
- Changes in stool appearance
- Changes in bowel movement frequency
- Sensations of incomplete stool passing
- More mucus in the stool
- Muscle spasms in the bowel
- Changes in the gut microbiome
- Increased intestinal permeability, which can add inflammation and pain and alter the immune system
Managing stress and anxiety to alleviate IBS symptoms
How do you get rid of anxiety-induced IBS and exit this cycle of pain?
While it would be wonderful to take a magical pill that could alleviate all your symptoms, the reality is that it can take effort and focus to reduce IBS and anxiety symptoms.
Thankfully, there are many different strategies you can use to help address and manage your stress and anxiety, such as mindfulness/relaxation techniques (meditation, deep breathing), cognitive behavioral therapy (CBT), various forms of exercise, and physical activity. There are also various at-home apps and online programs that can be helpful as well. We like the Calm app, Heart Math, Dynamic Neural Retraining System (DNRS), and many others.
Mindfulness and relaxation techniques
Mindfulness and relaxation techniques, such as prayer, meditation, deep breathing exercises, and mindful eating can help calm the nervous system and improve gut health.
Cognitive-behavioral therapy (CBT)
Cognitive behavioral therapy can help you manage stress and anxiety and has been shown to help many people with IBS. Whether you meet with a counselor online or in person, this can be a big step toward healing.
Exercise and physical activity
Exercise is a healthy, effective way to reduce stress, improve digestion, and support overall health.
When experiencing gut symptoms, high-intensity exercises can sometimes cause more stress on the gut. This is why we recommend low-impact options like walking, yoga, pilates, or swimming that are more gentle on the digestive system.
Try to incorporate at least 20-30 minutes of exercise a few times a week. You can work your way up to exercising every day.
Dietary adjustments
For IBS patients, certain foods can increase stress on the gut and trigger symptoms.
The most common IBS dietary triggers include:
- Grains
- Dairy
- Sugar
- Caffeine
- Spicy foods
- High FODMAP foods
- More
At RHS, we do extensive food and microbiome testing to individualize the diet for each patient with IBS. By reducing or taking out these particular foods, for a time, many patients experience relief from their symptoms.
Building a support system
Don’t minimize the importance of your social circle when it comes to health and wellness. Being around people you enjoy, sharing a laugh, and sharing support with your loved ones can help minimize gut problems and anxiety.
Consider counseling to help manage the stress and anxiety in your life. Dealing with unresolved emotional issues can often improve gut symptoms.
You can also join support groups with people who share your same conditions and learn how they are managing their symptoms.
Testing
Comprehensive testing is crucial in finding overlooked problems, clues, and causes of gut and anxiety issues.
Some of the common tests we run at RHS to help personalize the plan include:
- Genetic testing for gluten sensitivity predisposition
- Food allergy panels
- Food sensitivity panels
- Stool testing
- Organic acids testing
- Nutritional deficiencies
- Adrenal/cortisol panel
- Hormone panel
- And others
Learn to relax
Find a hobby that relaxes you and captures your attention. Be intentional about getting physical activity every day. Try to drink enough water, eat healthy food, and take care of your body. Taking care of your body is taking care of your brain, and taking care of your brain can help improve your gut health. Everything is connected in some way or another.
Find relief from IBS
While stress, anxiety, and IBS can feel relentless and unfixable, there is hope for you. There is hope. You can feel better. At Restorative Health Solutions, we see IBS get better often with our comprehensive approach and “Test, Don’t Guess” strategy.
If stress and IBS are affecting your quality of life, a consultation with Dr. Paul Deglmann could be your first step toward relief. Call (952) 479-7801 or email frontdesk@rhsedina.com to schedule your free, 15-minute consultation to see how our personalized approach might help you.
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