How Stress Affects Irritable Bowel Syndrome (IBS) And Other Digestive Problems

Remember as a child when you felt nervous and excited the night before the first day of school? You may have told your parents, “I have a stomach ache.” Were you suddenly sick? Or was it something else?

Could it be that there is a relationship between your emotions and your gastrointestinal (GI) tract or gut? Does it explain why feeling anxious causes IBS symptoms to flare up in some people? Or, does it make sense that in a period of increased stress, constipation develops in others?

Actually, it all fits together when you understand the brain-gut connection.

Contents:

What Is The Brain-Gut Connection?

What Are Functional Gastrointestinal Disorders (FGID)?

Is Stress Affecting Your IBS Symptoms?

How Are FGIDs Diagnosed?

What Are The Other Functional Gastrointestinal Disorders (FGID)? And How Is Stress Related?

Which Other Health Problems Occur With FGIDs?

What Are Common Treatments For IBS And Other FGIDs?

Goodpath’s Integrative Approach

What Is The Brain-Gut Connection?

The brain-gut connection (also called the gut-brain connection) is a very complex communication system between the brain, part of the central nervous system, and the GI tract, where the enteric nervous system is embedded. The enteric nervous system, sometimes called the “second brain,” is a network of nerve cells within the GI tract.

To add to the complexity, the pathway between the brain and organs (autonomic nervous system), endocrine glands, and gut bacteria (microbiota) are also involved.

Although we still have much to learn, this system helps explain the relationship between your stress level and emotions, your brain function, and your GI tract. In other words, your emotions and stress affect your GI tract and your GI tract affects your emotions. It’s a two-way street.

What Are Functional Gastrointestinal Disorders (FGID)? And Why Is Stress A Trigger?

IBS is one of many functional gastrointestinal disorders. This group of very common GI conditions is closely linked to the brain-gut connection. They are called “functional” because there is a problem with the way the GI tract functions or works. The symptoms may be related to one, or a combination, of the following:

  • Abnormal movement of food through the intestines

  • Heightened sensitivity of the nerves in the intestines

  • Changes in brain processing 

  • Altered GI tract lining (mucosa) and immune functioning

  • Changes in gut bacteria (microbiota)

Is Stress Affecting Your IBS Symptoms?

A person with IBS has a group of signs and symptoms that affect the colon, or large intestine. The symptoms often change over time and may be mild, moderate, or severe. Depending on the severity, they can have a significant impact on quality of life. 

Now that you know that IBS is a functional disorder - i.e. it is related to the brain-gut connection,  it makes sense that “irritable” is part of its name. Not only can feeling stressed or irritated affect IBS, but the GI tract itself is also irritated - i.e you have GI symptoms. You may have worsening abdominal pain, diarrhea, or constipation, for example. 

You may also feel more stressed when your symptoms worsen. This creates a continuous cycle of stress - symptoms - stress - and so on.

How Are FGIDs Diagnosed?

There aren’t specific diagnostic tests for FGIDs. Other GI conditions are diagnosed based on actual structural changes in the gut. For example, doctors can see changes in the lining of the GI tract in people with inflammatory bowel disease (IBD) when they view it with a scope (colonoscopy).

With functional GI conditions, there aren’t actual changes to the structures of the GI tract. That means findings on such tests are usually normal - despite the presence of mild-to-severe disease.

IBS and other FGIDs are usually diagnosed by discussing your symptoms with your doctor. Diagnostic tests may be done to exclude other causes for your symptoms.

What Are The Other Functional Gastrointestinal Disorders (FGID)? And How Is Stress Related?

IBS is the most common functional GI disorder however, there are many other functional disorders affecting the GI tract.  Like IBS, they are also due to dysfunction of the brain-gut connection. And, once again, there is a two-way relationship between stress and emotions and symptoms.

These FGIDs may affect the esophagus, stomach and small intestine, large intestine, gallbladder, anus and rectum. 

Some examples are:

  • Functional dysphagia (affects the esophagus). This is trouble swallowing without actual changes in the esophagus.

  • Functional dyspepsia (affects the stomach and small intestine) is indigestion without a known cause.

  • Functional gallbladder disorder.  This disorder causes a problem with the way the gallbladder functions.

  • Functional constipation (affects the large intestine). Here, we see difficult or infrequent bowel movements. 

There are also FGIDs that are more common in infants and toddlers, like colic, and in children and adolescents, e.g., various abdominal pain disorders.

Which Other Health Problems Occur With FGIDs? And Are They Also Affected By Stress?

To further add to the challenges of coping with IBS and other FGIDs, many people have other non-GI functional disorders. These disorders are also impacted by stress in a way that is not completely understood, but is likely similar to FGIDs.

They include fibromyalgia, chronic fatigue syndrome, chronic back pain, chronic headache, chronic pelvic pain, and temporomandibular joint (TMJ) dysfunction.

Additionally, depression, anxiety, and other mental health conditions are very common among those with IBS or other FGIDs.

What Are Common Treatments For IBS And Other FGIDs? And Do They Address Stress?

Treatments for IBS, as well as other FGIDs, may lessen symptoms (e.g. abdominal pain) and/or address the brain-gut connection. 

Prescriptions, Over-the-Counter Medicines, and Supplements

Treatment for IBS, as well as other FGIDs, may include prescription and over-the-counter (OTC) medicines and supplements for symptom relief. 

Prescriptions

For example, it may be recommended that a person with IBS take certain prescription medications like:

  • Antispasmodics to lessen cramping

  • Antidepressants to relieve pain and improve symptoms in general 

The Brain-Gut Connection -- Again

We already know that FGIDs are linked to abnormal brain-gut functioning. And we know the symptoms of these disorders are related to several factors, including increased sensitivity of the nerves in the intestines and changes in brain processing. So how does an antidepressant help? By decreasing the sensitivity of the nerves in the intestines and supporting brain processing - all while decreasing psychological stress.

OTCs

OTC medicines for IBS may include osmotic laxatives (those that draw water into the GI tract), such as polyethylene glycol (Miralax)​​ to help with bowel movements and loperamide to slow the movement of food through the GI tract.

Supplements

Guar gum and fiber, like psyllium, are recommended for IBS-C since they increase the consistency of stool and the frequency of bowel movements (see also soluble fiber-rich foods below). Peppermint oil is another supplement that generally improves IBS symptoms. And probiotics can help lessen overall IBS symptoms, as well as abdominal pain.

Diet and Nutrition

To lessen IBS symptoms, dietary recommendations include the following: 

  • A food diary to help identify and avoid dietary triggers (foods that worsen symptoms)

  • A low FODMAP diet (fermentable oligo-saccharides, di-saccharides, mono-saccharides, and polyols) can help lessen IBS symptoms and support gut bacteria and hormones.

  • Soluble fiber-rich foods (like whole-grain foods; nuts and seeds; berries, apples and pears; and peas, broccoli, and squash) 

Mind-Body Therapies

Since IBS and other FGIDs are related to an abnormal brain-gut connection, it makes sense that mind-body therapies are a significant part of treatment. Evidence supports the effectiveness of mind-body methods, -such as mindfulness meditation - in reducing stress, improving mood, and increasing overall quality of life.

Some mind-body therapies are:

Physical Activity

Exercise and physical activity can positively impact both IBS symptoms and emotional health.  Much research supports the benefits of exercise for anxiety, depression, and other mental health conditions, as well as overall stress reduction. Exercise can also help prevent GI symptoms and regulate the movement of food through the intestines. 

Goodpath’s Integrative Approach

Goodpath understands the relationship between stress, IBS, and other digestive problems. That’s why we address anxiety, stress, and depression in our programs. In order to do just that, we offer programs that include personalized supplements and medicines, mind-body therapies, exercise, and diet.

Take the Goodpath IBS Assessment if you want to know what program we recommend for you.