Stressing Out Over IBS

IBS and stress connections and treatments

/ Author:  / Reviewed by: Robert Carlson, M.D

Irritable bowel syndrome, or IBS, is a gastrointestinal disorder than can be quite unpleasant. Symptoms like abdominal pain, diarrhea, constipation, cramping and bloating may affect patients with IBS.

Thankfully, as Women’s Health (a website provided by the US Department of Health and Human Service’s Office on Women’s Health) reports, IBS “does not lead to serious disease, such as cancer. It also does not permanently harm the large intestine (colon).”

Though the disorder is not life threatening, these symptoms can be a source of stress for those coping with IBS.

What's more, the stress caused by symptoms may not be the only way in which tension interacts with the disorder.

IBS and stress seem to be connected, and researchers and medical professionals are exploring exactly how. Does more stress worsen the condition? Are stressed out people more likely to develop IBS? And maybe the most hopeful question for patients – can getting a handle on stress in their life bring some relief to IBS symptoms?

The Biological Connection

In an article published by the University of North Carolina School of Medicine, Howard Mertz, MD, Associate Professor of Medicine and Radiology at Vanderbilt University explored the connection between stress and IBS.

As Dr. Mertz points out, many systems inside the body interact closely with the stress response system, including the cardiovascular system and sweat glands. The processes of the gastrointestinal system can also be stimulated by a sense of stress.

The Anxiety and Depression Association of America (ADAA) explains another stress-gastro connection: "The colon is in part controlled by the nervous system, which responds to stress."

In IBS patients, stress can cause spasms in the colon, which may lead to unpleasant symptoms, according to the National Digestive Diseases Information Clearinghouse (NDDIC).

“The colon has many nerves that connect it to the brain. These nerves control the normal contractions of the colon and cause abdominal discomfort at stressful times,” explains NDDIC. “In people with IBS, the colon can be overly responsive to even slight conflict or stress.”

While there seems to be a clear biological connection between stress and gastrointestinal symptoms, it is important to note that there is no evidence that stress causes IBS. In fact, doctors and researchers are still searching for what may cause IBS. Currently, there is no known cause.

Furthermore, while stress may play a role in some patients' IBS, this is not true across the board. Stress is only one potential element that may factor into IBS. 

According to the Mayo Clinic, "For reasons that still aren't clear, if you have IBS you probably react strongly to stimuli that don't bother other people. Triggers for IBS can range from gas or pressure on your intestines to certain foods, medications or emotions."

A certain food may trigger symptoms in one patient but not another. Similarly, stress may worsen symptoms in some patients but not all. 

What The Stress Factor Means for Treatment

For patients that are affected by stress, there are a variety of IBS treatments or strategies for coping that may not seem immediately like intuitive ways to treat a gastrointestinal disorder, but could help patients ease symptoms.

Though stress and IBS can be connected, as mentioned before, there are still many additional mental and emotional factors associated with IBS that professionals don’t yet completely understand.

According to Dr. Mertz, “Emotional distress is very common in IBS patients, particularly those who seek medical treatment for the condition. Anxiety and depression are significantly increased in IBS patient populations, present in nearly 40 percent.”

Because of the stress and emotional factors, treatments ranging from psychotherapy to hypnosis, and even certain antidepressant medications may help soothe IBS symptoms.  

“Recent evidence indicates the drugs may work by reducing the brain’s response to intestinal pain during stress,” writes Dr. Mertz.

Women’s Health reports on several types of psychotherapy that may help IBS patients, including cognitive behavioral therapy, or CBT. CBT can include a variety of therapy types and strategies.

“The type of CBT used to treat IBS may focus on managing life stress. Or, it may focus on changing how a person responds to anxiety about IBS symptoms,” reports Women’s Health.

Dynamic psychotherapy, in which a short-term but intensive method is taken, may center around detailed and thorough discussions about potential connections between emotional responses and symptoms.

Hypnosis or hypnotherapy is also sometimes used to treat IBS. According to Women’s Health, after patients are put into an “altered state of consciousness,” suggestions that help them visualize pain disappearing may be made.

Putting It All Together

As more is learned about the connection between IBS and stress, and about all the factors contributing to IBS, doctors can better treat these uncomfortable symptoms. 

Since IBS triggers vary from patient to patient, there is also a wide variety of effective treatments.

Women's Health reports that for some, diet changes and avoiding certain foods may help. For others, medications like anti-diarrheals, fiber supplements or prescription IBS medications may do the trick. Still others may respond to one of the psychotherapy methods mentioned earlier. 

Some patients can make strides in easing symptoms by taking steps to manage stress in their day-to-day lives. Women’s Health suggests regular exercise, meditation, yoga and massage as methods that can help people with IBS reduce stress and hopefully reduce symptoms. 

If physical IBS symptoms don't improve with stress reduction methods, perhaps these methods will lead to a life with less tension despite symptoms.

Reviewed by: 
Review Date: 
January 27, 2013