IBS and Stress

IBS AND STRESS, how it affects your Irritable Bowel Syndrome digestion and ways to reduce symptoms are all discussed below.

If you have been stressed, you'll know that it affects your symptoms.

But what is stress and how can you reduce your levels?

IBS and Stress

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What is Stress?

It is your body’s RESPONSE to mental, physical and emotional loads put on it.

It is the overwhelming feeling that you experience when too much of these elements are placed on you as a person.

There are many reasons for this including exam, work, relationship or financial stress to name but a few.

Symptoms include sweating, increased heart rate, flushing, agitation, mood changes, feeling of impending doom, emotionally labile, muscle tension, dry mouth and headaches.

With IBS and Stress you also experience worsening of your bowel symptoms, particularly abdominal cramps and diarrhoea.

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A Model of IBS and Stress

Stress Model - The Brain-Gut Axis

WORSENING SYMPTOMS are explained through the brain-gut axis theory.

This theory is based on excessive signals sent to the brain from both external and internal stimuli.

The stimulation can occur from smells, visual stimuli, touch and hearing.

These stimuli result in signals sent to the brain which in turn interpret them as feelings.

In the brain there are various chemical messengers which can influence brain signals.

The main one is SEROTONIN and increased levels can result in excessive, abnormal signalling to the bowel through nerve impulses from the spinal cord.

Serotonin is also present in the bowel, in high concentrations too.

Abnormal signalling causes release of adrenaline or epinephrine. These increase your heart rate, cause flushing and make you feel hot. You may experience intense feelings of anxiety and develop hyperventilation or panic.

Stress and digestion are intimately linked as bowel motility increases which results in cramps and diarrhoea.

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How Can You Manage Symptoms?

The first thing in managing your IBS and stress is actually RECOGNISING you have it.

Whilst this is usually obvious to the sufferer, this isn't always so. If in any doubt, discuss this with your doctor for further advice.

Having ascertained you have it, are there any simple measures you can take to relieve this?

Well, the obvious answer is to avoid the precipitant, but this is often not easy or possible.

Taking time out from the stress may help, for example having breaks when revising for exams.

Another example is to allocating work load to others if suffering from work stress.

Exercise is an excellent way of relieving symptoms as well as being good for your general health.

Make sure that you eat a balanced diet and try to avoid excessive amounts of stimulants such as caffeine in tea and coffee.

Hypnotherapy is a method of altering perception and we know it can help with both IBS and stress.

Cognitive behavioural therapy can also help and is as advised for refractory symptoms by the National Institute For Clinical Excellence.

Aromatherapy is both relaxing and therapeutic. Whether the touch and smell stimuli have a modifying effect on stress signals is debatable, but certainly some people find it beneficial.

Drugs may have a role for some people with stress and IBS. Beta blocker drugs, such as propranolol, can help to reduce symptoms of palpitations and are sometimes employed if anxiety is a prominent feature.

Anxiolytic medications such as the benzodiazepines e.g. Diazepam or Valium can be used as a short term measure.

Antidepressants can sometimes be helpful; particularly the tricyclic antidepressant group, such as Amitriptyline, have some benefit in neuromodification along with the SSRI group, such as Paroxetine and Fluoxetine, which affect Serotonin (see Brain-Gut axis).

Specific stress management courses may benefit along with psychotherapy from your family doctor or from a psychotherapist.

Finally, if you prefer self-help I would highly recommend the book by Dr Steve Peters called "The Chimp Paradox".

It’s an easy read, may seem rather bizarre at times although it really sums up why we "are what we are" and shows you ways of reducing your stress and anxiety.

The Chimp Paradox has also been used by some of the British Olympians including Sir Chris Hoy with the obvious results he has achieved.

For anyone with IBS and stress, I think this is an excellent opportunity for you to change the way you think about your illness and see how your illness can be a reflection of you too.You can pick up your copy by going to Chimp Paradox.

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Clinical Evidence

There is evidence for the effect of stress on IBS. An example of this is the Prevalence and factors associated with irritable bowel syndrome among medical students of Karachi, Pakistan: A cross-sectional study. Naeem SS, Siddiqui EU, Kazi AN, Memon AA, Khan ST, Ahmed B. This study looked at medical students diagnosed with IBS according to the Rome criteria. Nearly 56% of the students with IBS had anxiety symptoms.

Another study, Clin Gastroenterol Hepatol. 2012 Apr;10(4):385-90.e1-3. Epub 2011 Dec 16. Association between early adverse life events and irritable bowel syndrome. Bradford K, Shih W, Videlock EJ, Presson AP, Naliboff BD, Mayer EA, Chang L. looked at adverse life events such as physical, psychological and relationship abuse before the age of 18. This showed a correlation with the development of IBS, particularly in women.

The final study of interest, J Health Psychol. 2011 Jan;16(1):91-8. Epub 2010 Jul 14. The association between irritable bowel syndrome and the anxiety vulnerability factors: body vigilance and discomfort intolerance. Keough ME, Timpano KR, Zawilinski LL, Schmidt NB looked at the role of anxiety in Irritable Bowel Syndrome symptoms. It showed increased vigilance to bodily sensations and increased desire to avoid them too.

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