Stress and IBS (Irritable Bowel Syndrome)

As an IBS (irritable bowel syndrome) sufferer, I've noticed that I need to make more urgent trips to the bathroom when I'm stressed out. And that stress can increase if no bathroom is immediately available, making the symptoms of abdominal pain, cramps, bloating and gas even worse. In other words, IBS can become a vicious cycle of stress causing uncomfortable symptoms as well as additional stress resulting from those symptoms. Indeed, some people react to IBS by isolating themselves at home, where they can be near a bathroom at all times.

As many as 20% of the population suffers from IBS. It's a disorder that causes diarrhea alternating with constipation because the IBS sufferer's intestines are hypersensitive to the material passing through, resulting in abdominal pain and increased contractions (or decreased contractions in the case of constipation).

Studies have shown that stress doesn't cause IBS but can certainly make it worse. How does that work? The technical theory is that stress leads to inhibition of the sympathetic nervous system and too much adrenalin production, which causes arrhythmic contractions of the intestinal musculature. In layman's terms, stress translates into stomach pain, diarrhea or constipation.

Do people with IBS tend to suffer more from psychiatric disorders? It seems so. A number of studies have shown that people who are chronically angry or anxious have more active colons. Generalized anxiety disorder (GAD) and various forms of depression are common in IBS sufferers. Interestingly, IBS sufferers have an abnormal brain response to bowel pain that results in anxiety and arousal rather than, in the case of people without IBS, the release of natural opiates. People who are anxious or depressed tend to be hypersensitive about their bodies, which can exacerbate IBS symptoms. Chronic or extreme stress may affect the immune system and lead to IBS. One segment of the population that may suffer more from IBS is those who were sexually or physically abused as children.

It's even been demonstrated that climate can affect IBS. Hot humid weather is the culprit because heat is a natural stressor and humidity affects serotonin levels in the gut and lowers pain tolerance. Or, you just may prefer one type of weather over another and be unhappy and irritable in other kinds of weather, leading to IBS symptoms.

What about lack of sleep as a stressor? It turns out that less than a good night's sleep and chronic fatigue can also trigger IBS symptoms.

Although specific foods usually do not cause IBS, individuals with IBS may be more sensitive to particular foods or the amount of food taken in during periods of stress. Hormonal changes are also related to symptoms. Proof that IBS is related to emotional balance comes from evidence that cognitive therapy, biofeedback, hypnosis, relaxation training, meditation, yoga, tai chi and aerobic exercise, or just reading an absorbing book, playing with your pets, or listening to your favorite music, can all ameliorate symptoms. So, besides eating wisely and avoiding intake of food when severely stressed, one can learn to manage stress through these other readily available modalities.

Can conventional medicine help you deal with IBS? Absolutely. Physicians can prescribe various medications such as antispasmodics, antidepressants, antidiarrheics, or fiber supplements in the case of constipation. There is also a new class of medicines in development that can change the actions of neurotransmitters and lessen IBS symptoms.

What can you do to help yourself fight IBS symptoms? When you eat, relax. If you're upset, don't eat. Think good thoughts when you're eating. Regular stomach massage preceded by a warm moist towel can decrease intestinal contractions. See a therapist if you need to talk about issues that stress you. Don't repress either good or bad feelings; release them in constructive ways. Keep good friends around you and join an IBS self-help group. Get adequate sleep, even if it means taking a nap during the day. Most important, always remember that you're not alone and you shouldn't be ashamed of what's happening to your body.