Irritable Bowel Syndrome and Stress
By Laura Jennings
Irritable bowel syndrome (IBS) is a common gastrointestinal disorder affecting over 10% of the population. IBS impairs quality of life and can make social situations difficult. Therefore, individuals with IBS are more susceptible to anxiety, depressive symptoms and stress.
What are the symptoms of IBS?
Symptoms of IBS can include:
Abdominal pain
A change in the frequency of bowel habits
Cramping
Bloating
Diarrhea / Constipation (or both)
Fatigue
Lack of control over bowel habits (incontinence)
Stress has been implicated as both a consequence and cause of IBS and has been shown to disturb the gut-brain axis, which manifests as bowel sensitivity. Researchers still heavily debate whether the cause of IBS is due to bowel mechanisms or the result of a busy brain.
How can a busy brain cause IBS?
Stress activates the “fight or flight” response in preparation to fight off an external stressor. Negative feedback notifies the body when the stress has passed to bring the body back to a state of calm. However, when stress persists and the body remains in a chronic state of fight or flight due to persisting social, emotional or physical triggers (which is the case for most people in today’s society) inflammatory pathways become activated. Activation of inflammatory pathways causes a direct impact on the permeability of the gut, which allows bacteria to cross over. Abnormal bacterium interacts with the immune system and changes the bidirectional signaling communication between the gut and the brain. It is not just immediate stress that can alter the microbiome; stress in early life can have a lasting impact on the nature of gut bacteria!
Individuals who seek clinical treatment for IBS present with coexisting psychiatric disorders, such as generalized anxiety disorder and panic disorder. Treatment for mental health disorders with antidepressants has been shown to offer relief from IBS symptoms. However, it is difficult to know whether these coexisting psychiatric disorders are merely a reaction to people losing their freedom, spontaneity and feelings of shame and embarrassment that are associated with having IBS.
How should we manage IBS?
Stress contributes to predisposing the body to IBS via altered gut microbiota but likely perpetuates symptoms due to the social stigma that accompanies the syndrome. Screening in clinical settings for psychological stressors, such as panic disorder and generalized anxiety disorder might be a stepping-stone for early intervention. Genes that show activated inflammatory pathways could be another potential early indicator for IBS. Gastroenterologists should work alongside psychologists to manage the disorder and improve the outcomes for patients who present with symptoms. Managing stress should be a first line treatment given that pharmacology has shown to be largely ineffective for managing IBS.
ABOUT LAURA JENNINGS
After five years working in the corporate world in luxury fashion and technology, Laura trained as a yoga teacher and joined the team at My Method, curating exciting and diverse wellbeing programmes for private clients and corporates.
Laura has a passion for holistic wellbeing and nutrition and has joined the Be Well team to support with content creation, workshop development and more. She is progressing in the world of health and wellness and is continuing her studies, starting a Masters in Nutrition at King's College London in September 2021.