If you suffer from irritable bowel syndrome (IBS) and you feel an urgent need to go every time your boss pings you, your mother-in-law texts, or your friends change plans at the last minute, it’s time to focus on the stress that could be triggering your symptoms. After all, IBS is a breakdown in the signals the brain sends to the gut and the gut sends back to the brain — and this bodily response can be worsened by stress, according to the International Foundation for Functional Gastrointestinal Disorders (IFFGD).
“Stress increases the hormone cortisol, and it can impact our digestive system,” says Megan Riehl, PsyD, a gastrointestinal psychologist at Michigan Medicine in Ann Arbor.
“People with IBS have trouble down-regulating digestive distress. For example, a person with IBS may feel the digestive process with some gurgling or discomfort and that sets off stress signals and a fear that they will need the bathroom urgently.”
A study published in the American Journal of Gastroenterology found that participants living with IBS who reported experiencing anxiety and stress were more likely to report more severe symptoms, cycle through more treatments, and say their symptoms negatively impacted their daily life than patients who did not report psychological distress.
“Behavioral treatments for IBS are needed as a complement to medicine to get patients over the finish line,” says Brennan Spiegel, MD, a gastroenterologist and the director of health services research at Cedars-Sinai in Los Angeles. “Patients need to develop skills and train their brain to overcome the symptoms of IBS, and that means combating stress.”
So if you’re living with IBS, make sure you’re not neglecting to manage your stress levels, as they can significantly impact your gastrointestinal symptoms.
Here are three ways to reduce IBS-related stress.
1. Exercise to Relieve Stress With IBS
You don’t have to be a member at a CrossFit box or fancy gym to reap the mental health benefits of physical activity. Moderate exercise like walking, jogging, swimming, cycling, and yoga are enough to reduce stress and improve IBS symptoms. A review published in Digestive Diseases and Sciences found that yoga and walking at a brisk pace were equally effective in improving IBS symptoms, and both were more effective than medicine alone.
“Exercise helps boost our endorphins and lower cortisol levels, which means we feel happier and less stressed,” says Dr. Riehl. “That’s when the brain and gut send much more favorable signals to each other.”
The American Psychological Association points out that an exercise habit increases levels of norepinephrine, a hormone and neurotransmitter that helps decrease stress. Exercise also trains the mind to cope with anxiety and panic.
2. Breathe Deeply to Help Manage Stress and IBS Symptoms
Deep breathing is one of Riehl’s go-to techniques when teaching her patients to reduce stress.
“Stress makes for shallow, short breaths,” she says. “When we slow our breathing down, we kick-start the parasympathetic system that calms us down and gives a nice massage to the digestive organs. That reduces spasming and urgency.”
One technique she is particularly fond of is diaphragmatic breathing. As demonstrated by Michigan Medicine, it involves slow and deep breathing that affects the brain as well as the cardiovascular, respiratory, and gastrointestinal systems. One study divided 40 people into two groups; one control group and one group who received training in diaphragmatic breathing. After eight weeks, the group who received breathing training had lower levels of the stress hormone cortisol and were less prone to negative emotions.
Another study, published in Cell Reports, found that just five minutes of breath work per day improves mood and reduces anxiety. The researchers found that cyclic sighing, which emphasizes prolonged exhalations, to be the most effective.
3. Try Gut-Directed Hypnosis
Gastrointestinal psychologists have found that gut-directed hypnosis is extremely effective at reducing stress and improving IBS symptoms. In this technique, a trained therapist guides a patient into a focused state of awareness and deep relaxation. (IBSHypnosis.com has a directory of therapists.) Through suggestions and imagery, gut-related hypnosis aims to calm the digestive tract and steer attention away from physical discomfort.
One study, published in The Lancet Gastroenterology & Hepatology, looked at IBS patients who received standard care from a gastroenterologist and compared their outcomes to those who were treated with a multidisciplinary approach, including gut-directed hypnosis. Researchers found that 83 percent of those who received multidisciplinary treatment experienced symptom relief, compared with 63 percent of the standard care group. Those treated with the multidisciplinary approach were also much more likely to have significant improvement in IBS symptoms and overall quality of life.
“Oftentimes, when people with IBS fail to find relief with other strategies, they tend to have success with gut-directed hypnosis, as long as they’re open to trying it,” notes Riehl.
“We can develop the skills to stop the brain from perseverating on GI-specific worries,” she says. “For example, we can start to retrain the mind when someone is always imagining that they will have a bowel accident in public. It’s how we identify and think about IBS in our day-to-day life that can make [our symptoms] better or worse.”
Additional reporting by Ashley Welch.
