Can stress cause IBS? Understanding the gut-brain connection and ways to find relief

Introduction

As we welcome Spring and emerge optimistically from beneath our woolly jumpers, we also welcome Stress Awareness and IBS Awareness Month this April. Hence the reason why we are answering this common question, can stress cause IBS?

It’s no coincidence that these topics sit alongside each other, as there is an intricate connection between stress, anxiety, and Irritable Bowel Syndrome (IBS). This connection is called the Gut-Brain Connection.

For more about general gut health, browse the Gut Health Clinic or Dawn’s blogs, Microbiome Testing and Best Food for Gut Health.

In this blog, we’ll explore if stress can cause IBS, alongside:

• The Gut-Brain connection and IBS
• What stress and the stress response is
• How stress and anxiety affects your body and mind (including IBS)
• Simple, evidence-based techniques rooted in mindfulness, cognitive behavioural therapy (CBT) and Self Compassion to help manage stress and IBS symptoms.

#1 The Gut-Brain Connection and IBS

Did you know that IBS is increasingly recognised as a condition affecting both the irritable bowel and the irritable brain?

What this means is the gut-brain axis is a two-way communication system between the central nervous system and the enteric nervous system, often called the ‘second brain’.

This connection helps to explain the question, “can stress cause IBS?”.  Stress and anxiety can trigger, or worsen IBS symptoms, and conversely, IBS can lead to increased stress and anxiety, creating what feels like a vicious cycle.

There’s a two-way communication system between the brain and the digestive system

#2 What Is Stress? Understanding the Stress Response

Stress is the body’s natural reaction to a perceived threat or challenge.

When we experience stress, our brain activates the sympathetic nervous system, triggering the fight-flight-freeze response.

This response is designed to protect us – to help us survive immediate danger – by releasing stress hormones like cortisol and adrenaline.

#3 So how does the Stress Response work?

1. The amygdala, the brain’s emotional centre, detects a threat (real or perceived). 

2. The hypothalamus signals the adrenal glands to release adrenaline and cortisol – these hormones increase heart rate, blood pressure, and energy levels, preparing the body for action.

3. The hippocampus is responsible for memory and learning and gains awareness from the environment: it helps the body remember when a stressful situation is over (sending a signal to the Hypothalamus to stop releasing stress hormone) and also interprets the context of a stressful situation depending on past experience.

4. The prefrontal cortex, the brain’s command centre/CEO, helps us ‘think through’ our response so we can regulate our emotions and helps with decision making and a most appropriate response for the context.

5. Once a threat is gone, the parasympathetic nervous system helps the body return to a state of balance. The diagram below shows the stress response.

While the stress response is helpful in emergencies, chronic stress keeps the body in a heightened state of alert, which can lead to burnout, anxiety, depression, and physical health issues.

When stress becomes a daily occurrence, it can take a serious toll on your well-being. We’re going to take a look at some of these next.

#4 How Stress and Anxiety Impact IBS

As we are now aware, the gut and brain are closely connected via the gut-brain axis.

Stress is a well-documented trigger for IBS flare-ups, disrupting this communication and significantly affecting IBS symptoms in various ways, including:

Altered gut motility:

Stress hormones can affect digestive processes, leading to diarrhea, constipation, or abdominal discomfort.

Increased pain sensitivity:

Stress can heighten pain perception in the colon and rectum, resulting in more severe abdominal pain.

Disrupted gut microbiota:

Stress can alter the balance of gut bacteria, which can play an important role in digestive health and immune function.

Heightened awareness:

Stress can lead to greater focus on bodily sensations, amplifying the perception of IBS symptoms.

Stress can alter the balance of gut bacteria which have an important role in digestion and overall health

#5 Other physical impacts of stress:

🦠 Weakened immune system – high cortisol levels over time suppress the function of white blood cells, making it harder for the body to fight off infections and illnesses.

💥 Increased muscle tension (leading to headaches, neck and back pain).

❤️ Increased risk of heart disease and high blood pressure – adrenaline and cortisol, activated by the stress response, lead to a faster heart rate, constricted blood vessels, and elevated blood pressure; when experienced chronically, this can contribute to plaque buildup in arteries and further increase the risk of cardiovascular issues.

🍟  Stress can also lead to unhealthy coping behaviours like overeating, smoking, or lack of exercise, which can further increase the risk of heart disease.

😴  Chronic fatigue and exhaustion.

#6 Mental and emotional impact of chronic stress:

• Increased anxiety and worry
• Difficulty concentrating, or forgetfulness (brain fog)
• Increased irritability or emotional outbursts
• Higher risk of depression
• Disrupted sleep patterns

#7 Finding relief: evidence-based ways to manage stress and IBS symptoms

Fortunately, stress isn’t something you have to live with and the good news is, there are several effective strategies to manage both stress and IBS symptoms:

Mindfulness, Cognitive Behavioural Therapy (CBT) and Self Compassion offer powerful tools to help retrain your brain, regulate your nervous system, and create a sense of calm.

Let’s take a look at each one here…

Mindfulness-Based Stress Reduction (MBSR)

MBSR has shown significant benefits for IBS patients. A study found that 71% of
participants experienced improvements in gastrointestinal symptoms after an 8-week
MBSR program.

Technique: Practice the 5-4-3-2-1 Grounding Exercise:

• Identify 5 things you can see
• 4 things you can touch
• 3 things you can hear
• 2 things you can smell
• 1 thing you can taste

Benefits: This exercise helps to direct your attention away from any feelings of discomfort by anchoring you in the present moment, thereby helping to reduce feelings of stress or anxiety.

MBSR has shown significant benefits for IBS patients.

Cognitive Behavioral Therapy (CBT)

CBT is effective in managing both stress and IBS symptoms by helping individuals reframe stressful thoughts and develop more helpful thoughts and coping mechanisms.

I love Charlie Mackesy’s book “The Boy, The Mole, The Fox and The Horse”. One of my favourite quotes in the book is…

“One of our greatest freedoms is how we react to things”.

Charlie Mackesy – British artist, illustrator and author

 This is so true and CBT offers tools to help us respond to difficult situations in more helpful ways, by adapting the language we use in a given context.

Technique: Thought Reframing Exercise

• Write down a stressful thought related to your IBS (e.g., “I’m always going to
struggle with this!”)

• Challenge it: Is this 100% true? What evidence do you have? (e.g. “actually, there
have been many times when I cope really well and enjoy symptom free periods.”)

• Replace it with a more balanced thought (“I am resilient and enjoy my life despite
having discomfort at certain times”)

Benefits: By changing the way you interpret and respond to certain triggers, you can shift from feeling overwhelmed to feeling empowered.

CBT helps patients reframe stressful thoughts

Self-Compassion

Practicing self-compassion can reduce stress and create a sense of inner calm, which may help alleviate IBS symptoms.

Technique: Self-Compassion Break

• Acknowledge your feelings: (e.g. “This is a difficult moment with my IBS.”)

• Remind yourself: (e.g. “Many people with IBS struggle with stress and anxiety. I am
not alone”)

• Offer kindness: (e.g. “I choose to be gentle with myself as I manage my
symptoms.”)

Benefits: By shifting from self-judgment to self-kindness, it’s possible to reduce stress and create a sense of inner safety and calm.

Conclusion

While stress is an inevitable part of life, it doesn’t have to control you. By incorporating these evidence-based techniques into your daily routine, you can better manage both stress and IBS symptoms.

Remember, the gut-brain connection means that managing stress through these methods can positively influence your digestive health and overall well-being. Which is good news! As practicing these techniques is totally within your
control and inexpensive to implement.

So as we observe Stress Awareness Month and IBS Awareness Month this April, lets
focus on understanding and nurturing the relationship between our gut and our brain.

In doing so, we can take significant steps towards managing IBS symptoms and improving our quality of life.

Next Steps

Try one of the techniques above and see how it impacts your stress levels.

Commit to daily relaxation – even 5 minutes can make a difference.

Consider working with a mindset coach if stress is affecting your well-being.

References

World Journal of Gastroenterology, Oct 2014, Hong-Yan Qin et al, “Impact of psychological stress on irritable bowel syndrome”

mindsethealth.com, May 2023, Harley, “IBS and Stress: The Gut-Brain Link, Causes, and Management“

PubMed, Sept 2020, Naliboff et al, “Mindfulness-based stress reduction improves irritable bowel syndrome (IBS) symptoms via specific aspects of mindfulness”

PubMed Central, Sept 2017, Hoffman and Gomez, “Mindfulness-Based Interventions for Anxiety and Depression”