IBS and Stress
So, I would now like to address IBS and Stress. It affects your digestion in so many ways.
I aim to give you advice and a possible model for this put forwards by Steve Peters in the "Chimp Paradox".
If you have been stressed, you will know that it affects your Irritable Bowel Syndrome. But what is stress and how can you reduce your levels?
What is Stress?
Stress is your body’s response to mental, physical and emotion loads that are put on it. It is the overwhelming feeling that you experience when too much of these elements are placed on you as person.
There are many reasons for this whether exam stress, work stress, relationship or financial stress to name but a few.
Stress results in symptoms of 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 diarrhea.
A Model of How Irritable Bowel Syndrome Stress Occurs
Worsening stress symptoms are explained through the brain-gut axis theory.
This theory is based on excessive signals being sent to the brain from both external and internal stimuli. The stimulation can occur from smells, visual stimuli, touch and hearing.
These stimuli are sent as signals to the brain which in turn interpret them as feelings.
In the brain there are various chemical messengers that 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 can also cause release of adrenaline or epinephrine.
This has the effect of increasing your heart rate, flushing, you feel hot; you may experience intense feelings of anxiety and develop hyperventilation or panic.
Stress and digestion are intimately linked. Bowel motility increases and this can cause the cramps and diarrhea common to IBS.
How Can You Manage Your Stress?
The first thing in managing your IBS and stress is actually recognizing that you are stressed. Whilst this is generally obvious to the sufferer, this isn't always so. If in any doubt, discuss this with your doctor for further advice.
Having ascertained that you have stress, are there any simple measures that you can take to relieve this?
Well, the obvious answer is to avoid the precipitant of your Irritable Bowel syndrome stress, but this is often not easy or possible.
Taking time out from the stress may be possible such as breaks when revising for exams or trying to divert work load to others if the stress comes from work.
Exercise is an excellent stress reliever 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 is useful for some people with stress. We know in IBS and stress, hypnotherapy has some proven benefit and you can read more about this by going to the IBS and hypnosis therapy page.
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 IBS and stress. Beta blocker drugs 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 too; particularly the tricyclic antidepressant group such as Amitriptyline in IBS 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.
I have personally found this an excellent book which has helped me. 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 at Amazon by going to Chimp Paradox.
Clinical Evidence for Stress and IBS
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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