IBS and Stress
Stress and anxiety can trigger IBS symptoms. Simple ways to try to relax and reduce these factors include:
- Take regular exercise such as walking, swimming or cycling
- Try relaxation techniques such as meditation or yoga
- Hypnotherapy or behavioural therapies such as cognitive behavioural therapy (CBT)
Why does stress effect IBS?
In IBS, the gut is more sensitive and there is increased gut response to stress. This may help explain why symptoms worsen during stressful times.
IBS results from a complex interaction between the brain and gut. Managing causes of stress that may be associated with IBS symptoms should be considered when trying to improve symptoms.
How can I manage stress more effectively?
Research has shown that increasing physical activity is not only good for your physical health but also your mental wellbeing. A regular fitness routine has been shown to contribute to a sense of wellbeing and mental health. Specific research into those with IBS has shown that increasing physical activity can improve gut symptoms and should be considered alongside dietary changes.
How active do I need to be?
The government recommends that adults in England should aim to undertake in at least 150 minutes of moderate intensity physical activity each week.
- Start small and build up gradually
- Try to listening to music whilst exercising
- Team up with a friend to help you stay motivated
- Consider the type of exercise that works for you and fits best with your lifestyle e.g. walking or cycling to work rather than driving
Relaxation techniques are recommended to help reduce stress and anxiety and include yoga and meditation.
A review of the literature looking at the effect of yoga as a treatment option for IBS suggests that yoga is a feasible and safe accompanying treatment for people with IBS.
Yoga offers physical benefits such as increased flexibility and strength as well as contributing to stress reduction.
Some NHS IBS services or clinics offer meditation, mindfulness meditation or mindfulness-based stress reduction (MBSR), where exercises are taken from traditional meditation. MBSR was developed specifically to help people cope with and improve ongoing symptoms caused by chronic illness. It can help to relieve the consequences of a range of conditions, such as stress, anxiety and IBS.
Top relaxation techniques
- Take a break- even stepping away from a stressful situation for a few minutes or taking time out of your normal routine can help you to feel calmer e.g. read a book, run a bath, etc
- Focus on your breathing- taking time to breathe more deeply can lead to you feeling calmer and improve your wellbeing. Breathe in through your nose and then out through your mouth. Count as you breathe to keep a steady rhythm.
- Listen to music- this can help you feel calmer and distract you from any stressful thoughts you might be having.
- Picture yourself somewhere relaxing and peaceful- even if you are unable to change your location physically this can help transport you to a calm and quiet place. Close your eyes and imagine what it looks like, what sounds there might be….
- Active relaxation- gentle exercise such as yoga or Pilates can help you relax and unwind
- Spend time in nature- spending time outside can be good for your physical and mental wellbeing. Take a walk, tackle some gardening….
- Tech Check- whilst great for helping you to stay connected and up-to-date technology can also lead you to feel stressed and busy. Simple things like taking a break from your phone and emails and replacing this with some relaxing activities can help instil a sense of calmness.
If you don’t see any improvement in your symptoms with dietary changes and/or medication after 12 months your doctor may recommend cognitive behavioural therapy or hypnotherapy.
Cognitive Behavioural Therapy
Cognitive Behavioural Therapy (CBT) is a therapy which involves changing the way people think and behave to help them manage their problems. It is based on the idea that thoughts, feelings, physical sensations and actions all interconnect and that negative thoughts and feelings can lead to becoming trapped in a vicious cycle.
The aim of CBT is to help deal with problems in a more positive way by breaking them down into manageable parts and change negative patterns to improve how the person feels.
CBT is sometimes used to help treat people with long-term complications such as IBS. Although CBT does not offer a cure for the symptoms it can help people better cope with them.
There has been some research into gut-related hypnotherapy to help improve symptoms in those with IBS with one study concluding that the effects of hypnotherapy are similar to those of a recommended dietary treatment (the low FODMAP diet) in terms of relief of gut symptoms. Despite the success of hypnotherapy as an intervention, there are a lack of skilled gut-related hypnotherapists and the time commitment associated with this type of treatment may prevent it being a feasible option.
If you are considering hypnotherapy, ensure you choose a member of the British Medical Hypnotherapy Association to provide this.
Your GP will be able to provide you with more information on CBT.