IBS and Stress

Lifestyle Advice
Stress and anxiety can trigger IBS symptoms. Simple ways to try to relax and reduce stress and anxiety include:

• Take regular exercise such as walking, swimming, or cycling
• Try relaxation techniques such as meditation or yoga
• Try hypnotherapy or behavioral therapies such as cognitive behavioral therapy (CBT)

Why does stress effect IBS?

In people who have IBS, the gut is more sensitive and there is often an increased 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 shows 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 United States government recommends that adults aim to undertake in at least 150 minutes of moderate intensity physical activity each week.

Getting Started:

• Start small and build up gradually
• Listen to music while 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 during your lunch break or biking to work rather than driving)

Relaxation Techniques

Yoga and meditation are relaxation techniques that may reduce stress and anxiety.

Yoga
Medical research suggests that yoga is a feasible and safe supplementary treatment for people with IBS.
In addition to stress reduction, practicing yoga offers the physical benefits of increased flexibility and strength.

Meditation
Some clinicians 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- 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 help you feel calmer. 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 external stressors.
• 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 health. Take a walk, tackle some gardening….
• Tech Check- While great for keeping you connected and up-to-date, technology can also add to stress and feelings of being constantly busy. Taking a break from your phone and emails and filling this time with more relaxing activities can bring a sense of calmness to your day.

Behavioral Therapies

If you don’t see any improvement in your symptoms with dietary changes and/or medication after 12 months, your doctor may recommend cognitive behavioral therapy or hypnotherapy.

Cognitive Behavioral Therapy
Cognitive Behavioral Therapy (CBT) is 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 are all interconnected, and that negative thoughts and feelings can trap you 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 changing negative patterns to improve how the person feels.
CBT is sometimes used to help treat people with long-term illnesses, such as IBS. Although CBT does not offer a cure for the symptoms, it can help people better cope with them.

Hypnotherapy
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 benefits of hypnotherapy as an intervention, it can be difficult to find a skilled gut-related hypnotherapist, and the time commitment associated with this type of treatment may make it a less attractive option.

If you would like to consider behavioral therapies to improve your IBS symptoms, a gastroenterologist or other member of your healthcare team should be able to provide more information.