Do Stress and Anxiety Cause IBS?

There is no single known cause of irritable bowel syndrome (IBS). Instead, experts think it is a combination of several different factors. But more research is needed to determine exactly how these issues arise and come together to cause IBS. It is also unclear which factors might cause IBS versus worsen symptoms that already exist.^1,2

A few of these potential factors include:^1,2

• Issues with the way the gut moves food through the digestive system (gut motility)
• An increased sensitivity to gut-related pain (visceral hypersensitivity)
• Gut inflammation from an imbalance of immune system cells or the proteins they make
• Changes to the gut caused by infections
• Changes in usual gut bacteria
• Sensitivities or allergies to certain foods
• Genetic changes that increase the risk of IBS in families
• Stress, anxiety, depression, or other mental health issues

Stress and other mental health concerns is a factor that has gotten a lot of attention in recent years as experts learn more about what they call the gut-brain axis.³

Understanding the gut-brain axis

All the organs and systems in your body are in close communication with one another. Your brain is part of your central nervous system. It sends signals in the form of hormones, proteins, or other messengers called neurotransmitters.^3-5

These signals help tell different parts of your body what to do. When these signals are out of balance or not performing their normal role, different health issues can arise.^3-5

Just like the brain can send signals to the rest of the body, the body can send signals back to the brain. The gut is a great example of a system that has this constant back-and-forth communication. The gut has its own network of nerves and signals that are called the enteric nervous system. Some people refer to this gut-driven nervous system as the body's "little brain."³

The relationship between the brain and the gut is called the gut-brain axis. Together, these play a role in sensing pain. They can also lead to changes in gut motility, inflammation, and more.^3-5

The amount and type of bacteria in the gut can affect the gut-brain axis too. This is sometimes called the microbiota-gut-brain axis.^3-5

The gut-brain axis and IBS

Because the brain and gut are so closely linked, many experts wonder if mental health distress can be a cause of IBS. The answer to this is not very clear. But experts do know that stress and anxiety are triggers for IBS symptoms. They also know that stressful events early in life, like childhood abuse, are linked to an increased risk of developing IBS.^1,2,6

Overall, it is not clear clear whether or how stress can directly cause IBS to develop in the first place.^1,2,6

Some researchers have looked at mice to try to find the answer. One team found that mice with stress and depression had increased gut motility and diarrhea. These mice also had increased sensitivity to pain that could explain some of the abdominal pain experienced in IBS.⁷

What is helpful about this study is that the IBS-like symptoms occurred after the mice were exposed to stress, not before. This suggests that stress and mental health issues may be a cause of IBS rather than a symptom trigger. But much more research is needed to understand the true relationship between the 2.⁷

The cycle between stress and IBS symptoms

While stress can worsen IBS symptoms, IBS symptoms can cause their own stress. This relationship can create a cycle that is hard to break. The cycle can keep going, leading to both worsening stress and worsening IBS if not stopped. This is why stress reduction and mental health support are often part of IBS treatment plans.⁸

Finding ways to reduce stress

Lowering stress can be difficult. But there are several things you can do on your own to help bring down your stress level:^4,6,8

• Journaling
• Enjoyable and safe physical activity like dancing, walking, gardening, or group exercise classes
• Yoga
• Hobbies like making art, singing, or playing board games with friends
• Meditation and mindfulness
• Deep breathing techniques
• Joining a support group (either in-person or online)

Depending on your situation and other health conditions you may have, these tactics might not be enough. If this is the case, there are more formal options to reduce stress, like talk therapy.⁹

One therapy approach that has been studied as a way to potentially improve IBS symptoms is cognitive behavioral therapy (CBT). CBT can be performed by many licensed mental health providers. Hypnotherapy and acupuncture are other stress-reduction options that can be performed by a trained professional in a more formal setting.^6,9

Some people with IBS may benefit from anti-anxiety or antidepressant drugs if they have underlying anxiety or depression. A few of these drugs may also help with reducing pain perception. Talking honestly with your doctor about your mental health and stress levels can help you create the best, safest plan for your overall well-being.⁸