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Breaking Down the Four Pillars of Health: Stress Management!

The fourth and final pillar of gut health, and arguably the most important, is stress management. “Stress” is a term for normal responses in the body that are needed for health and survival; however, consistently (“chronic”) high stress levels can have a negative impact on our physiological functions, especially IBS symptoms. Even if you’re careful with foods and medications that cause you gut discomfort, stress itself can be the main cause for being extremely symptomatic and disrupting your normal routine.

IBS is characterized by an increased gastrointestinal response to stress. Stress can either be a perceived event (psychological stress – loss of job, divorce, history of abuse) or as a physiological event (diet, hormonal changes or physical activity). Any one of these stressors can alter gut motility and sensations in the gut, which especially impacts individuals with digestive and gastrointestinal issues.

IBS can result from a very intricate biological interaction between the brain and the gut – this is why addressing psychological and emotional stressors that may be associated with IBS symptoms is the first step in understanding IBS triggers. Not all people with IBS have symptoms of psychological distress, but for those who do, stress management techniques become critical in managing IBS symptoms.

Stress management techniques

In our practice, even in those who do not have psychological distress, we often see people develop what we call an ‘inappropriate brain-gut connection’ – when we develop fear and distrust around the foods we are eating due to being unwell, this in itself can be a form of stress that could trigger IBS symptoms.

Food anxiety may increase the likelihood of having an IBS “attack” after eating a meal – in other words, the concerns, worries and fears of eating food may precipitate the symptoms themselves, rather than the food itself.

Try our super simple mindfulness technique to help reduce stress and build body trust

For everyone with IBS, especially those who struggle with trusting their body, or notice a heightened level of stress, it may be helpful to take 5 deep belly breaths before each meal with this simple mindfulness technique:

  • Place one hand on your tummy and one hand on your chest – notice the rise and fall of your tummy and chest, taking in how you are feeling.
  • Notice any sensations going on in your body.
  • Remind yourself – my body is able to do exactly what I need it to do. It can digest exactly how it should, and the food I’m going to eat is going to nourish my body and help to rebuild my gut health.

Relaxing before a meal, slowing down, and being mindful while eating, and building more body awareness will help to manage stress and IBS symptoms. Work with your gastroenterologist or dietitian to determine which foods are actually triggering your symptoms.

Many people experience extreme abdominal symptoms (pain, cramping, diarrhea or constipation) with a stressful event such as losing a job. Other individuals experience symptoms with busy and stressful lifestyles – lots of work deadlines, carpools, family commitments, etc. It’s really important for these individuals to find stress management and self-care techniques that work for them and that they can include on a regular basis. Some examples include:

  • Guided meditation
  • Reading
  • Knitting or needlework
  • Bubble baths
  • Calling a family member or a friend
  • Exercise
  • Listening to music

It’s important to note that everyone’s stress management techniques are different, but what’s most important is to include stress management activities into your regular routine.

Many people can be troubled by unresolved emotional issues such as a death in the family or a difficult divorce. It’s important to discuss these issues with a health care provider, such as a counsellor or a psychologist, to help improve IBS symptoms from a stress management point of view. Talk to your doctor to determine the best options for you.

Stress and emotions are a very individualized problem that is unique to every person. For most IBS sufferers, their symptoms can be managed by adjusting their lifestyle, diet and incorporating exercise; for others, they may require medication and/or counseling to manage symptoms. Talk to your health care provider to determine what is best for you.

To read more of the Four Pillars of Gut Health series, click here:

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.


  • Andrea Hardy RD moderator author
    2 years ago

    Hi @dorise thank you so much for sharing your experience. It can be very disempowering when you feel like you aren’t being heard or that stigma around IBS impacts your ability to receive compassionate care. There is a LOT of information to confirm that the communication between the brain and the gut is bi-directional – the ‘talk’ goes both ways – so you’re right in your thinking there! I don’t have a particular article on I can refer you to off the top of my head, but that definitely inspires my future posts to touch on this topic so stay tuned!

    Sincerely, Andrea Hardy, RD team member

  • natasha
    2 years ago

    I’ve been doing meditation.

  • Andrea Hardy RD moderator author
    2 years ago

    Excellent Natasha! Meditation is such a great way to connect with your body and practice non-judgement. Thank you for sharing your experience with mindfulness and IBS – Andrea, team member

  • Besjordan
    2 years ago

    Excellent article, I can definitely relate to the “food anxiety” the author mentioned. I follow a low FODMAP diet but must admit I’ve very anxious when eating out that I might inadvertently eat a high FODMAP food which could trigger a reaction. This is especially true while I’m traveling. I hadn’t thought about how my anxiety about the food could be triggering the reaction and not the actual food itself. I’m going to incorporate your mindfulness techniques with my prayers before I eat. Thank you for posting this.

  • Andrea Hardy RD moderator author
    2 years ago

    I’m so glad I was able to add some support to your IBS journey – please share how your mindfulness techniques work to manage symptoms! Andrea, irritablebowelsyndrome,net team member

  • DorisE
    2 years ago

    Good article. At 74 and this IBS D started about 15 or so years ago. I do have anxiety, have had depression, former abusive marriage, single parent, family in another country, cancer 1985, migraines since child, half thyroid with goiter removed, laser and eye floaters, tinnitis, tmj, and bad reaction to a quinolone drug for frequent UTIs that gave me something like peripheral neuropathy in arms and legs, pain in feet and hands…. Now facing gluocoms… SORRY, , not trying to have the longest list, but in my mind I either was born with poor immune ststem or many medications over the years have wrecked my bowel s. Some people i know of various ages have way less or way more medical issues and stress but dont have IBS D, or C.
    I listen to guided meditation on utube, have been to therapist etc etc. I DO find it does help with stress… but some in medical field I feel are being brainwashed that its all in our heads… makes me angry. Wish i Could find an article I read proving its not brain to gut reaction, but gut to brain.. as in, gut is fed up feeling this way and is shaking down the brain for an explanation!

    I apologise for being negative

  • Kelly Dabel, RD moderator
    2 years ago

    Thank you for commenting and sharing Besjordan. So glad this was helpful to you. Hope you are able to implement some strategies to help curb your anxiety. Wishing you the best. Thank you for being part of our community! Kelly, Team Member

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