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
- Knitting or needlework
- Bubble baths
- Calling a family member or a friend
- 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.