Stress Management

Reviewed by: HU Medical Review Board | Last reviewed: March 2023

Although stress does not cause irritable bowel syndrome (IBS), stress can act as a trigger for symptoms such as diarrhea, constipation, and abdominal pain. It is also believed that stress may lead to changes in the permeability of the intestinal wall. When the intestinal wall is compromised, food that has not been adequately broken down can pass through to the bloodstream, causing an immune response and inflammation in the body. These events can also cause the symptoms of IBS.1

Lifestyle modifications, including changes to diet, exercise and stress management, have been shown to improve IBS symptoms, and stress reduction is a recommended therapeutic approach to managing IBS.1,2 Stress management includes learning why a person feels stress and learning healthy coping strategies to reduce that stress.3

The stress response: fight or flight

Stress is an automatic psychological and physical reaction of the body to the demands of life. The stress response, also called the “fight-or-flight” response, prepares the body to cope with a threat. When faced with a stressor, hormones are released into the body to mobilize energy to fuel a response.

Common signs of this state are an increased rate of breathing, increased heart rate, anxiety, and a shift of blood flow to the larger muscles in the body. These physiological changes ready the body to fight or flee from a threat. In some cases, the body may also have a “freeze” response to a stressor. In this case, the muscles are tensed and poised for action but are not used.

The stress response begins in the brain, as sensory information is sent to the amygdala, the portion of the brain responsible for emotional processing. The amygdala sounds the alarm when it perceives a threat. However, the amygdala can’t tell the difference between real or perceived stressors, causing the same physical reactions in the body for both. Once the threat is gone, the body is supposed to return to a relaxed state. Unfortunately, with the nonstop pace and rapidly changing environment of modern life, this alarm system rarely shuts off.3,4 Chronic stress that continues for weeks or months can lead to health problems.5

Tips for relieving stress

After understanding how the body handles stress, it is important to note what causes stress and employ healthy techniques for handling them.3

  • Relaxation response – One of the most effective ways in reducing stress is to use activities or techniques to create the relaxation response in the body. Relaxation approaches include deep abdominal breathing, visualization, prayer, meditation, yoga or tai chi.
  • Physical activity – Exercise, such as walking, benefits the body by deepening the breath and by relieving muscle tension. Physical activity that combines movement, deep breathing and mental focus, such as yoga, tai chi, and qi gong, can help induce calm.
  • Social support – Receiving emotional support from friends, family and companions can help during times of stress and crisis.4

Additional Treatment for IBS

While stress management plays an important role in the treatment of IBS, patients generally use a combination of approaches to manage their symptoms. Other treatment strategies include adding exercise, making dietary changes, adding fiber or probiotics, using medication, or trying complementary or alternative medicine.

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