The relationship between Chronic Stress and Irritable Bowel Syndrome (IBS): what everyone living with IBS should know
The relationship between Chronic Stress and Irritable Bowel Syndrome (IBS): what everyone living with IBS should know
Did you know that up to 15% of the population struggle with IBS, often in silence? As someone who understands the challenges of living with IBS, I wanted to share insights about how chronic stress affects gut health – and what you can do about it.
Understanding Chronic Stress
In today's fast-paced world, chronic stress has, for many people, become a constant companion. But what exactly is it? Chronic stress isn't just about having a bad day at work – it's a persistent state of activation in our body's survival system, often occurring without us even realizing it.
Before we dive into how chronic stress affects your digestive system I’ll define ‘chronic stress’ so that we’re all on the same page.
Chronic stress is a harmful physiological and emotional state resulting from the continuous, long-term, activation of the body's survival system without allowing sufficient time for recovery between activations. Some people live in a chronic stress state without realising they are because the state becomes habitualised as their “new normal”. This phenomenon is known as chronic stress adaptation.
The impact of chronic stress on the digestive system
Okay so now we know what chronic stress is, it’s time to explore what is it’s impact on our digestive system, particularly for those with (IBS).
The impact:
Disruption of the gut-brain axis. The gut-brain axis is the bidirectional communication system between the head brain and the gut brain (the enteric nervous system in the digestive tract). IBS is now classified as a Disorder of Gut-Brain Interaction. These disorders are characterized by GI symptoms that are related to any combination of motility disturbances, visceral hypersensitivity, altered mucosal and immune function, altered gut microbiota, and altered central nervous system (CNS) processing. Chronic stress is known to play a significant role in the development and exacerbation of these disorders.
Disruption of the Autonomic Nervous System (ANS): The ANS controls involuntary bodily functions, including digestion. It has two branches: the sympathetic nervous system (SNS), which in response to a threat, activates the survival (stress) response, and the parasympathetic nervous system (PNS), which controls “rest and digest” functions. Chronic stress leads to an imbalance in the ANS with increased SNS activity and decreased PNS activity.
o SNS Over-activation: The SNS slows down digestion by reducing blood flow to the intestines, inhibiting peristalsis (the muscle contractions that move food through the digestive tract), and decreasing digestive enzyme production.
o PNS Under-activation: Decreased PNS activity impairs normal digestive processes such as gut motility (the movement of food through the digestive tract), food breakdown, urination, and defecation. When the PNS is underactive, the body’s ability to regulate these processes is compromised, leading to slower bowel movements, difficulty passing stool, and constipation. This reduction in PNS activity can also contribute to other digestive issues.
Hormonal Changes: Chronic stress leads to the buildup of stress hormones like cortisol and adrenaline in the bloodstream. These hormones, when excessive, can:
o Cause inflammation in the gut.
o Create a vulnerable gut lining by decreasing blood supply, suppressing mucus production, and altering the gut’s acidity and bacteria balance.
o Affect nerve cells in the gut, making them more sensitive to pain.
Gut Motility Issues: Stress hormones like adrenaline and cortisol can disrupt gut motility, leading to irregular contractions and spasms of the muscles along the digestive tract. This can cause slower bowel movements and difficulty passing stool, leading to constipation and/or faster bowel movements leading to diarrhea.
Increased Intestinal Permeability: Chronic stress can increase the permeability of the intestinal lining, also known as “leaky gut”. This allows harmful substances to pass into the bloodstream, triggering further inflammation and potentially leading to systemic health issues.
Changes in Gut Microbiota: Chronic stress can disrupt the balance of bacteria in the gut (dysbiosis). This can lead to digestive problems, inflammation, and may affect mood and behaviour.
o Reduced Diversity: Chronic stress can decrease the diversity of gut bacteria, which is associated with various health issues, including IBS and mood disorders.
Increased Sensitivity: Chronic stress can make the gut more sensitive to pain and other stimuli, leading to increased awareness of normal digestive processes like gas movement. This heightened sensitivity can contribute to symptoms like bloating and abdominal pain.
Changes in Gastric Secretions: Chronic stress can increase stomach acid production, leading to heartburn and acid reflux. Sometimes, chronic stress can reduce digestive enzyme secretion, affecting nutrient breakdown and absorption.
Impact on Specific GI Conditions:
o IBS: As mentioned above, chronic stress is a major factor in the development and worsening of irritable bowel syndrome (IBS). It can cause symptom flare-ups and exacerbate symptoms, -such as abdominal pain, bloating, diarrhea, and constipation.
o GERD: Chronic stress can weaken the oesophageal sphincter, leading to gastroesophageal reflux disease (GERD).
o Inflammatory Bowel Disease (IBD): Chronic stress can increase the frequency of relapse in IBD.
o Functional Gastrointestinal Disorders (FGID): Chronic stress is strongly linked to the onset and exacerbation of functional gastrointestinal disorders.
Other Physical Effects: Chronic stress can cause:
o Muscle tension that can contribute to abdominal pain.
o Changes in appetite.
o Sleep problems.
o Chronic fatigue.
Vicious Cycle: Chronic stress and digestive issues can create a self-perpetuating cycle where the stress worsens symptoms which trigger more stress, which worsens symptoms, and round and round it goes.
Altered Neurotransmission: It has been estimated that approximately 95% of serotonin is in the GI tract and enteric nervous system - the remaining 5% being in the central nervous system. Serotonin is essential for regulating mood. Chronic stress can impair the production of serotonin in the gut, potentially affecting mood.
Individual Sensitivity: People with IBS are more sensitive to the effects of chronic stress on their digestive system. They may experience greater changes in gut motility, pain perception, and emotional symptoms, and may have an amplified production of stress hormones.
Strategies for Managing Chronic Stress and Improving Gut Health
It’s important to note that while chronic stress can worsen digestive problems, like IBS, it is not always the root cause. However, managing chronic stress is a vital part of any strategy to gain relief from digestive symptoms and improving overall well-being.
In developing your personal chronic stress relief plan, you may choose to seek help from an expert who specialises in chronic stress management. This could be a psychogastroenterologist, a mental health professional, a gut directed hypnotherapist, a cognitive behavioural therapist, a stress management coach.
However, and importantly, there are many techniques you can learn and practice, daily, by yourself, to reduce your chronic stress. When choosing techniques, you are going to need practical solutions that fit into your busy schedule.
Here’s an overview of what a typical chronic stress relief plan could include:
1. Target your chronic stressors. Once you’ve identified your chronic stressors determine whether you can:
a. avoid the stressor (e.g. if a particular route to work is a daily stressor, explore alternative routes)
b. change the stressor so it is no longer identified as a threat by your survival system (e.g. have honest conversations with your manager about your excessive workload and achieve a reduced workload.)
c. change your survival system’s classification of the situation from a threat to non-threat (e.g. reframe your monthly presentation to senior management from threat to opportunity. See it as an opportunity to share valuable information and show your competence and experience.)
2. Learn and practice techniques to switch off the SNS and turn on the PNS using techniques like deep breathing techniques and vagus nerve stimulation.
3. Learn and practice relaxation techniques to release chronic stress from your mind and body. Such techniques include - scheduling “micro-breaks” for stress relief (2-3 minutes every hour); practicing mindfulness, self-havening, emotional freedom technique (EFT), self-hypnosis. These techniques can take as little as two minutes to perform yet reap enormous benefits.
4. Engage in regular movement/exercise: Physical activity can help reduce the level of stress hormones in your body, ease tense muscles and improve gut motility.
5. Maintain a healthy diet.
6. Prioritise quality sleep.
It’s also important to learn and practice ways to minimise experiencing chronic stress in the future.
The Takeaway
While chronic stress can significantly impact your digestive system, especially if you have IBS, it's important to remember that you're not powerless. By understanding the connection between chronic stress and gut health, and implementing chronic stress-reduction strategies, you can take control of your chronic stress, reduce your IBS symptoms and improve your overall well-being.
Remember, managing chronic stress is a journey, not a destination. Be patient with yourself and celebrate small victories along the way.
And also remember, while chronic stress and IBS can feel overwhelming, you have more control than you might think. To repeat - you are not powerless.
The Power of Small Steps
Understanding the connection between your chronic stress and gut health is the first step on the road to recovery. By creating a personal chronic stress relief plan and putting it into action you can take control of your chronic stress, and in doing so, help reduce your IBS symptoms and improve your overall well-being.
It’s important to remember, managing chronic stress is a journey, not a destination. Be patient with yourself and celebrate minor victories along the way.
As someone who understands this journey, I encourage you to start small, stay consistent, and most importantly – be compassionate with yourself. Every stress-reduction technique mastered, and every symptom-free day is a victory worth celebrating.
Reach out if you'd like to explore any of the points contained in this post.
About the Author: Tony Yuile specialises in gut directed hypnotherapy for the treatment of functional gastrointestinal conditions like IBS. His personalised Freedom from IBS program helps people living with IBS, gain significant long-lasting relief from the condition.
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