IBS is irritable bowel syndrome and describes a condition that causes irregular and unpleasant bowel movements. It is a disorder of the gut with symptoms including bloating, diarrhea, cramping, tiredness, headaches, muscular pain and abdominal pain.
Interestingly, IBS is thought to be at least partly regulated by psychological factors. The syndrome is more common in women than in men and episodes often occur alongside chronic stress/anxiety or depression. In particular there is a strong link between IBS and stress, which often acts as a 'trigger' for IBS symptoms. We will examine that connection here more closely.
While stress is something that occurs in the head and IBS is something that occurs in the gut, it's important to remember that the two are often linked. In fact, the gut is sometimes described as the 'second brain' due to its role in secreting hormones – particularly during the stress response. This is why we might feel 'butterflies' when we're nervous and it's where expression such as 'crapping yourself' come from.
That said, it actually isn't completely understood why the link between IBS and stress exists, though there are many potential mechanisms and so several theories that might explain it.
For instance, stress hormones can cause contractions and this is something which could immediately impact on bowel movements by causing sufferers to tense muscles relating to the stomach and to bowel movements. Likewise, these contractions are also suspected to cause potential spasms in the colon. Caffeine also stimulates the colon in a similar way which is why drinking a mug of coffee will often encourage bowel movements.
Stress also impacts on the digestive system. This is because the role of stress is partly to direct more blood flow and oxygen to the parts of the body that would be more likely to need them in a crisis. This includes the brain and the muscles but not things like the digestive system. This is why stress will often also cause indigestion and chronic stress can potentially lead to malnutrition symptoms. This is also another reason that IBS and stress are so closely related. It has also been suggested that the immune system might be involved and may cause problems with bowel movements.
Stress also causes other changes that can encourage sudden toilet trips or stomach pain. Stress for instance makes us breathe more quickly and shallower which can result in more trapped gas (particularly if you are swallowing air and/or saliva) and abdominal discomfort. Likewise, stress also causes us to become more switched on and alert – it heightens our sensitivity to internal and external cues and this then means that we're more likely to notice discomfort that might signal an impending need to run to the toilet.
In all these ways, stress hormones can result in those with IBS needing to run to the toilet suddenly and urgently, or can exacerbate already existing stomach pains. But what it can also do is to prevent recovery from IBS in the long term.
In studies, it was found that those with any exposure to chronic stress at all would be much less likely to experience any recovery from IBS symptoms. Ongoing stress and increased androgen levels for instance might have an impact on the microbial population of the stomach and acid content. This can then affect digestion, gas and other factors on a long-term basis.
Furthermore, any stomach issues caused by unhealthy bacteria or infection will be less likely to be dealt with seeing as the immune system will be suppressed during chronic stress.
If you suffer from IBS then and you feel that stress is exacerbating it, what can you do?
The most obvious answer is simply to avoid stress. Sometimes this will be easier said than done but if you are unable to avoid stressful situations then you should look at learning better coping techniques to help you handle the pressures of life without letting them have negative impacts on your wellbeing. Cognitive behavioral therapy is a form of psychotherapeutic treatment that shows patients how to control and minimize their stress response with positive affirmations, breathing exercises and a number of other techniques.
Also important is to try and address the IBS in other ways. This might mean looking for food allergies or intolerances that could be acting as potential triggers, or it might mean just eating more simply. Avoiding tea and coffee is also a good idea as this will put your body in a more anxious state and act as a diuretic.
Ultimately, everyone is different and everyone will respond differently to different types of treatment. The key is to learn what triggers your own stress response and what causes problems with your digestion and bowel movements. Once you better understand these things, you can then alter your daily routines, diet and mental state to try and minimize triggers.