Why does stress make my IBS worse?

Did you ever feel nauseous before a presentation? Or had a sinking feeling in your stomach before a test? Stress can do that to us. Our minds and bodies constantly communicate; emotional factors play a significant role in all gastrointestinal disorders. 

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How intense these symptoms are, varies greatly depending on the person. Some of us only have an upset stomach occasionally; others can barely function with digestive distress. Your body is unique, and so the approach to overcoming digestive problems should be too. 

If you have IBS there is a miscommunication between the gut and brain within the gut brain connection and this creates a hypersensitivity of the gut.  The gut is over reactive to certain foods but also to psychological stress which exacerbates symptoms. Often, both feed on each other; the stronger your body responds to stress, the more worried you might become about it letting you down. That, in turn, sends stress signals to your gut. To understand why let me give you a little overview of that part of your body:

First, there is the autonomic nervous system. It triggers life-sustaining functions such as breathing and body temperature. As you would assume, it is very complex and extends from the brain to all major organs. 

It has two major divisions: The sympathetic nervous system which triggers the "fight or flight"- response and the parasympathetic nervous system which calms the body after danger - real or perceived- has passed. These two systems also interact with the gut's own nervous system: the enteric nervous system that deals with- you guessed it- your digestion. It is sometimes called "the second brain"  because it relies on the same types of neurons and neurotransmitters that we find in the central nervous system. And this is how it works:

After it senses that food has entered the gut, the neurons signal muscle cells to contract so the food can move further along. Along the way, it is broken down into useful nutrients and waste. Whilst this is happening, the enteric nervous system constantly communicates with the central nervous system via the vagus nerve and neurotransmitters such as serotonin. Your gut bacteria produce around 95% of the serotonin in your body- that's how intertwined the gut and your mood are.

This "brain-gut axis" plays a vital role in understanding IBS. It will naturally slow down your digestion when you go into fight or flight mode. That way, it frees up all the available energy to deal with the perceived threat. Less severe stress can upset the delicate balance in your gut and cause abdominal pain or diarrhoea. If these problems persist (as is the case with IBS), they can, in turn, generate more stress and anxiety and trigger a physical reaction. Soon, you find yourself in a downward spiral. 

What can help?

Studies have shown that psychological methods can help with the cause and symptoms of gastrointestinal problems such as IBS. Cognitive behavioural therapy (CBT) helps you become aware of counterproductive thoughts and tools for changing them.  Helen Brooks specialises in gut-directed hypnotherapy, a technique specially developed for those with IBS. It helps by calming the autonomic nervous system which in turn communicates with the enteric nervous system. It enables you to take control of your IBS symptoms and better connect with your body and mind. 

And that presentation? It will soon become a breeze- the techniques you learn will stand you in good stead in all stressful situations.

Lucinda McPherson