By Annika Wood & Sascha McMeekin
Are your IBS symptoms causing you to feel stressed, or is your stress contributing to your IBS? Help!
Increased stress, anxiety and/or depression can often be accompanied by symptoms such as bloating, gas, constipation, or pain in those with irritable bowel syndrome (IBS). Struggling with IBS symptoms can often cause these feelings of stress, anxiety, low mood, and irritability, just like these feelings can also trigger IBS symptoms. External stressors may come from work, relationships or study, however, they can still influence your IBS symptoms. This is due to the very close link between your gut and your mind; the gut-brain axis.
What is the gut brain axis?
The gut brain axis refers to the connection between your gut and your brain. This connection involves a bi-directional flow of information between your gut and brain. This means that signals from your gut can impact your brain and vice versa.
The gut is being increasingly referred to as a ‘second brain.’ Your brain and gut are connected through nerves and neurotransmitters. Neurotransmitters are chemicals that are produced in the brain and have a role in controlling your feelings. These neurotransmitters can also be produced in your gut and have been shown to influence feelings of fear, anxiety and happiness just like those that are produced by your brain.
How does the gut-brain axis relate to IBS?
This relationship between your brain and your gut, and its impact on IBS, is a growing area of research. The close connection and bi-directional flow of information between the gut and brain can cause symptoms of IBS, which can then impact on how we feel and our emotions, but in this same way, our emotions can bring on or worsen IBS symptoms. For example, when we are feeling stressed or anxious this can either promote or exacerbate IBS symptoms occurring in our gut. Likewise, IBS symptoms can cause feelings of stress, anxiety, depression and low mood.
Alternative therapies for IBS
Following a low FODMAP diet can help manage IBS symptoms and reduce flare-ups, which in turn can help improve feelings of stress and anxiety resulting from symptoms. Using a combination of these alternative therapies alongside traditional diet therapies for controlling IBS may result in better symptom reduction and quality of life in people with IBS. Given this close link between our brain and gut and its impact on IBS symptoms, it makes sense to consider that feelings of anxiety and depression may be more common in the IBS population. Therefore, alternative therapies should be considered in IBS management to improve mental health and to calming your gut-brain axis.
Gut-directed hypnotherapy is one method with increasing evidence as an effective adjunct therapy for IBS. This involves hypnotherapy to regulate and normalise gastrointestinal function to the subconscious area of our mind. This therapy may work through the reduction of symptoms by improving gastrointestinal motility and reducing sensitivity, and through reducing levels of anxiety, stress, and other negative emotions. Gut hypnotherapy paired with a low FODMAP diet has shown to have greater improvements overall and may be a worthwhile combination for IBS management.
Another alternative therapy for IBS is Cognitive Behavioural Therapy (CBT). This method is commonly used to treat many health problems including anxiety and depression, but can also be used to improve an individual’s physical health for example with weight management. In IBS, this therapy involves helping the individual understand how their thoughts and feelings can play a role in their symptoms. Relaxation techniques, stress control, self-regulation and information about the gut-brain axis has been included in CBT for IBS.
Simple strategies to help calm the gut-brain axis
There are many simple strategies that you can do on your own to calm your gut-brain axis. Here are 5 ways to help you reduce your stress levels and therefore your IBS symptoms:
1. Mindfulness & Meditation
Mindfulness is a method to help you focus your attention and bringing yourself into the present moment. This is an effective way to become more aware of and take control of your thoughts and feelings to prevent stress and anxiety. Meditation is a type of relaxation therapy for the mind and body that has proven effective in reducing stress and anxiety. This can involve focusing on your breath, body movements, a mantra, sounds or visuals. If you are a beginner, joining a meditation course or attending classes can be a great introduction. One of my favourite’s in Perth is the Mindfulness Meditation Hub.
2. Yoga
Yoga combines the stress-relieving actions of exercise and deep-breathing to promote mental health and wellbeing. Signing up to a beginner’s yoga class may be a great way to support your mental health. Blooming Happy Yoga’s outdoor sessions in Hyde Park are hard to beat.
3. Light exercise
Exercise stimulates the release of feel-good endorphins and can also help relax muscles that may have become tense due to stress. Even a short, low-intensity walk can provide benefits to our mental health and improve our mood. We are lucky to be spoilt for choice when it comes to beautiful places to walk in Perth – take your pick from City Beach, Kings Park or on the Applecross Foreshore.
4. Having a bath
Taking time out of a busy schedule to relax in a bath can help relieve stress and anxiety. Stress can also cause muscles to become tense and a warm bath can help release this tension.
5. Journaling
This is where a person writes down their thoughts and feelings for the purpose of self-reflection. Journaling can be an effective way of rationalising your thoughts and making sense of situations that have occurred. Through better understanding your thoughts and feelings and ultimately yourself, journaling can be an effective strategy to reduce stress and anxiety. This is a cheap, simple, and easy way to improve your mental health, all you need is paper and a pen!
Try one of these activities next time you find yourself feeling stressed or anxious to help reduce or prevent these feelings causing or worsening IBS symptoms.
If you are struggling to manage your IBS, please do not go on alone. Sascha McMeekin is a Monash-certified Accredited Practising Dietitian who has over 9 years of experience helping people manage their Irritable Bowel Syndrome. Find out how Sascha can help you by clicking here.
References
Dinan TG, Cryan JF. Gut-brain axis in 2016: Brain-gut-microbiota axis - mood, metabolism and behaviour. Nature reviews.Gastroenterology & hepatology. 2017;14(2):69-70. http://dx.doi.org/10.1038/nrgastro.2016.200.
Black CJ, Thakur ER, Houghton LA, Quigley EMM, Moayyedi P, Ford AC. Efficacy of psychological therapies for irritable bowel syndrome: systematic review and network meta-analysis. Gut. 2020;69(8):1441.
Peters SL, Yao CK, Philpott H, Yelland GW, Muir JG, Gibson PR. Randomised clinical trial: the efficacy of gut-directed hypnotherapy is similar to that of the low FODMAP diet for the treatment of irritable bowel syndrome. Aliment Pharmacol Ther. 2016;44(5):447-59.
Lackner JM, Jaccard J, Keefer L, Brenner DM, Firth RS, Gudleski GD, et al. Improvement in Gastrointestinal Symptoms After Cognitive Behavior Therapy for Refractory Irritable Bowel Syndrome. Gastroenterology. 2018;155(1):47-57.