“Stress increases the hormone cortisol, and it can impact our digestive system,” says Megan Riehl, PsyD, a gastrointestinal psychologist at Michigan Medicine in Ann Arbor. “People with IBS have trouble down-regulating digestive distress. For example, a person with IBS may feel the digestive process with some gurgling or discomfort and that sets off stress signals and a fear that they will need the bathroom urgently.” A study published in April 2021 in the American Journal of Gastroenterology found that participants living with IBS who reported experiencing anxiety and stress were more likely to report more severe symptoms, cycle through more treatments, and say their symptoms negatively impacted their daily life than patients who did not report psychological distress. “Behavioral treatments for IBS are needed as a complement to medicine to get patients over the finish line,” says Brennan Spiegel, MD a gastroenterologist and the director of health services research at Cedars-Sinai in Los Angeles. “Patients need to develop skills and train their brain to overcome the symptoms of IBS, and that means combating stress.” So if you’re living with IBS, make sure you’re not neglecting to manage your stress levels, as they can significantly impact your gastrointestinal symptoms. Here are three ways to reduce IBS-related stress.
1. Get Physical
You don’t have to throw down loads of cash at a CrossFit box or jab-jab-cross until you’re sore at a boxing class. Moderate exercise like walking, jogging, swimming, cycling, and yoga are enough to reduce stress and improve IBS symptoms. A review published in December 2019 in Digestive Diseases and Sciences found that yoga and walking at a brisk pace were equally effective in improving IBS symptoms, and both were more effective than medicine alone. “Exercise helps boost our endorphins and lower cortisol levels, which means we feel happier and less stressed,” says Dr. Riehl. “That’s when the brain and gut send much more favorable signals to each other.” The American Psychological Association points out that an exercise habit increases levels of norepinephrine, a hormone and neurotransmitter that helps decrease stress. Exercise also trains the mind to cope with anxiety and panic. RELATED: 5 Exercises for IBS Symptom Relief
2. Breathe Deeply
Deep breathing is one of Riehl’s go-to techniques when teaching her patients to reduce stress. “Stress makes for shallow, short breaths,” she says. “When we slow our breathing down, we kick-start the parasympathetic system that calms us down and gives a nice massage to the digestive organs. That reduces spasming and urgency.” One technique she is particularly fond of is diaphragmatic breathing, which involves slow and deep breathing that affects the brain as well as the cardiovascular, respiratory, and gastrointestinal systems. A study published in June 2017 in Frontiers in Psychology divided 40 people into two groups; one control group and one group who received training in diaphragmatic breathing. After eight weeks, the group who received breathing training had lower levels of the stress hormone cortisol and were less prone to negative emotions. RELATED: 5 Ways to Practice Breath-Focused Meditation
3. Gut-Directed Hypnosis
Gastrointestinal psychologists have found that gut-directed hypnosis is extremely effective at reducing stress and improving IBS symptoms. In this technique, a trained therapist guides a patient into a focused state of awareness and deep relaxation. Through suggestions and imagery, gut-related hypnosis aims to calm the digestive tract and steer attention away from physical discomfort. In a study published in the September 2016 issue of Alimentary Pharmacology and Therapeutics, 72 percent of participants found that their symptoms improved after they followed gut-directed hypnotherapy, and they maintained the improvement for at least six months. “We need to standardize holistic treatments like gut-directed hypnosis that specifically target the communication of the gut-brain axis,” says Dr. Spiegel. “When patients have failed everything else, they succeed at this as long as they’re open to trying it,” notes Riehl. “We can develop the skills to stop the brain from perseverating on GI-specific worries. For example, we can start to retrain the mind when someone is always imagining that they will have a bowel accident in public. “It’s how we identify and think about IBS in our day-to-day life that can make [our symptoms] better or worse,” she adds. RELATED: Mindfulness Meditation Reduces IBS Symptoms and Anxiety, Study Finds
