Can Stress Affect the Functioning of the Gut and my IBS Symptoms?
Have you ever noticed that your stomach feels upset when you're stressed? This isn't just a coincidence—there's a complex relationship between the gut and the brain. In this blog post, we'll explore how stress can affect the functioning of the gut and exacerbate symptoms of Irritable Bowel Syndrome (IBS).
Understanding the Gut-Brain Connection
The gut-brain connection refers to the two-way communication between the gut and the brain. This communication occurs via the nervous system, hormones, and the immune system, forming what is known as the gut-brain axis (Mayer, 2011). Stress, emotions, and psychological factors can influence gut function, while gut health can, in turn, impact mood and mental well-being.
There’s now a great deal of evidence that IBS should be considered a disorder of the gut-brain axis, which means managing our stress levels is important. We might not actually feel like we’re stressed, but modern life is busy, and our bodies are much more physiologically stimulated than perhaps ever before. Lots of us are in a state of constant doing rather than being, and this has an effect on our gut’s functioning through the nervous system.
The Impact our Nervous System has on Gut Function
The central nervous system in the brain, is made up of nerves that control our bodily processes. When our body is under stress, are nervous system responds by triggering a physiological change, known as the "fight or flight" response. The ‘fight or flight’ response is driven by the ‘sympathetic’ branch of our nervous system – you can think of this like the gas peddle of a car, or an ‘on’ switch. It sets of a chain reaction of stress hormones, such as cortisol and adrenaline, that increases your heart rate, pumps more blood to your muscles and slows your digestive processes down, or even stops them. For example, it can increase inflammation, alter movement of food through the gut, reduce intestinal blood flow, and reduce gastric secretions.
When the perceived stressor is over and we feel calm, and the opposite system is activated – ‘the rest and digest state’. This is driven by the ‘parasympathetic’ branch of our nervous system, which is like taking the foot off the peddle and reactivating our normal bodily processes. In this state, stress hormones reduce, our heart rate slows and our digestive processes return to normal.
This system was an evolutionary mechanism, to ensure that when we were under threat from a predator or bad weather, we took immediate action and ran away with the extra energy and blood flow that was supplied from the stress response. Fast forward to this modern age, and it becomes quite a problem, as many of us never feel like we can run away from that lion, and our bodies remain in a hyper-vigilant state. This can have a significant impact on our gut’s functioning and can contribute to the development, or exacerbation of irritable bowel syndrome (IBS). For individuals with IBS, stress can be a significant trigger for symptom flare-ups with studies showing that it can exacerbate gastrointestinal symptoms including abdominal pain, bloating, and altered bowel habits (Mönnikes et al., 2001). For a person with a lot of stress in their life, IBS symptoms can become quite severe. For example, its estimated that 40-60% of those with IBS, have depression or anxiety. We also know illness, grief, trauma and major life events can all worsen symptoms associated with IBS (Singh et al., 2012).
Here are 5 Ways Stress Can Impact our Gut Health:
1. Changes in Gut Motility: Stress activates the body's "fight or flight" response, which can lead to changes in the contractions of the gastrointestinal tract. Some individuals may experience an increase in contractions and spasms in the colon, leading to symptoms such as diarrhoea or abdominal pain. Others may experience a decrease in motility, resulting in constipation.
2. Altered Gut Permeability: Chronic stress may contribute to increased gut permeability, often referred to as "leaky gut." This means that the lining of the intestines becomes more porous, allowing substances that would normally be restricted to pass through. This change in permeability can potentially contribute to inflammation and may be associated with gastrointestinal symptoms.
3. Impact on Gut Microbiota: Stress can also influence the composition and activity of the gut microbiota. The gut microbiota refers to the diverse community of microorganisms residing in the gastrointestinal tract, including bacteria, viruses, fungi, and other microbes. These microorganisms play essential roles in digestion, immune function, metabolism, and overall health. The gut microbiota can also affect the bidirectional communication between the gut and the brain. Changes in the microbiota may contribute to gastrointestinal symptoms and may also have implications for mental health (Konturek et al., 2011).
4. Activation of the Enteric Nervous System: The enteric nervous system, often referred to as the "second brain," is a complex network of neurons in the gut that can operate independently of the central nervous system. Stress can activate the enteric nervous system, leading to changes in gut function and symptoms such as cramping and discomfort.
5. Sensitisation of the Gut: Stress can sensitise the gut, making it more responsive to normal stimuli; we call this visceral hypersensitivity. This heightened sensitivity may lead to the perception of pain or discomfort at lower levels of stimulation, contributing to symptoms commonly associated with IBS, such as abdominal pain or bloating. To learn more about visceral hypersensitivity, click here.
How to target the Gut-Brain Connection
If you feel stress could be a factor, a key tip is to ensure you are ‘closing each stress cycle’ – this means exploring different things that help calm your nervous system after a busy few hours or stressful event. This can look like different things, to different people, it might be yoga in the morning, a gentle walk after work, or simply enjoying a cup of tea in the garden – whatever makes you feel calm. If you would like help with regulating your nervous system, I teach different evidence-based techniques such meditation, breathwork and body tension release techniques. Please reach out for a session with me if you’re interested, I would love to help as this is something I’m passionate about, and these are all techniques I have used to help myself. Additionally, stress management techniques and interventions aimed at reducing psychological distress have been shown to improve IBS symptoms and quality of life (Zijdenbos et al., 2009). If you know you have anxiety and depression, CBT is the gold standard psychotherapy for addressing these, however I would recommend speaking with your GP before working with me, as you may benefit from more specialist psychological support.
Stress is Not Always the Sole Cause of IBS!
While stress can be a contributor to IBS symptoms, it usually isn’t the only factor! The relationship between stress and gut health is individual and can vary among people. Some people with IBS may experience an increase in symptoms during periods of stress, while others may not despite high levels of stress. Lifestyle, sleep, exercise, and diet are equally as important to consider, all of which I can cover in an initial holistic assessment. For more information about my services, click here.
References
Konturek, P. C., Brzozowski, T., & Konturek, S. J. (2011). Stress and the gut: pathophysiology, clinical consequences, diagnostic approach and treatment options. Journal of Physiology and Pharmacology, 62(6), 591-599.
Mayer, E. A. (2011). Gut feelings: the emerging biology of gut-brain communication. Nature Reviews Neuroscience, 12(8), 453-466.
Mönnikes, H., Tebbe, J. J., Hildebrandt, M., Arck, P., Osmanoglou, E., Rose, M., ... & Klapp, B. (2001). Role of stress in functional gastrointestinal disorders. Evidence for stress-induced alterations in gastrointestinal motility and sensitivity. Digestive Diseases, 19(3), 201-211.
Singh, P. Staller, K. Barshop, K. Dai, E. Newman, J. Yoon, S. Castel, S. Kuo, B. (2015) Patients with irritable bowel syndrome-diarrhoea have lower disease-specific quality of life than irritable bowel syndrome-constipation. World Journal of Gastroenterology. 21(26) : 8103-9.
Zijdenbos, I. L., de Wit, N. J., van der Heijden, G. J., Rubin, G., Quartero, A. O., & Bijl, R. V. (2009). Psychological treatments for the management of irritable bowel syndrome. The Cochrane Database of Systematic Reviews, (1), CD006442.
