Stress and IBS Blog
The Gut Brain Axis: Strategies to Optimize Digestion and Improve Irritable Bowel Syndrome (IBS):
Bloating, gas, constipation, diarrhea.....the symptoms of IBS affect millions of people
IBS is a disorder of the “gut-brain axis”
What is the “gut-brain axis”? This means our brain talks to our gut and vice versa.
So what? If we can change our stress response, we can change our symptoms
Read on for strategies to improve your stress response AND your IBS symptoms
Feeling uncomfortable after eating what we think is a “healthy” meal, avoiding making plans because we aren’t sure when we’ll next have to run to the bathroom, googling home remedies for constipation....are any of these patterns part of your day to day life? The symptoms of IBS are all too common.
While it’s important to check in with your physician for any of these symptoms to rule out other causes, if you are diagnosed with IBS, you may be left feeling somewhat hopeless. You’re told your condition is not “serious” but it sure feels serious to you, affecting every day of your life.
What if you could change your digestive function by changing your stress response?
For any condition like IBS, we would always recommend implementing the foundations of a healthy lifestyle like a nutritious diet, exercise, and getting sufficient quantity and quality of sleep, but one other extremely important area that is often overlooked is our stress response.
The way we respond and react to daily stressors has a profound effect on the gut-brain axis. By working on this communication system between our digestive tract and our brain, we have the opportunity to gain better control of our symptoms and improve our quality of life.
Highlights/Thread:
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Irritable Bowel Syndrome affects 5% of people and can have a significant effect on quality of life.
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The brain and the gut communicate with each other through the gut brain connection.
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Psychological stress is one factor that can worsen symptoms of IBS through this gut brain connection.
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Stress reduction strategies can improve symptoms and quality of life in those with IBS
The Basics of Irritable Bowel Syndrome:
Bloating, gas, diarrhea, constipation. Sound familiar? These symptoms are so common that Irritable Bowel Syndrome, or IBS, is thought to affect 5% of the US population, or 1 in 20 people. While there are many factors that contribute to IBS, the American College of Gastroenterology does consider it to be a disorder of the gut-brain axis. What does this mean?
The Effects of Stress on IBS: The Gut Brain Connection:
It turns out that the central nervous system (the brain) and enteric nervous system (the nervous system in the GI tract) talk to each other. Chronic stress is one factor that can affect this gut-brain axis and contribute to IBS symptoms. Inputs from the brain affect the nervous system in the gut, and vice versa. When this signaling pathway between the brain and gut is disrupted by stress and other factors, it can result in trouble with motility and secretions in the GI tract and exacerbate symptoms related to IBS. Again, while there are many factors that can contribute to IBS, we are focusing on stress in particular as it is one important trigger that is sometimes overlooked.
When we talk about the effects of stress, researchers have found that acute and long-term stressors, as well as stressors in early life and adulthood, can all have an impact on the digestive tract. While there are several mechanisms that have been proposed as to how these stressors affect the composition and function of the gut microbiome and digestive symptoms, some of the main theories involve effects on biofilm and mucous production, as well as changes in gut motility, intestinal permeability, and immune function.
Chronic stress can also affect how we feel sensations in our body including in our intestinal tract in the case of IBS. A study in children actually showed that stress increased the perception of stomach pain.
Stress and IBS: How can we improve the Gut-Brain Connection:
Because of the association between stress, the brain and the GI tract, it makes sense to include stress reduction techniques directed at the brain and gut-brain axis when looking at adjunct therapies for IBS. In fact, gut directed psychotherapies are recommended by the American College of Gastroenterology as part of an overall treatment approach for patients with IBS. These types of therapies can include relaxation therapy, cognitive behavioral therapy and hypnotherapy, among others. The American College of Gastroenterology also provides general tips on belly breathing to help activate the parasympathetic nervous system and help with various digestive disorders. Overall, the goal with any of these techniques is to intentionally activate the parasympathetic “rest and digest” state of our nervous system, which can modulate the impact of stress on the GI tract and improve symptoms.
Here’s a summary of some resources to consider to improve the gut-brain connection by modulating the stress response:
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Heart Rate Variability Biofeedback [link to our resources on HRV biofeedback/app when available]
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Meditation: there are a LOT of options here, Tara Brach has many resources available including meditations and a body scan
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Mindfulness Based Stress Reduction based on the work of Dr. Jon Kabat-Zinn, classes offered here
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Cognitive behavioral therapy (CBT): you can search for a practitioner that offers CBT through this directory
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Hypnotherapy: Listen to this podcast with Dr. Andrew Huberman and Dr. David Spiegel; they include this link for finding a practitioner
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Yoga, tai chi
Conclusions:
External stressors that we encounter on a daily basis are unavoidable and often outside of our control. What we can control is our response to these stressors. By employing one of various stress reduction strategies, it is possible to improve symptoms and quality of life in those with IBS.
SEPARATE BLOG FOCUSED ON HRV
What does Breathing and Heart Rate Variability have to do with Irritable Bowel Syndrome? The Gut Brain Axis and how Self-Directed Heart Rate Variability Biofeedback Can Improve IBS symptoms.
The Research Behind the use of HRVB and IBS:
HRVB is an easy to implement intervention that uses breathing exercises to work on the gut-brain axis. This results in a shift towards a more parasympathetic “rest and digest” state, which can modulate the impact of stress on the GI tract.
Several studies have shown promise in using deep breathing as a method to improve HRV and reduce the symptoms involved in IBS and other functional GI disorders.
A 2011 study showed that deep breathing reduced perceived gastrointestinal pain in all study volunteers. This shows that activating the parasympathetic nervous system with deep breathing may help reduce pain signaling in those with IBS and other functional GI disorders.
A 2013 study showed HRVB significantly reduced IBS symptom severity in patients who had not responded to traditional therapies for IBS. In addition to helping their digestive symptoms, HRVB also improved anxiety, depression and global symptom scores in these patients. As part of this study, patients were taught how to slow their breathing patterns to calm their nervous system. Specifically, patients were taught how internal thought patterns and worry affected their nervous system, and how slowing their breathing patterns in a specific way reduced the internal worry/negative thought patterns.
Finally, a 2014 study in children with IBS or functional abdominal pain showed HRVB resulted in full remission of symptoms in 69% of patients. Similar results were found in those children with functional abdominal pain.
Conclusions HRVB and IBS:
External stressors that we encounter on a daily basis are unavoidable and often outside of our control. What we can control is our response to these stressors. We can improve our response to stress and how it affects us by learning tools such as HRVB. For those with Irritable Bowel Syndrome and other forms of functional abdominal pain, Heart Rate Variability Biofeedback can be an extremely helpful self-directed tool for reducing symptoms and improving quality of life.