For many people with Irritable Bowel Syndrome (IBS), stress is a major trigger for their symptoms. In fact, the power of stress at triggering IBS symptoms is often so great that it doesn’t matter how many other management strategies you have in place, an acutely stressful event can trigger your IBS symptoms anyway.
This is something I continually struggle with too. Stress, whether it’s a prolonged sense of being overwhelmed, or a particularly acute case of anxiety, has always made my IBS worse. When I first started following a low FODMAP diet and got so much relief from my symptoms, I had hoped that stress would no longer be a problem for me.
Boy was I wrong.
Admittedly little day-to-day challenges don’t have the same impact as they used to, but I’ve unfortunately had to concede that acute stress can bring me to my knees even worse than FODMAPs can. As I now describe it… “you can out-stress a low FODMAP diet”.
But even if stress does overpower a low FODMAP diet and/or other IBS management strategies you use, that doesn’t mean you should give up on those strategies because they can still provide considerable relief from day-to-day triggers. Instead, it’s about working out ways to manage the impact of stress.
To do this, you first need to understand how stress affects you, which means getting to know what stress is and why you can never get rid of it completely. The next step is to find ways to minimise the impact of stress so that it doesn’t trigger your IBS as often. Let me explain…
What is stress?
By definition, stress is anything that challenges your normal physiological processes to deviate from their optimal functioning. What that means is that stress is anything which challenges you in a way that results in your body and/or mind working differently from normal. In many cases this change in function will be negative and will make you perform less optimally, although sometimes certain biological functions can change in a positive way – for instance, making you more alert for a short period of time.
It’s also really important to understand that stress isn’t always due to negative events. Stress can also be caused by positive things.
Positive stress includes starting a new job, going back to study, buying or selling a house, starting a new relationship, having a baby, and getting married. These are all things you want to happen (i.e. they are positive), but they’re challenging and do impact your life.
What does stress do to your body?
Regardless of whether a stress is positive or negative, you’ll feel changes to your body and/or your mind. Perhaps your:
- muscles tighten up, making your back or neck sore, or giving you a headache.
- heart rate and breathing suddenly speed up.
- body starts sweating, even if it’s not hot outside.
- body starts shivering or shaking, even if it’s not cold outside.
- gut tightens up, making you feel nauseous, and destroying your appetite.
- bowels speed up or slow down, causing diarrhoea or constipation.
- body starts craving sugar and you end up eating sweet things.
- mind becomes overactive to think of ways to deal with the stress.
- mind becomes depressed because it’s overwhelmed by the stress.
- feelings become agitated, so you’re barely able to sit still and not able to sleep.
These are just some of the reactions you may get to stress. You may get some of them, many of them, or even other symptoms. Also, some symptoms may be very severe while others are just an irritation.
As IBS is a very individual condition, the way your IBS is affected by stress may be completely different to how another person with IBS is affected by stress. You may also find that different types of stress trigger different IBS symptoms.
How quickly does stress occur?
Stress can come on really fast. Think about how you’d react if you suddenly had to give a talk to 100 people in 15 minutes. This would cause a very rapid stress onset, but it would also disappear after you completed the talk.
Stress can also come on really slow, such as when it gradually builds up over time due to ongoing pressures in your life. For instance, you may have issues at work, financial concerns, a sick family member, lack of sleep, ongoing physical pain, or simply be struggling to find enough time each day to get things done. Those types of stress creep up on you so you often aren’t aware it’s there until something pushes you over the edge.
Of course stress can also occur anywhere between those two time frames. It may appear over a really hectic week or maybe after you’ve had to make several big decisions a few days in a row. It can also creep up slowly over a day, where you think things are okay and you’re handling it well, but when you suddenly stop for a moment, you realise your body has tightened up, your mind is having trouble staying on track, and your body is screaming with the symptoms of stress.
What can you do to decrease the impact of stress on your IBS?
Since stress is always coming and going from your life, there’s little point trying to banish stress altogether. Certainly it’s good to minimise the amount of stress in your life if you can, but it helps to know you’ll never truly be able to remove it from your life.
Instead, a better strategy is having coping mechanisms for when stress occurs. There are many different approaches – some will work for you while others may not. You’ll also find that the best strategy may depend on the type of stress you’re experiencing. For instance, if you’re really agitated then a seated meditation might not work, but walking or running might.
Here are some stress-busting strategies to consider:
- Get moving – walk, run, cycle, swim, or do anything that gets you moving. Whatever you prefer to do, even circuit or resistance training, playing basketball or kicking a football.
- Release your stress/anger physically with boxing, kickboxing, or anything that lets you hit something (of course making sure that protective gear is always used).
- Meditate – sitting still and meditating can be really helpful to clear your mind. Focussing on your breathing can be beneficial because it helps to slow your breathing, directly countering one of the symptoms of stress.
- Do a moving meditation – if you want to meditate but can’t sit still, try a mindfulness-based physical activity such as yoga, pilates, tai chi, or qi gong. These activities move your body and create mindful attention, effectively calming down your mind.
- Take a bath/shower to release tension in your body and calm your mind. If you pay attention to how your body is feeling and imagine the water washing away your stress, it’s like a meditation practice.
- Ask for help – maybe you can decrease or even remove the stress by asking someone to help you. This strategy is particularly useful at work, but can also be good at home if someone else in your family can lighten your load.
- Talk to someone – a friend, family member, co-worker, or healthcare professional. It doesn’t matter who, so long as it’s someone you trust and who’ll provide a compassionate ear.
- Change your environment – going to a different place and being in a different environment can sometimes help. You could go to a café, a park, the beach, a movie theatre – anything that puts you into a different frame of mind.
- Sit outside in the sun with a cup of tea and maybe a bite to eat. This is a great strategy to put into action on a daily basis when eating lunch or having an afternoon break.
- Listen to music – whether it’s a soothing melody or an upbeat dance tune, it’s about what will suit you the best.
It’s good to test out these strategies when your stress levels aren’t too high so that when stress hits you have an action plan. But remember to be flexible so that if one strategy isn’t working, you can try something else. At times you may even need to use several strategies one after the other.
But if you’ve been under a more prolonged form of stress that’s crept up over time, you may need to make some of these strategies a regular part of your life to help get your stress levels back under control. And if you’re unable to minimise this type of ongoing stress in your life, for instance if you have a very stressful job, then using some of these strategies on a daily basis may be essential for keeping your IBS under control.
My personal approach to managing IBS and stress
Because the impact of stress can be so dramatic on my gut, I’ve found that a 3-pronged approach is essential for keeping things under control. It’s not a magical cure-all, but it means that I can now resist most day-to-day stress and am only triggered by much bigger forms of stress that occur out of the blue.
Here’s what I like to do:
- Minimise the overall amount of stress as much as possible and try to avoid certain situations that are likely to be very stressful for me.
- Add stress-busting strategies to my daily routine. My favourites are exercise (of any type), sitting outside at lunch time (when it’s not freezing), and a short meditation at the start or end of the day. I also like to do moving meditations each week. While it’s rare for me to do all of these things in one day, or even do one of these things every single day, I do my best not to skip more than one day at a time.
- Have an action plan for when things become too much. My favourite strategies are changing the environment I’m in, going for a walk, listening to music, asking for help or talking to someone.