Stressed Out

If you live with inflammatory bowel disease (IBD), you know it can take a toll on your mental and physical health. It’s normal to experience stress when you have IBD. But too much stress can impact your symptoms and make them more difficult to manage.

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Does Stress Cause IBD?

IBD is an autoimmune disease that damages your digestive tract and produces painful symptoms. There is no cure for IBD and doctors aren’t sure what causes it. But the right combination of these risk factors might be to blame:

  • Genetics.
  • Exposure to certain things in the environment, especially cigarette smoke.
  • Frequent use of NSAID medicines like aspirin or ibuprofen.
  • History of antibiotic use.
  • Changes in your gut microbiome (the bacteria in your digestive tract).
  • An overactive immune system.

There’s no proof that stress by itself causes IBD. However, chronic stress might contribute to changes in your microbiome and how your immune system works. Those changes may increase your risk of developing IBD, especially if you have other risk factors.

People with IBD often report feelings of anxiety and stress, but it’s difficult to know which came first: the IBD or the stress.

Stress and IBD Symptoms

Stress is your body’s normal response to something you see as a potential threat. Your brain signals an alarm, and your body goes into “fight or flight” mode. Hormones increase your heart rate and blood pressure, and tense your muscles to fight off the threat.

Everyone experiences stress and anxiety at one time or another. It can cause you to feel nervous, on edge, or worried about what might happen in the future. When you have IBD, those feelings can become constant.

It’s not unusual to feel stressed when you’re not feeling well or you’re anxious. After all, IBD symptoms like severe belly pain and diarrhea may interfere with work or your daily life, relationships, and routines. In fact, about 35% of people with IBD develop anxiety as a result of living with IBD.

Unfortunately, chronic stress may cause your symptoms to flare more often. That’s because the stress response also affects your digestive tract, causing it to tense up and contract. That can lead to more urgency, diarrhea, or constipation.

In addition, chronic stress can make it harder to manage IBD because:

  • You might feel hopeless and unable to manage your health.
  • You might be less likely to take your medicines on schedule.
  • Your chances of needing surgery might be higher.

Over time, stress can pull you into a vicious cycle of negative emotions and more frequent symptoms. Living with IBD and chronic stress can have a negative effect on your quality of life.

How to Manage Stress When You Have IBD

It’s possible to manage IBD-related stress and anxiety. Doing so can improve your quality of life, minimize your symptoms, and may reduce the risk of relapse. Your UPMC health care team includes behavioral health specialists who can teach you techniques to put the brakes on stress.

There’s no one-size-fits-all solution to managing stress, so it’s smart to try various techniques to find what works best for you. Some stress- and anxiety-reducing techniques that can work include:

  • Cognitive behavioral therapy (working with a therapist).
  • Positive self-talk (reframing negative thoughts or worries).
  • Breath work or diaphragmatic “belly” breathing.
  • Guided meditation or hypnotherapy.
  • Yoga or tai chi.
  • Regular moderate exercise.
  • Anxiety or antidepressant medicine (if needed).

Think about joining a support group. IBD is an isolating disease. You may feel less stressed knowing there are others who personally relate to your situation

When you’re living with IBD (or any chronic disease), it’s important to remember you’re not alone. Your UPMC health care team includes a wide range of specialists ready to support you every step of the way.

Sources

Cells. Inflammatory Bowel Disease: A Stressed “Gut/Feeling" LINK

Frontiers in Pediatrics. Stress Triggers Flare of Inflammatory Bowel Disease in Children and Adults. LINK

Crohn's and Colitis Foundation. Depression and Anxiety. LINK

About Digestive Disorders

The UPMC Digestive Disorders Center cares for a wide range of gastrointestinal conditions and diseases, from diagnosis to treatment. Upon referral from your physician, we coordinate your testing and treatment. If you have a complicated condition, we can refer you to one of UPMC’s digestive health centers of excellence. Most of our office visits and outpatient procedures take place at UPMC Presbyterian or UPMC Magee-Womens Hospital in Oakland. We also provide inpatient care at UPMC Montefiore or UPMC Presbyterian in Oakland.