If you've ever experienced nervousness and wound up in the bathroom shortly after, or gone through a stressful life change only to experience more chronic gastrointestinal (GI) distress, you're not alone. Research suggests that there is a strong connection between your head, nerves and gut.
But a high-stress career or home life doesn't mean you're doomed to spend much more time than you'd prefer in the bathroom. Treating stress-related GI conditions with a combination approach - addressing both gut health and mental health - is helpful in reducing symptoms.
Stress-related irritable bowel syndrome
It’s conservatively estimated that irritable bowel syndrome (IBS), chronically occurring abdominal pain associated with altered bowel habits in the absence of organic GI disease, affects 10-15% of U.S. adults. Many functional GI problems are due to people leading stressful lives and not coping with stress in an optimal way.
IBS is a stress-sensitive disorder, the National Library of Medicine states. Under stress, the body releases higher levels of hormones that activate its flight-or-flight response, a natural response to life-threatening situations. These hormones also affect many different bodily processes to help us deal with the threat. In this way, the GI system becomes an innocent bystander that is altered by the stress hormones. Elevated levels of cortisol, in particular, are to blame. In addition to causing the colon to spasm, high cortisol can change the levels of good bacteria in your gut, and may affect other digestive organs that support the correct function of your large intestine.
People with IBS symptoms may have abdominal pain, bloating, diarrhea and/or constipation. Other symptoms of stress-induced IBS may include tension headaches or back pain. Many people with IBS also suffer from other GI conditions, such as reflux disease and dyspepsia, and non-GI-related conditions, including depression, anxiety, chronic fatigue syndrome and more.
Stress-induced IBS symptoms may appear when undergoing a large life change, even in adolescents. For example, a high school student preparing to transition to college may experience functional GI problems. At a younger age, GI problems caused by anxiety may cause stomachache or nausea.
This factor of age is relevant when distinguishing between stress-related IBS and other GI conditions. The onset of IBS usually occurs in young adulthood and can persist intermittently throughout life. It is unusual for IBS to occur later in life without any prior symptoms. The majority of young adults, as much as 80%, who go to the doctor with GI symptoms that are vague, chronic and stable over time are experiencing functional problems related to stress. However, a gastroenterologist, a doctor who specializes in treating disorders of the GI system, will rule other other possible causes, such as colitis.
Treatments and the promise of prebiotics and probiotics
Treating the GI symptoms of stress-related IBS is just part of the solution. Long-lasting changes require addressing stress levels. Once other GI conditions are ruled out, comprehensive treatment may include a trial of antidepressant medication or a mental health counseling referral. These methods are designed to address the root cause of the condition, not just treat the symptoms.
Research from neurobiologists at Oxford University suggests a strong connection between gut bacteria and mental health. The study found that prebiotic supplements, which are dietary fibers that boost healthy bacteria in the GI tract (different from probiotics which are actual strains of good bacteria), could have a positive impact on stress-related disorders, such as anxiety and depression.
Probiotics have proven especially helpful in people with active IBS, especially ulcerative colitis and IBS that tends toward constipation.
When to seek help
Regardless of the suspected cause, anyone experiencing GI symptoms that interfere with daily living should consult a doctor. Sometimes, when IBS symptoms change or become more severe, it is related to lifestyle changes, but sometimes the symptoms may be due to other causes. A doctor can evaluate your symptoms and help determine the proper treatment for you.