With a global presence of 11% in the general population, irritable bowel syndrome (IBS) is a common and debilitating functional disorder that contributes significantly to health-care resource consumption. IBS, characterized by chronic abdominal pain or discomfort and change in bowel habits, is thought to have multiple factors associated with the disease including biological, social, psychological, and illnesses caused by medical treatment or drugs. Importantly, recognition of the relevance of interactions among these factors is increasing. Clinical and evidence-based studies indicate that factors such as depression, anxiety, somatisation, illness behaviour, illness anxiety, and stress may be associated with IBS.
Have you ever had a “gut-wrenching” experience? Do certain situations make you “feel nauseous”? Have you ever felt “butterflies” in your stomach? We use these expressions for a reason.
The gastrointestinal tract is sensitive to emotion. Anger, anxiety, sadness, elation — all of these feelings (and others) can trigger symptoms in the gut.
The brain has a direct effect on the stomach and intestines. For example, the very thought of eating can release the stomach’s juices before the food gets there. This connection goes both ways. A troubled intestine can send signals to the brain, just as a troubled brain can send signals to the gut. Therefore, a person’s stomach or intestinal distress can be the cause or the product of anxiety, stress, or depression. That’s because the brain and the gastrointestinal (GI) system are intimately connected.
This is especially true in cases where a person experiences gastrointestinal upset with no obvious physical cause. For such functional GI disorders, it is difficult to try to heal a distressed gut without considering the role of stress and emotion.
Gut health and anxiety
Given how closely the gut and brain interact, it becomes easier to understand why you might feel nauseated before giving a presentation or feel intestinal pain during times of stress. That doesn’t mean, however, that functional gastrointestinal conditions are imagined or “all in your head.” Psychology combines with physical factors to cause pain and other bowel symptoms.
Psychosocial factors influence the actual physiology of the gut, as well as symptoms. In other words, stress (or depression or other psychological factors) can affect movement and contractions of the GI tract, make inflammation worse, or perhaps make you more susceptible to infection.
In addition, research suggests that some people with functional GI disorders perceive pain more acutely than other people do because their brains are more responsive to pain signals from the GI tract. Stress can make the existing pain seem even worse.
Based on these observations, you might expect that at least some patients with functional GI conditions might improve with therapy to reduce stress or treat anxiety or depression. And sure enough, a review of 13 studies showed that patients who tried psychologically based approaches had greater improvement in their digestive symptoms compared with patients who received only conventional medical treatment.
In a study from Harvard University affiliates, forty-eight patients with either IBS or Inflammatory Bowel Disease (IBD) took a 9-week session that included meditation training. The results showed reduced pain, improved symptoms, stress reduction, and a decrease in inflammatory processes.
Evaluation of patients with suspected IBS
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