Even as a dietitian, I spent a shocking amount of brainpower working to understand my digestive symptoms, more specifically stress management for IBS, or irritable bowel syndrome. IBS is a common gastrointestinal disorder characterized by abdominal pain, discomfort, and unpredictable changes in bowel habits. It may include symptoms like diarrhea, constipation, or both. The exact cause of IBS is unknown and everyone’s symptoms are so individualized. We do, however, know that lifestyle factors like diet, exercise, and stress contribute to its development or exacerbate symptoms.

After years of making diet changes only to have very little success managing my condition, it dawned on me that maybe, just maybe, nutrition wasn’t the hero of the story here. In fact, stressing about my diet might have been making my digestive symptoms worse over time.

Trust me, I tried all the diets: FODMAP, low carb, intermittent fasting, juice cleanses, and more. Nutrition is just one piece of the puzzle when working toward improved digestion. Exercise, sleep habits, medications, and stress also impact our gut health. For me, understanding the impact stress has on my digestion and finding ways to manage my stress were the keys that ultimately unlocked the door to better gut health and consistently improving my IBS symptoms.

How mental stress leads to stomach issues

If you’ve ever experienced butterflies in your stomach when you’re nervous or excited, you’ve felt the connection of the gut-brain axis. This pathway is linked by the vagus nerve, a large part of our nervous system that connects our brain to our stomach and other digestive organs.

Stress can feel intangible and can be hard to quantify. Sometimes it is challenging to recognize the warning signs of stress, and for many, physical symptoms are the initial tip that our systems are overloaded. A stomachache, nausea, headaches, and GI distress are all ways stress shows up in our body.

The vagus nerve is the physical part of our body that gets activated when we are stressed. “When our bodies are in a sympathetic state, commonly known as ‘fight or flight’, digestion is suppressed,” says gut health dietitian Julie Balsamo, RD. “As a result, our central nervous system slows muscle contractions and decreases digestive secretions. This combination creates the ideal conditions for exacerbating IBS symptoms.”

In conjunction with the physical body symptoms we might experience stress can negatively impact our microbiome, home to four trillion bugs in our gut that function to digest our food, support our immune health, and support our mental health. “Stress causes the release of hormones and neurotransmitters from the brain that can alter the ecosystem of healthy gut bacteria, shifting them into an unhealthy state,” says William Li, MD, physician, scientist, and bestselling author of Eat to Beat Disease: The New Science of How Your Body Can Heal Itself and Eat to Beat Your Diet: Burn Fat, Heal Your Metabolism, and Live Longer.

What stress management for IBS looks like

In today’s hustle-bustle world, removing stressors isn’t possible or realistic. Rather, we want to become more resilient to stress and find ways to cope more positively by reducing the negative effects of stress on our bodies and minds. While stress management will mean something different to everyone, this may involve recognizing stress triggers, practicing relaxation techniques like deep breathing and meditation, staying physically active, eating healthy foods, seeking support from others, and knowing when to ask for help as necessary.

Despite its vague description, my digestion improved once I started managing my stress consistently. I always thought stress management sounded boring, and I had to learn that it’s about taking steps to take care of myself and building resilience against stressful moments. Here are some of the tactics that have worked for me:

• Going to therapy: This is the number-one thing that helps me understand my stress and actively take steps to improve my symptoms. Engaging in somatic therapy, which teaches you how to listen to your body, can be particularly impactful. Skills like learning to set boundaries, asking for help, and time management, may all come up to manage stress.
• Upping my activity: Not just exercise, but generally increasing my lighter activity, like walking, throughout the day makes a huge difference. I got a walking pad and regularly stroll on it at a slow and steady pace most days.
• Getting quality sleep: Getting to bed early is one of the easiest things I can commit to for guaranteed better digestion. The research shows there is a huge connection between IBS and sleep disorders¹.
• Cutting back on alcohol: As a toxin, alcohol is filtered through our digestive process and our liver. Thus, GI issues are common with alcohol, and stress levels rise with increased alcohol consumption. I am not a huge alcohol consumer, but even with one or two drinks, I notice an impact on my digestive health.
• Limiting my caffeine consumption: Caffeine is a stimulant and impacts digestion by stimulating a bowel movement. Multiple servings of caffeine can worsen IBS symptoms, plus they may disrupt sleep and stress levels later.
• Prioritizing my IBS when travel planning: Since travel is a trigger for so many with IBS, managing your stress levels before and during travel is a must. Traveling with medication if you need peace of mind, and taking time to learn your triggers will help you manage your symptoms on the road.

IBS is considered a chronic condition that requires ongoing management and support. Treatment typically focuses on managing symptoms through lifestyle changes, dietary modifications, medication, and stress management techniques. However, it’s important to know that symptoms can improve drastically with the right personalized treatment plan for you.

To be diagnosed with IBS, work with a gastroenterologist and a dietitian to create personalized treatment options. Everyone’s digestive health is different and what has worked for one person may not help another.