It is both invalidating and frustrating to be told there is nothing that can be done for IBS and that your symptoms are largely emotional, and stress-based. This misunderstanding is often simply a failure of communication. What your doctor means is that there is no pharmaceutical pills that will suppress all your IBS symptoms, not enough to falsely claim it a ‘cure’. But there are things you can do to alleviate your symptoms.
Labeling your IBS symptoms “emotional” really means your nervous system is highly sensitive and the complex cascade of hormonal and chemical reactions that is your digestive system, is both fragile and easily triggered. It is notably more sensitive to pain, cramping and distention and your gut flora and fauna (the microbiota) may be out of balance, causing inflammation.
Furthermore, the dysregulation of serotonin in the nervous system that runs through your intestine may additionally increase your sensitivity. (Serotonin is a mood enhancer, hormone, and neurotransmitter. It helps us regulate sleep and digestion and it regulates mood amongst other things). And the acknowledgment by the medical establishment that our emotional responses affect our chemical responses, should be seen as a belated but much-needed recognition of the holistic nature of the human organism.
A 2023 study found IBS patients to have high levels of GI-specific anxiety. The study goes on to say, “Psychotherapies, such as cognitive-behavioral therapy (CBT) and hypnosis, have exhibited positive effects on improving symptoms, and the results can reflect the importance of the biopsychosocial aspects of IBS.” A finding that validates both the local and emotional or social aspects of IBS.
Not everyone who has IBS is anxious, but the inconsistency of the bowel’s action and its impact on our daily lives can create a loop of anticipation anxiety, even in the absence of external stressors. And it is important to recognize how easily influenced our emotions are by our digestive tract and vice versa. After all, we digest new information, we are gut-wrenched with grief, we have butterflies in our stomach, we can’t stomach the way someone behaves. Once we accept that we have a fragile nervous system and that our emotions do play a significant part in our digestive health, we can find constructive ways to manage our IBS.
Cultivating Mental Health & Wellbeing
Our ability to recognize stress triggers is key to managing them. Often our stresses are exaggerated when we remember them at four in the morning when we cannot sleep, or when we are triggered. Writing them down in a list form, allows us to identify a more realistic picture.
Spend a week or two feeling into your enteric (digestive) nervous system and identifying what makes you feel calm and rested. It may be a warm bath with Epsom salt and lavender oil, candles, and a good playlist. It may be lying on your back on the grass in the sun. Laughing with little nieces or nephews, a swim in the ocean or a simple walk around the block can increase the feel-good hormones and our sense of joy and purpose in life. It may be having tea with your grandmother or eating a forbidden food – something you love but usually restrict. It may be watching a great series with a loved one or getting into a freshly made bed by yourself or working in the garden or on a creative project. Write a list and put it on the fridge or pinboard where you can see it.
Use this time to also observe what irritates or triggers your enteric nervous system. Stress from work, difficult family relations, a toxic partner, driving or sitting in traffic, environmental pollutants, certain smells, or noises that put your nervous system on edge, or foods that irritate you. Without judgment, simply observe and write a list. Often our negative triggers cannot be eliminated from our lives, but our response to them can be observed, and once we learn to calm down the nervous system itself, we can practice doing so also when our stresses are high.
Anxiety and trauma are held in an ancient part of the brain and it cannot be reasoned with. But it can be circumvented and reframed through bodywork, breathwork, meditation, somatic therapy, and eye movement therapy (EMDR). By retraining the brain to manage pain, stress, anxiety, and trauma, we establish new pathways creating new feedback loops between the gut and the brain, and this can reduce our symptoms. Furthermore, by increasing things that enhance a sense of wellbeing we reinforce structural changes in our brain chemistry which impacts our gut chemistry towards a more rested and calm state.
Rebecca Bermeister
