Stress, whether psychological or physical, plays a major role in the development of IBS and symptoms. When the body is stressed, the body goes into its “fight or flight” response. Heart rate and blood pressure are elevated, airways are opened, epinephrine (adrenaline) is released, senses are sharpened, and glucose is released into the blood. This response starts in the brain, but after the initial response is complete the body begins to respond via the HPA axis. Hormones are shifted, and cortisol (stress hormone) is released. The HPA axis is also the bidirectional communication pathway between the community of gut bacteria (microbiota) and the brain.
So what does this mean?
Activation of the HPA axis during chronic psychological or physical stress has been shown to alter the composition gut microbiota and increase gut permeability. These are both key factors in IBS. Changes in the gut microbiota and gut permeability has been linked to the development of depression and anxiety, due to altered communication along the HPA axis, as well as chronic inflammation. This is the gut-brain cycle that can be tricky for those living with IBS. Research has also shown that exposure to stress early in life can actually increase susceptibility to stress because the HPA axis is abnormal, which also puts that individual at risk of gut dysbiosis (changes in microbiota) and IBS. In reverse, gut bacteria can produce brain chemicals along the HPA axis called neurotransmitters, including dopamine, norepinephrine, GABA (gamma-aminobutyric acid) and the precursors to serotonin. Alterations in these neurotransmitters can impact how we feel. For those with IBS, this means that gut dysbiosis may be leading to feelings of anxiety or depression. There is also a small amount of research that shows a possible connection between a healthy gut microbiota and reduced risk for neural conditions, like alzheimer’s and dementia.
What can we do?
The role of stress in the development of IBS and symptoms highlights the need for a stress management approach to manage IBS. You can reduce stress by eliminating unnecessary stressors in your life, by increasing dopamine and lowering cortisol levels with exercise, and reducing cortisol and lowering heart rate through breath and meditation. There is also research to support gut directed hypnotherapy to help with psychological symptoms.
It’s also important to support the gut microbiota to prevent poor signaling from the gut to the brain that could lead to anxiety and depression. Our gut bacteria are so complex and unique, and there’s still so much we have to learn about them. The goal is to have a diverse, and large number of beneficial bacteria populating the gut. This can help reduce negative bacteria, and will contribute to improved digestion and a stronger immune system.
Here are a few ways you can support a healthy gut microbiota:
Plants! Eat a plant-heavy diet from whole grains, fruits, vegetables, and plant-proteins (legumes, nuts/seeds, tofu/tempeh). These provide fiber that the beneficial bacteria feed on and thrive on!
Less sugar, caffeine & alcohol. These are all fine in moderation, but excessive amounts can promote negative bacteria, which would lower beneficial bacteria.
Exercise! Low intensity exercise has been shown to support beneficial bacteria.
Get outside. Being in the outdoors not only increases your feel good hormones, but the microbes in the area and on the ground can help increase beneficial bacteria inside the gut.
Probiotics. There is limited research here, but there is a small amount of evidence to support using supplemental probiotics to support a beneficial gut microbiota. Work with a dietitian to pick a probiotic that is best for your needs. It’s also helpful to eat probiotic-rich foods from yogurt, kimchi, kefir, sauerkraut, and kombucha.
Reduce the stress! This is a bit repetitive, but we already know the stress response can alter the gut microbiota, so if you want to increase your beneficial bacteria you have to reduce stress levels. If you have a hard time getting control of this, a mental health professional could be helpful.
Avoid excessive antibiotic use. Antibiotics are incredible for getting rid of bacterial infections in the body, but they also clear out some of the beneficial microbes. Antibiotics should not be the first line of therapy for every single infection, so talk with your doctor about all options before starting an antibiotic round.
That’s a lot of information, so take a second and set one action item today that you can start implementing into your life to support your gut microbiota and reduce your stress!