Updated on PSYCHE AND BODY

Irritable bowel: when the abdomen feels

Irritable bowel syndromeis a disease of the digestive system that affects up to 20% of people worldwide. It is one of the most common diagnoses in the gastrointestinal tract and a common cause of sick leave.

“Irritable bowel syndrome is a chronic disease that needs to be managed in the long term,” explains Dr. Roshaan Saloojee, a general practitioner at Med-Healths. Even if the symptoms do not lead to a serious illness, they can put a heavy burden on patients in everyday life.

What exactly causes irritable bowel syndrome is still not known exactly. However, it is generally accepted that there is a close relationship between gut health and psyche. This is due to the so-called gut-brain axis. If youget anxiety and stress under control, it would be possible for the intestines to calm down as well.

What causes irritable bowel syndrome and who is affected?

“The exact cause of irritable bowel syndrome is not known, but possible causes include hypersensitive nerves in the gut or immune system. Diet can also play a role. Especially foods that pass through the intestine too quickly or too slowly cause discomfort. Another factor is stress or a family history,” explains Dr. Saloojee.

Under certain conditions, irritable bowel syndrome is more common. For example, a bacterial intestinal infection can trigger this syndrome. Stress, in turn, increases the risk of developing irritable bowel syndrome after an infection.

You are more likely to develop irritable bowel syndrome if:

  • you are under 50
  • you are a woman
  • Irritable bowel syndrome runs in your family
  • you suffer from anxiety disorders , depression or other mental health problems.

What symptoms are typical of irritable bowel syndrome?

Common symptoms of irritable bowel syndrome are:

“The symptoms come and go,” explains Dr. Saloojee. “They can last for days, weeks or months and vary in severity.”

What is the connection between our brain and the gastrointestinal tract?

There is a close connection – and virtually every good function is sensitive to stress. Most of us have experienced first-hand how our digestive systems react to emotions and psychological stress. Think of expressions like “butterflies in my stomach” or “this makes me sick to my stomach”.

The reason for this is that there is a direct connection between our gut and the brain: the so-called gut-brain axis. The central nervous system, which includes our brain and nerves, is divided into two parts: the sympathetic and parasympathetic nervous systems.

“The sympathetic nervous system controls organ functions in stressful situations, while the parasympathetic nervous system regulates them at rest. In addition, there is the so-called enteric nervous system or intestinal nervous system, which controls the intestines – also known colloquially as the abdominal brain,” explains Dr.Saloojee.

The term gut-brain axis describes the mutual communication between the central and the gut nervous system.

Because of the gut-brain axis, emotions can impact the gut and affect it in a variety of ways. The intestines can also influence the psyche.Digestive disorders can therefore also trigger psychological disorders such as panic attacksand depression. Conversely, anxiety and stress affect our intestinal flora and our well-being.

That’s not to say that all gut symptoms associated with mental health are due to irritable bowel syndrome. For example, anxiety can cause anything from stomach pain to aChange in bowel movements .

Can Stress and Anxiety Cause IBS Symptoms?

Stress, anger and fear activate the central nervous system. The releasedStress hormonesin turn activate the nerve cells in the intestinal wall. This affects the digestive processes in the intestines and results in diarrhoea, constipation, flatulence or discomfort.

On the other hand, irritable bowel syndrome itself can also trigger stress and anxiety, leading to a vicious circle. A survey of patients with irritable bowel syndrome revealed that44% also suffered from anxiety disorders and 84% from depression.

“While the link between stress and irritable bowel syndrome is clear, stress is usually not the only influencing factor – even though it plays a central role,” explains Dr. Saloojee.

Themicrobiome (the totality of bacteria in the gut) also plays a major role. A change in the composition of the bacteria can affect digestion. Therefore, irritable bowel complaints also occur after gastrointestinal infections or antibiotic treatment.

Stress and trauma can make IBS symptoms worse. There are often trigger factors, moments in the life of patients that are particularly stressfuljust before the symptoms of irritable bowel syndrome appear .

How can irritable bowel syndrome be treated?

“Some sufferers manage their symptoms by changing their diet and lifestyle and reducing stress,” says Dr.Saloojee. However, when simple lifestyle changes aren’t enough, a combination of medication and psychotherapy can help.

“If there is psychological stress, psychotherapy can be useful. Cognitive behavioral therapy, hypnosis, relaxation therapy are particularly effective. and mindfulness practices,” adds Dr.Added Saloojee. With the help of cognitive behavioral therapy, sufferers can break through negative thought patterns and attitudes and learn to change them in order to change behaviors that can contribute to physical and mental illness.

You can also learn relaxation techniques. “Patients are beginning to understand exactly how well symptoms are related to their stress response. Research shows thatCognitive Behavioral Therapycan help improve good symptoms and quality of life, and reduce stress and anxiety.”

Some researchers believe that patients with irritable bowel syndrome suffer from increased gut sensitivity that makes normal gas andbowel movements more painful. That could be why some people with irritable bowel syndrome find medications like antidepressants helpful. Because these not only improve the mood, but also reduce the hypersensitivity of the intestine and the sensation of pain.

How can I prevent stress-related irritable bowel symptoms?

drSaloojee recommends identifying the most important stress factors first. “To find triggers like this, it can be helpful to keep aDiary of Gut Symptoms each day and see if there’s a link between your mental state and having irritable bowel symptoms,” she says.

Once you find the triggers, you can do something about them. Due to the close connection between the brain and gut, this can lead to an improvement in symptoms or fewer flare-ups

Here are a few tips from Dr. Saloojee:

  • Try incorporating yoga, meditation, breathing exercises, and regular exercise into your daily routine to reduce stress.
  • Maintain a Good Sleep Routine by going to bed at regular times, avoiding screen devices like tablets or smartphones before bed, and keeping the bedroom dark.
  • Get at least 7-8 hours of sleep a night.
  • Drink at least 8 glasses of water a day .
  • Cut down on caffeine, which stimulates the gut.
  • Eat smaller meals.
  • Avoid fried or greasy foods.
  • Avoid foods that can trigger discomfort—this can include dairy, beans, lentils, cabbage, broccoli, or other foods that cause gas.
  • Probiotics (good bacteria) have a positive effect on the intestinal flora and can relieve gas and bloating.
  • Also, try to include more fiber in your diet.
  • If necessary, take medication to relieve symptoms.
  • Contact your family doctor for further support.

When should I go to the doctor?

“Anyone who has symptoms of irritable bowel syndrome that interfere with daily living should seek medical advice,” said Dr. Saloojee.

Your doctor will ask you about your symptoms and your medical history, examine you and possibly arrange for a blood or stool test. There is no specific test to diagnose irritable bowel syndrome, but these tests can rule out other conditions such asFood Intolerance(e.g. to sugar substitutes, lactose intolerance, fructose intolerance), inflammatory bowel disease, intestinal infections, celiac disease and colon cancer.”

You should take the following symptoms seriously:

If you experience any of these symptoms, it could be a sign of a more serious condition and you should see a doctor urgently.

If you’re struggling with stress, anxiety, or IBS symptoms, talk to your friends and family about it, and contact your doctor for help.

Darrick Robles

I was born with the vocation of being a doctor. I have worked in public health centers in California and Washington, ​​in social projects in low-income countries, and in pioneering private centers in integrative medicine. Currently, I am the founder and medical director of the social enterprise Med-Healths, in which I combine my medical care work with giving conferences on health and well-being in business and social environments.