Stress and IBS

Why and how stress induces changes in gastrointestinal function is the subject of constant research in many IBS centres, including our own. Certainly, many sufferers consider that stress is an important factor and is responsible for triggering flare ups of their symptoms. Many researchers believe that Irritable Bowel Syndrome may be a primary disorder of the brain/gut axis and we show here another view of the Brain Gut Axis which we hope illustrates the interconnections between the brain and the intestines.

Psychological factors that influence the mental state of IBS sufferers (work stress, family or relationship stress, getting held up in a traffic jam, even the stress of planning a journey for some sufferers, or even turning out for a sporting event and certainly interviews and exams) are thought to cause chemical changes or imbalances in the brain that may in turn influence motility (the propelling of contents through the gut). These stress related chemical changes may also influence the perception of pain signals sent to the brain from the sensory nerve endings that respond to events occurring in the intestines.

American researcher Drossman and his colleagues found that 70% of the non-patient population surveyed reported that they suffered from changes in bowel function as a reaction to stressful situations. Over half this group also experienced abdominal pain and severe discomfort under stress conditions.

However, these 'gut reactions' tend to occur more frequently and more severely in those who suffer from IBS and in a Quality of Life Survey we conducted with the anti-spasmodic OTC drug Equilon herbal, 45% of respondents had been treated or were currently undergoing treatment for stress (Summer 1999) and a further 3% were considering receiving treatment for stress. Half of those reporting stress treatment believe that their psychological situation helped to contribute to their IBS in the first place.

Other studies have found that IBS sufferers tend to have a lower threshold for coping with stressful situations and are more likely to react to negative events that in turn, can have catastrophic effects on the workings of the gut.

Similarly, the relationship between life events and gastrointestinal symptoms has long been accepted and many doctors believe that these symptoms frequently reflect either acute or chronic life stress.
Environmental stresses such as marital difficulties, problems with children or parents and worries related to business or career are shown to be common causes. Childhood stress has also been suggested as having a role in the aetiology of IBS, with early parental loss, parental alcoholism or unsatisfactory relationship between or with parents and obviously sexual and physical abuse are major contributory factors.

As we have pointed out earlier, every IBS case is unique and even in those instances where we determine stress as a primary cause, its manifestations will differ from sufferer to sufferer.

We have found however, that low doses of the psychological drug amitriptyline have a controlling influence on motility so that we can then address the other symptoms - which more often than not, include diarrhoea where a course of Imodium is usually effective.

   


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