Stress and flares: What you should know

Everyone experiences stress from time to time. However, when you have inflammatory bowel disease (IBD), it’s important to consider how stress may impact your condition—and do your best to manage it.

“There’s a bidirectional link,” says Megan Riehl, PsyD, a clinical psychologist and assistant professor of medicine in the Division of Gastroenterology at the University of Michigan Health System in Ann Arbor. “Stress can certainly lead to increased risk of flare and can trigger IBD symptoms, but then there’s also stress associated with having IBD.”

In other words, it can become a vicious cycle: it can be overwhelming to deal with day-to-day life with IBD, when things like unexpected flare-ups of symptoms can strike at any moment—and yet, stress can actually trigger your symptoms and bring on a flare.

The brain-gut connection

The strongest connection in our bodies is the link between the brain and the gut. “Stress can increase GI inflammation,” says Dr. Riehl. “So there’s an actual brain-gut pathway that impacts our gastric secretions and inflammation, which impacts the functioning of the gut.”

What’s more, when you’re feeling stressed, you may be more likely to turn to unhealthy habits, like poor diet choices, or forget to take your medicine, which can in turn make IBD symptoms worse.

Take steps to keep stress at bay

Research has also shown that your individual personality may influence disease activity, and your individual personality traits can also play a role in your immunological reaction to stress—and how well you cope. So it’s important to recognize how you deal with stress, and take steps to keep it in check.

“Recognize that there are certain coping strategies that are helpful for managing stressors that are in your control,” says Riehl. Start with these steps:

1. Attend regular checkups: Keep your medical team informed of changes in your health or your symptoms so they can give guidance and support based on the medical therapy you’re using.

2. Eat a healthy diet: Make sure you’re following a healthy diet, which includes identifying—and avoiding—any foods that cause your symptoms to flare. A GI Registered Dietitian can help you figure out a diet that works best for you, and make any necessary dietary changes.

3. Stay active: Exercise when you’re able to, and modify exercise if you’re flaring.

4. Join a support group: For some people, connecting and forming meaningful relationships with other people living with IBD can help mitigate some stress. It may be helpful to talk to others experiencing similar issues and have a community of people who “get it.”

5. Know when to reach out for additional help: If you’re still having trouble managing the stress or the emotional toll of living with a chronic disease like IBD, you should see a GI Behavioral Health Provider who can help you reduce your stress by using belly breathing techniques, meditation, making lifestyle changes, and more.

Ready for more support?

To get support managing your stress, meet with an Oshi Health GI Behavioral Health Provider and regain control from your digestive issues. 

Medically reviewed by Matthew J. Hamilton, MD