By Kristen Sturt
Stress relief tips, Crohn's patient relaxes and de-stresses

Medically reviewed Matthew J. Hamilton, MD

When you live with inflammatory bowel disease (IBD), the stress often feels overwhelming, especially during a flare. Pain, fear, stigma, sleeplessness and the unpredictability of the disease can all factor into your worries. And while stress doesn’t cause IBD, it may worsen symptoms, contribute to flares and damage your quality of life. Try these tips to keep it in check.

1. Acknowledge your stress.

“It’s really important to be checking in with yourself and identifying how you are feeling,” says Megan Riehl, PsyD, Clinical Director of the GI Behavioral Health Program at the University of Michigan in Ann Arbor. “Recognize that this is really common,” she adds, and that your feelings are normal.

Once you’ve accepted how you feel, concentrate on next steps. Dr. Riehl recommends asking “What do I have control over in my life?” or “What can I modify?” Let go of what you can’t change and focus on what you can.

2. Take time for yourself.

Self-care is an important component of managing stress. Whether it’s reading a book or having lunch with a friend, set time aside every day to do something you enjoy, to relax and take your mind off things. Mark it in your calendar to make it official, or to let others know you’ll be unavailable.

At the same time, beware of overcommitting. Listen to your body, and be aware of how too many obligations might affect your disease. Remember that it’s okay to RSVP “no” to an event if you’re not feeling up to it.

3. Lean on your social circle.

“Whether we have a chronic illness or not, we don’t want to burden our loved ones,” says Dr. Riehl. “I work with patients to recognize the importance of a support system and develop communication skills to say, ‘I could really use some help.’”

So, be open about your situation with family and friends. Most importantly, “be very specific about what would be helpful for you.” Whether you need a sympathetic ear or a nap, making clear requests takes the onus off others—and can help you feel better, faster.

4. Anticipate stress and plan ahead.

Think about potentially stressful situations in your day-to-day life and head them off by being prepared. Busy mornings? Pick an outfit or pack lunch at night, and build in extra time for rest and medical care. Getting dinner with friends? Map out bathrooms and bring an emergency kit with wipes, spare clothes, extra supplies and doctor-approved rescue medications. Going on vacation? Make sure you have enough medication and supplies for the trip. A little organizing up front can ease your mind down the line.

5. Prioritize good sleep.

Sleep troubles are common in IBD, which can then lead to fatigue—a chief stressor among patients. “If you’re feeling fatigued, it can certainly give you less energy to take care of your health and the day-to-day things that we all deal with,” says Dr. Riehl.

To sleep better, keep your room quiet, cool and dim before turning in. Stick to a consistent bedtime and wake-up time. Nix caffeine, screens and big meals in the hours before bed. See your provider, too, who can adjust your meds and find you a sleep specialist.

6. Get moving.

Regular exercise is a well-known stressbuster—and for IBD patients, it may reduce inflammation and improve bowel function, as well. However, people with IBD often find it difficult to work out due to symptoms, especially during a flare. So, talk to a provider, who can refer an experienced trainer or suggest the best regimen for you. As your disease allows, try light physical activities like walking, biking, swimming, yoga or tai chi. Even a post-lunch stroll can work wonders on your mood.

7. Try relaxation techniques.

Many patients find certain practices help reduce stress, such as meditation, guided imagery, soothing recordings or progressive muscle relaxation. Others are more successful with deep breathing exercises. Slowly inhaling, holding your breath and exhaling can ease muscle tension, lower blood pressure and sharpen your focus, among other benefits. Ask your provider about options. It may not be the first thing you try—or even second or third—but it’s important to keep trying until you find the right technique for you.

8. Know when stress is something more serious.

Anxiety and depression are common in IBD patients. If you’re avoiding people and favorite activities, are preoccupied with worrisome thoughts or feel hopeless about the future, see a mental health professional. They can start medication and other treatments, like cognitive behavioral therapy [CBT], which helps address negative thought patterns and is proven to help many with IBD. “CBT is very commonly used in gastrointestinal (GI) psychology and we really tailor it to GI-specific anxieties,” says Dr. Riehl.

9. Understand that stress won’t go away overnight.

“It’s a process,” says Dr. Riehl. “We can definitely modify stress levels, but it’s certainly going to take time and practice. If you give yourself the grace to recognize you’re learning a new skill, I think that it makes the journey a little bit easier.”

Medical reviewer and Oshi physician-partner Matthew J. Hamilton, MD is an Assistant Professor of Medicine at Harvard Medical School and a specialist in Gastroenterology, Hepatology, and Endoscopy at Brigham and Women’s Hospital Crohn’s and Colitis Center in Boston. He is a leading member of the research team at the BWH Crohn’s and Colitis Center, and has garnered national recognition for his research into the underlying inflammatory processes of IBD.

Oshi is a tracking tool and content resource. It does not render medical advice or services, and it is not intended to diagnose, treat, cure, or prevent any disease. You should always review this information with your healthcare professionals.