Day 5 - Learning

Stress ~ How to Wrestle it into Submission

Day 5 Task List

1. Make a commitment to yourself to get enough sleep each night, or a nap each day.

2. Begin a daily form of stress management: therapeutic heat, meditation, yoga, Tai Chi, or any other preferred practice that induces relaxation and introspection.

The potential for abnormal colon function is always present in people with Irritable Bowel Syndrome, but a trigger must be present to actually cause symptoms. Along with diet, stress is the greatest trigger there is.

Stress activates the sympathetic nerve plexuses, and stimulates excessive adrenaline production, which in turn upsets the rhythmic muscle contractions of the gut. Given that people with IBS are prone to suffer from irregular GI contractions by definition, it's easy to see why stress is such a powerful trigger. Several interesting studies have actually shown the direct link between emotional stressors and subsequent IBS flares.

One experiment with eighteen IBS patients investigated how different emotions would affect the muscle contractions of the colon. The patients were hypnotized and instructed to feel anger, excitement, or happiness. Colonic motility rates were measured, and found to increase significantly with anger and excitement. Happiness reduced colonic spasms, although interestingly, the hypnosis itself had already had this effect to a lesser degree (more on hypnotherapy as a treatment for IBS on Day 7).[1] A second study specifically looked at the effect of anger on the colon. Even at rest, patients with IBS had more active colons than the control subjects, and they demonstrated significantly greater colon muscle contractions than the controls when angered.[2] Yet another recent study has confirmed a direct relationship between daily stress and the level of IBS symptoms, finding a significant and positive correlation between the two.[3]

However, I'm guessing you're already well aware of these facts, thanks to plenty of painful personal experience. The question now is, what can you do about it? First, be aware of what actually causes stress in your daily life. The obvious culprits are the constant common worries about work, money, your family, your health – you know the drill. But there are some more subtle stressors you should be aware of as well.

It's not the heat, it's the humidity...literally

The climate in which you live can make a substantial difference in the frequency and severity of your attacks. Hot, humid weather in particular is actually a stress factor in and of itself, because 1) heat stresses the body, and 2) air pressure changes from humidity affect the levels of serotonin in the body (and over 90% of that serotonin is in your gut), which in turn reduces your pain tolerance level. You may also find that, personally, some types of weather just stress you out and make you depressed, irritable, or unhappy. It doesn't matter if your preferences seem typical or even logical (maybe you hate blue skies and love drizzle) – what's important is that you consciously note your feelings and physical reactions so that you can deal with them.

While you can't change the weather, of course, you can control where you live. Moving to a different region may sound like a drastic step to take to minimize IBS attacks, but if your local climate is seriously compromising your health you might want to at least consider it. I lived in New England for seven horrendously miserable years and spent every summer battling desperately to maintain stable health in the face of quite literally sickening hot, humid summers. I realized in the end that when I fight my body, my body wins, so I moved back home to the Pacific Northwest where heat and humidity never co-exist. This completely eliminated a serious recurring stress factor from my life. My colon is now much calmer and happier, and so am I. Was the temporary stress of moving worth the permanently beneficial end result? You darn well bet it was.

Get your Zzzzzzsss

The second subtle stress factor that can have a significant impact on IBS symptoms is sleep – or, more accurately, the lack thereof. It's simple common sense that, since a poor night's sleep results in fatigue and a corresponding lower stress-tolerance level, being tired would likely allow IBS to be more easily triggered. But a recent study actually proves this to be so. A significant correlation was noted between morning IBS symptoms and the quality of the previous night's sleep. In fact, morning IBS symptoms seemed to rise or fall in direct association with the prior night's quality of sleep. This is something I've long noticed in my own life. A less strong but still significant relationship was found between end of day IBS symptoms and the quality of sleep during the previous evening.[4] But then, you've probably already discovered this first-hand, haven't you?

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[1] Physiological effects of emotion: assessment via hypnosis. Whorwell PJ, Houghton LA, Taylor EE, Maxton DG. Lancet 1992 Jul 11;340(8811):69-72

[2] Effect of anger on colon motor and myoelectric activity in irritable bowel syndrome. Welgan P, Meshkinpour H, Beeler M. Gastroenterology 1988 May;94(5 Pt 1):1150-1156.

[3] The relationship between daily life stress and gastrointestinal symptoms in women with irritable bowel syndrome. Levy RL, Cain KC, Jarrett M, Heitkemper MM. J Behav Med 1997

Apr;20(2):177-193 [4] Dig Dis Sci 1993 Oct;38(10):1809-14. Effect of sleep quality on symptoms of irritable bowel syndrome. Goldsmith G, Levin JS.


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