Stress and Irritable Bowel Syndrome (IBS)
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Everyday life events can lead to stress:2Back to top
- Your commute
- Problems at home
- Money problems
Major life events can lead to stress:3Back to top
- Marital separation
- Family member leaving home
- A relationship ending
- Severe illness
- Death of a parent
- Abuse (emotional and physical)
Do any of your IBS symptoms flare up during times of stress? 4, 6Back to top
- Abdominal pain
- Passing mucous
- Feeling that bowel movement is incomplete
LET’S CONNECT THE DOTS BETWEEN STRESS AND YOUR STOMACHBack to top
Stress disrupts the brain-gut axis, leading to changes in gastrointestinal functioning: the movement of digestive contents along the digestive tract and the release of gastrointestinal hormones, causing diarrhoea or constipation. 7,8,9
In patients with IBS, a profound dysregulation of the brain-gut axis (BGA) takes place. 7
IBS management tips – FODMAPSBack to top
What are FODMAPs? 10
FODMAPs are certain types of carbohydrates that can pass through the small intestine without being fully absorbed. If they move on to the large intestine, they get fermented by the bacteria that lives there, causing gas.
They also draw in water leading to:Back to top
O = OLIGOSACCHARIDES such as onions, garlic, beans, artichokes, dried fruit, plums, watermelon, wheat, rye, barley, pistachio and cashew nuts. NOTE: not all nuts are high-FODMAP. Peanuts, walnuts and pecans, along with moderate portions of almonds, are low.
D = DISACCHARIDES such as milk and yoghurt. NOTE: many dairy products are low FODMAPs. Enjoy cheeses like parmesan, brie, cheddar and feta, as well as moderate servings of ricotta.
TIP: Many high-FODMAP foods become low-LODMAP in moderate servings.
M = MONOSACCHARIDES such as asparagus, sugar snap peas, apples, fresh figs, cherries, mango, pears, honey, agave and high fructose corn syrup. NOTE: pure maple syrup is an excellent replacement for honey. In baking, it’s a 1-to-1 substitute.
(A = AND)
P = POLYOLS such as peaches, blackberries, mushrooms and snowpeas, as well as sweeteners like mannitol, sorbitol, maltilol, xylitol and isomalt. NOTE: cutting sugar-free foods like gum and mints make these foods easier to avoid.
All patients with IBS should be treated holistically in order to improve their quality of life. 11
DOWNLOADABLE IBS TRIGGER DIARYBack to top
When you know the things that can make your IBS symptoms flare up, called triggers, you can make a plan to avoid them. That way, you can work on keeping problems with constipation, diarrhoea, abdominal pain, and bloating to a minimum. 2
IBS is different for everyone, but it may help to keep track of how you react to the most common symptom triggers and learn to prevent them. 2
Our downloadable IBS Trigger Diary – available online http://www.stressandmystomach.co.za/ may help you connect the dots in discovering what is making your IBS worse, and importantly, assisting your doctor in treating your symptoms.
The diary is simple to use:Back to top
- Anxiety and Depression Association of America. Stress. Available at https://adaa.org/understanding-anxiety/related-illnesses/stress Last accessed 14 July 2019
- Khatari M. WebMD. IBS Triggers and How to Avoid Them. Last reviewed 25 March 2018. Available at https://www.webmd.com/ibs/ibs-triggers-prevention-strategies?print=true Last accessed 4 July 2019
- Qin H-Y, Cheng C-W, Tang X-D, Bian Z-X. Impact of psychological stress on irritable bowel syndrome. World J Gastroenterol 2014;20(39):14126-14131
- National Institute for Health and Care Excellence (NICE). Irritable bowel syndrome in adults: diagnosis and management. Clinical guideline. Published: 23 February 2008. Available at nice.org.uk/guidance/cg61 Last accessed 4 July 2019
- Gastrointestinal Society. (2018). Rome III to Rome IV: Updates and Developments. [online] Available at: https:// www.badgut.org/information-centre/a-z-digestive-topics/rome-iv/ Accessed 3 July 2019
- Quigley E, Fried M, Gwee KA, Khalif I, Hungin P, Lindberg G, et al. Irritable bowel syndrome: a global perspective. World Gastroenterology Organization Global Guideline. Updated September 2015. Available at http://www.worldgastroenterology.org/UserFiles/file/guidelines/irritable-bowel-syndrome-english-2015.pdf Last accessed 4 July 2019
- Konturek PC, Brzozowski T, Konturek S. Stress and the Gut: Pathophysiology, Clinical Consequences, Diagnostic Approach and Treatment Options. J Physiol Pharmacol. 2011;62(6):591-599
- Tacheé Y, Kiank C, Stengel A. A Role for Corticotropin-releasing Factor in Functional Gastrointestinal Disorders. Curr Gastroenterol Rep. 2009;11(4):270–277
- Prins A. The brain-gut interaction: the conversation and the implications. S Afr J Clin Nutr 2011;24(3): S8-S14
- What are FODMAPs (Fermentable Oligosaccharides Disacchardies Monosaccharides and Polyols) clambellykitchen.com. Julie O’Hara, Health Coach (c) 2015 – 2016 Julie O’Hara Creative, LLC. All rights reserved. Available at URL:https://calmbellykitchen.com/blog/what-are-fodmaps-simple-guide-for-regular-chicks. Accessed 4 June 2019
- Singh P, Agnihotri A, Pathak M, Shirazi A, Tiwari R, Sreenivas V et al. Psychiatric, Somatic and Other Functional Gastrointestinal Disorders in Patients With Irritable Bowel Syndrome at a Tertiary Care Center. J Neurogastroenterol Motil. 2012;18(3):324-331
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