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Avoiding Stress-Induced IBD Flares

Understanding the connection between IBD and stress, with strategies to reduce stress.

Medically reviewed in June 2021

Stress can have numerous negative impacts on your health, and for people living with inflammatory bowel disease, stress may lead to flare-ups or worsening symptoms. Here, we look at the relationship between IBD and stress and some strategies for how you might better manage your stress levels.

What is IBD?
Inflammatory bowel disease (IBD) is a disorder that causes irritation and chronic inflammation of the gastrointestinal (GI) tract. The two major types of IBD are ulcerative colitis (UC) and Crohn’s disease (CD). Ulcerative colitis involves inflammation of the inner lining of the large intestine (colon), while Crohn’s disease involves inflammation that extends further into the intestinal wall and can affect any part of the gastrointestinal system.

It is not known why some people have IBD and others do not, but it is known that IBD is the result of abnormal immune system activity. In people who have IBD, the immune system reacts to environmental factors that trigger inflammation. These environmental factors could be due to allergic reactions, viral infections, or bacterial infections. There is also much evidence that suggests some people have a genetic predisposition to IBD.

IBD flare-ups and stress
People with IBD typically experience periods of relapse and remission—symptoms are present at times and go into remission at others. Research shows that stress can be a significant factor in IBD flare-ups.

Being diagnosed with Crohn’s disease or ulcerative colitis may increase worry, anxiety, or depression that could be exacerbated by day-to-day stress.

Stress is a topic that you should be discussing with your healthcare provider. If you are unable or uncomfortable visiting your healthcare provider’s office during the pandemic, you may want to consider a telehealth appointment.

In addition to working with a healthcare provider and adhering to a treatment plan, people with IBD are also advised to practice stress management in order to help keep flare-ups in check.

Some stress management tools to consider are:

  • Exercise daily. Regular physical activity can reduce stress levels, ease symptoms, and also benefit your overall physical and mental health. Because IBD can make exercise more challenging, people are advised to discuss safe approaches to exercise with their healthcare providers before starting a new routine or activity.
  • Participate in a support group. Speaking with others who are dealing with the same disease can ease your stress level and help you feel less alone. Many support groups meet online, which is helpful in limiting your exposure to coronavirus.
  • Keep a journal. Keeping a journal of how you are feeling each day—both physically and mentally—can provide useful information to both you and your healthcare provider and can help you recognize patterns in symptoms and moods. Journaling can also help you keep track of the things that are going well.
  • Work with a mental health practitioner. Approaches like cognitive behavioral therapy may help people with IBD manage the mental burden of the condition, including stress.
  • Mindfulness activities. These include things like yoga, meditation, and breathing exercises.

Remember that treating IBD is not a one-size-fits all approach. This applies to both the physical symptoms as well as the emotional and mental burdens. The important thing is finding an approach that works for you.

Sources:
Centers for Disease Control and Prevention. "Coping with Stress."
Mayo Clinic. "Stress Management."
Yue Sun, Lu Li, et al. "Stress Triggers Flare of Inflammatory Bowel Disease in Children and Adults." Frontiers in Pediatrics, 2019. Vol. 7, No. 432.
Cleveland Clinic. "Inflammatory Bowel Disease (Overview)."
Centers for Disease Control and Prevention. "What is inflammatory bowel disease (IBD)?"
Office on Women's Health. "Inflammatory bowel disease."
Cleveland Clinic. "Inflammatory Bowel Disease (Overview)."
Merck Manual. "Overview of Inflammatory Bowel Disease."
Crohn's & Colitis Australia. "Understanding the remission and relapse cycle in Crohn’s disease."
J. E. Mawdsley and D. S. Rampton. "Psychological stress in IBD: new insights into pathogenic and therapeutic implications." Gut, 2005. Vol. 54, No. 10.
Crohn's and Colitis Foundation. "Depression and Anxiety."
American College of Gastroenterology. "IBD Overview."
Cleveland Clinic healthessentials. "Taking Care of Your Mental Health Is a Key Piece of the IBD Puzzle."
Crohn's and Colitis Foundation. "Exercise."
Katelyn Collins. "5 Ways to Manage Stress Through Journaling." GastroGirl.

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