Avoiding Stress-Induced IBD Flares

Learn about the connection between IBD and stress, plus strategies to reduce stress.

A woman participates in an online support group for people with inflammatory bowel disease.

Updated on January 22, 2024

Stress can have numerous negative effects on your health. For people living with inflammatory bowel disease (IBD), stress may lead to flare-ups or worsening symptoms. 

Here’s what you should know the relationship between IBD and stress, plus strategies for how you might better manage your stress levels.

What is IBD?

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 to visit your healthcare providers office, you may want to consider a telehealth appointment.

In addition to seeking treatment from a healthcare provider and adhering to your treatment plan, people with IBD should also practice stress management to help keep flare-ups in check.

Some stress management tools to consider:

  • Exercise daily. Regular physical activity can reduce stress levels, ease IBD symptoms, and also benefit your overall physical and mental health. Because IBD can make exercise more challenging, discuss safe approaches to exercise with a healthcare provider 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.
  • Keep a journal. Recording how you are feeling each day—both physically and mentally—can help both you and your healthcare provider 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 load of the condition, including stress.
  • Mindfulness activities. These include things like yoga, meditation, and breathing exercises.

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

Article sources open article sources

Centers for Disease Control and Prevention. Coping with Stress. Reviewed April 25, 2023.
Mayo Clinic. Stress Management. August 10, 2023.
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). Reviewed May 3, 2021.
Centers for Disease Control and Prevention. What is inflammatory bowel disease (IBD)? Reviewed April 13, 2022.
Office on Women's Health. Inflammatory bowel disease. Updated June 7, 2022.
Merck Manual. Overview of Inflammatory Bowel Disease. Reviewed November 2023.
American College of Gastroenterology. IBD Overview. June 2019.
Xia B, Crusius J, Meuwissen S, Pena A. Inflammatory bowel disease: definition, epidemiology, etiologic aspects, and immunogenetic studies. World J Gastroenterol. 1998 Oct;4(5):446-458. 
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. Accessed January 17, 2024.
Cleveland Clinic healthessentials. Taking Care of Your Mental Health Is a Key Piece of the IBD Puzzle. November 21, 2019.
Crohn's and Colitis Foundation. Exercise. Accessed January 17, 2024.
Crohn's and Colitis Foundation. Find a Support Group. Accessed January 17, 2024.

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