DEAR DOCTORS: I had just started a new job when the pandemic happened. On top of the lockdowns and home-schooling our kids, I was diagnosed with IBS. My husband read there's research that it's caused by stress, and that makes a lot of sense to me. Can you please talk about that research?
DEAR READER: IBS is short for irritable bowel syndrome. It affects the stomach and the intestines, which are part of the gastrointestinal tract. The word "syndrome" means that IBS isn't a disease, but rather a collection of certain types of symptoms. These can include abdominal gas, chronic bloating, constipation, diarrhoea and ongoing changes to the frequency and urgency of bowel movements. Someone with IBS also often has increased sensitivity to abdominal pain. Taken together, these symptoms indicate that something has gone awry in the inner workings of the bowels.
IBS is seen in women more often than in men, and it typically arises in younger populations, generally under the age of 50. It's fairly common, occurring in up to 15% of the population. Because the symptoms are not life-threatening, many people don't take the time to get diagnosed. That means the percentage of people living with IBS is likely higher than the rate of doctor visits may indicate.
The symptoms of the syndrome can range from mild enough to just be annoying to severe enough to interfere with daily life. Previous research into the causes of IBS has focused on unresolved abdominal infections and changes to the make-up and behaviours of the gut microbiome. Now, as your husband has read, newer research has found evidence that stress and anxiety may play a role.
The study he is referring to, conducted by researchers in Tokyo, was published last year. They found that mice who were repeatedly placed in psychologically stressful situations went on to develop gastrointestinal symptoms consistent with IBS. Although previous research has looked into stress as a trigger for IBS, those studies used physical situations to trigger that stress. In this new study, the mice were placed into situations that didn't stress them physically but instead caused them to feel social anxiety. During the 10-day study, the researchers found that mice who spent 10 minutes each day in a socially stressful situation developed abnormally high levels of cortisone, the hormone associated with stress. The stressed mice also had changes to their bowel movements that are consistent with IBS, as well as increased sensitivity to abdominal pain. These changes persisted for weeks after the study concluded. The control group of mice, who did not undergo any social stressors during the study, did not have any of these physical changes.
Although this research doesn't explain the gut-brain connection in IBS, it does suggest new ways to look into the causes of the syndrome. It also underlines the importance of lifestyle changes for people with the condition. As someone living with IBS, you should avoid using tobacco and take steps to get quality sleep. If possible, add a stress reliever like yoga, meditation, tai chi or just a daily walk outside to your daily routine. Universal Features Syndicate
Dr Eve Glazier is an internist and associate professor of medicine at UCLA Health. Dr Elizabeth Ko is an internist and assistant professor of medicine at UCLA Health.
