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Irritable-Bowel-SyndromeIrritable Bowel Syndrome: The Stress Connection

Written by Dr Arien van der Merwe MBChB FRSPH MISMA NHA

Medical doctor, Author, Medical Specialist: Health & Wellbeing

 

The connection between stress and irritable bowel syndrome (IBS)

The exact cause of IBS remains uncertain, but the following trends that might help people make sense in finding possible underlying causes for their symptoms. The following have been identified in IBS:

  • They experience a lowered threshold for pain – register pain sensations quicker than other people
  • There exists a biological predisposition to respond to emotional stimuli with colon hypermotility (increased colon smooth muscle contractions)
  • There are findings of mildly elevated test scores on depression, anxiety, neuroticism
  • There tends to be a preoccupation with physical symptoms
  • Increased tension, leads to an increase in symptoms
  • ½ of patients reported psychological loss or threat of loss preceding the 1st episode
  • There is a perceived, subjective experience of stressful life events
  • Family history shows a tendency for special treats during childhood illness – treats for illness becomes a learned response
  • Mind-body issues: fear of letting go; insecurity; lack of self-confidence, self-esteem and personal power; tending to be easily intimidated by others, finding the expression of their own ideas and opinions very difficult

Stress management options that have proven to be very successful for IBS:

  • Self-awareness of stress triggers through stress assessments
  • Coping skills training for handling interpersonal conflicts positively
  • Hypnotherapy, autogenic training, biofeedback to control internal smooth muscle contraction
  • Relaxation training, incl. relaxercises, movement
  • Rest, massage
  • Family therapy: patient contracting to talk about IBS symptoms only with the health care practitioner, who should be sympathetic, but not indulgent); family members to ignore any complaints in the home
  • Group therapy – lectures, discussion, relaxation training, journal keeping 

Relaxation to build resilience to stress

  • Innercise as well as exercise.
  • Helps you to learn to keep your mind, emotions and body quiet or silent in order to optimise your efficiency, energy resources and enjoyment of the present moment.
  • Help you to access your own inner peace at any time when you need it.
  • Not to teach you to permanently shut off the stress response.
  • Increase range of responses to familiar stressors
  • Have a diversified range to choose from to help you respond to stressors more effectively, productively and creatively.
  • Rather than a worry, fear or anger response to triggers: become quiet, focused, aware of feelings, consciously relaxed, able to react pro-actively, responding, rather than reacting to stress triggers.
  • Any imaginary activity created in mind’s eye, experienced as real
  • Examples: meditation techniques, progressive muscle relaxation, visualisation and guided imagery, breath awareness, journal writing, mindfulness based stress reduction, etc.

Stress Solutions

1. Learn to breathe

  • All relaxation techniques make use of breathing as start for, or as a complete relaxation exercise in itself
  • Breathing is an Involuntary function that we can control
  • Shallow, short breaths: sympathetic drive increases, leading to feelings and symptoms of distress
  • Slow, deep breathing: parasympathetic drive, leading to deep relaxation, the opposite of the stress response
  • When pressure due to expansion of the chest wall & muscular contraction is taken off the thoracic cavity, sympathetic drive decreases, leading to relaxation

2. The relaxation response

  • Dr Herbert Benson, cardiologist, demystified and secularised Eastern meditation techniques
  • Requirements:
    • quiet environment to exclude external disturbance
    • mental device (such as a simple word, phrase, positive affirmation or mantra, gazing at a candle or flower, focusing on a sound; as focal  point for concentration to replace stressful thoughts
    • passive attitude to be receptive, open for thoughts to flow through rather than blocking them
    • comfortable position 
    • regular practice
  • This is how you do it: Sit quietly, becoming aware of your physical body, alternately tensing and relaxing muscle groups starting at the feet, moving up towards the face, head and neck. Then concentrate on your breathing. Make it slow and deep. Add a count of 4 (or whatever is comfortable to you) as you breathe in, hold for a count of four, breathe out to a count of 6. Repeat this for a few minutes. If your attention wanders, gently bring it back to your nostrils, the cool air on inhalation, the warm air on exhalation. You only need your own breath to become quiet, focused, serene. Once you’re completely relaxed, start repeating your chosen mantra over and over for a few minutes. Become aware of your body, wriggle your toes, feet, fingers and hands. Slowly come back to normal awareness. Rub the palms of your hands vigorously together and place it gently over your closed eyes. Open your eyes, and carry on with your day, knowing that your inner retreat can be accessed any day, any time.
  • Do the exercise every morning and evening. Start with 5 minutes at a time and gradually increase to 20 minutes twice a day

3. Positive affirmations

  • I deeply relax my muscles
  • I can do this
  • I will succeed
  • I am confident in every social situation
  • I am calm in my body, in my mind and in my emotions; or simply: I am calm
  • I am in touch with my peaceful inner centre
  • I surrender to a bigger presence than my own

In conclusion:

IBS can seriously curtail quality of life. Adapt your diet and lifestyle, practice regular stress management and relaxation techniques, and make use of effective treatment options to help you cope with the symptoms!

Further Reading / References:

  • Stress Solutions, Arien van der Merwe; Tafelberg Publishers 2006
  • Stress Solutions Relaxation CD, Arien van der Merwe; HSM Publishers 2008
  • Health & Happiness, Arien van der Merwe; Tafelberg Publishers 1998, 2000, 2006, 2009. Revised, updated edition HSM Publishers 2013. International Publication: Fox & Raven 2014
  • Herbal Remedies, Arien van der Merwe; Tafelberg Publishers 2003
  • The Creation of Health, Norman Shealy & Caroline Myss; Stillpoint Publishing 2008
  • Mind Matters, JR Millenson; Eastland Press 2005   
  • Encyclopedia of Natural Medicine, Michael Murray & Joseph Pizzorno; Little Brown & Company 2005
  • The Herbal Drugstore, Linda White & Steven Foster; Rodale Inc. 2000
  • http://drarien.co.za/naturalmedicine/articles
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