Psychological Factors and IBS Irritable Bowel Syndrome

Psychological factors Irritable Bowel Syndrome IBS

Irritable Bowel Syndrome: What is it?

Irritable bowel syndrome (IBS) is a functional disorder of the bowel. It affects almost twice as many women as men, and more and more young adults.

"[...] the number of irritable bowel syndrome diagnoses among young people ages 23 to 27 [increased] by 70 percent between 2005 and 2017."

Barmer Physicians Report 20194,

When our gut flora, or microbiome, is out of balance, our health suffers - and mental health problems can be the result. But stress and our psyche also have an inverse effect on the state of our digestion. Irritable bowel often develops or worsens during stressful life situations.

This includes not only stress at work, but also family problems, heartache, money worries, and other anxieties. Read more about irritable bowel syndrome and diagnosis here.

Irritable Bowel Syndrome: Symptoms

Typical symptoms of irritable bowel syndrome, which may occur alone, in combination, or alternately, include

Is IBS dangerous?

IBS is not initially life-threatening. However, it is a chronic condition that is associated with varying degrees of reduced quality of life: even going to work, meeting friends, going to a restaurant or the movies can be a challenge with IBS. This condition can be very stressful, which in turn can put more stress on the bowel - a vicious cycle.

Not surprisingly, IBS is sometimes accompanied by other stressful comorbidities. Common co-occurring diagnoses of IBS include

  • Depression and anxiety

  • Back pain

  • Somatoform disorders, i.e., physical complaints that cannot or cannot sufficiently be attributed to an organic disease High blood pressure (hypertension)

  • Pain (especially abdominal and pelvic pain)

  • Skin conditions such as atopic dermatitis

  • Acid reflux

When IBS is suspected, the first point of contact is usually a Gut Expert or doctor. This is where the diagnosis is made and appropriate treatment is suggested.

Depending on what triggers irritable bowel syndrome, it may be helpful to work with a nutritionist or psychotherapist. 

There is usually more than one trigger, but stress or emotional distress is often one of them. Surprising as it may seem, there is a close connection between the gut and the brain, called the gut-brain axis.

Brain and gut interact closely around the clock via nerve fibers, neurotransmitters, and immune cells. The most important pathway between the gut and the brain is the vagus nerve, which runs from the gut through the diaphragm, between the lungs and the heart, past the esophagus, through the throat, and into the brain. The vagus nerve is the largest nerve in the body.

However, communication via the largest nerve in the parasympathetic nervous system is usually not a one-way street. The exchange between gut and mind goes both ways:

  • From the brain to the gut: Anger and stress, for example, can affect bowel activity. Almost everyone knows the uncomfortable feeling in the gut before exams or after a heartbreak.

  • From the gut to the brain: Certain gut bacteria produce propionic acid, which is an important nutrient for immune defense cells in the brain (microglial cells). Studies suggest that reduced propionic acid production in the gut may contribute to diseases such as multiple sclerosis.

There is a close connection between the gut and the brain via the vagus nerve, the gut-brain axis.

Back to irritable bowel syndrome: On the one hand, our psyche can be the trigger for irritable bowel syndrome, but on the other hand, it can also be the trigger for further aggravation of the symptoms of an existing irritable bowel syndrome (e.g. due to a disturbed intestinal flora), because the communication between the intestine and the brain is disturbed.

We now know that the gut is closely connected to the psyche. Therefore, when treating IBS, it is important to avoid negative stress and to integrate relaxation techniques such as yoga or autogenic training into daily life. Walks in nature can also be beneficial.

The goal is to calm the nervous system in the head and stomach, sending a signal to the brain or gut: "All is well!"

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