Stress relief

Stress causes intestinal spasms in people with IBS, so reducing stress is a key part of treating the condition.

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Nerves in the colon control the intestine's contractions. Many nerves connect the colon to the brain, which helps explains why people get "butterflies" in their stomach when they're nervous or excited. In people with IBS, the colon can respond to even the slightest stressor. Beyond that, stress tends to make people especially aware of uncomfortable or painful symptoms.

Research has found that a history of stressful life events or current distress often precedes development of IBS. Other studies have found that people developed psychiatric disorders prior to, or at the same time as, IBS symptoms. The most common psychiatric disorders among IBS patients are depresion and anxiety. These disorders typically respond well to treatment, and if left untreated can make IBS symptoms worse. Treatment options include psychotherapy or counseling and medications, such as antidepressants.

One form of psychotherapy, cognitive behavioral therapy, has shown promise for patients with moderate to severe IBS and for those with IBS and anxiety or mood disorders. CBT can help patients learn coping strategies to control the symptoms brought on by anxiety. Patients work with a therapist to modify their thinking about stressful situations and their perceptions about their gastrointestinal symptoms. As patients' cognitive appraisal of their reality changes, their bowel symptoms often improve.

Other stress management options include:

• Relaxation training, such as meditation, guided imagery, or biofeedback
• Regular exercise, including walking or yoga
• Breathing techniques
• Getting enough sleep on a regular schedule

A diary may help you recognize stressors that activate symptoms. The diary should include the symptom experienced and its severity; associated factors such as diet, activity, or stress; emotional response (feelings of anger, sadness, helplessness); and thoughts associated with the incident. A record of stressors and associated responses may help you figure out positive ways to better deal with the stressors.