Unlike other diseases with a clear cause, many different factors may contribute to the origin of IBS. However, there is scientific evidence suggesting stress as a key factor in the onset of the disease. In addition to the physical and physiological stresses occurring from the common GI symptoms, the limitations of everyday life leads to further deterioration of both well-being and life quality. It becomes a negative spiral difficult to stop on your own. (1)(2)(3) 

The impact of stress on the gastrointestinal tract and microbiota 

Earlier stress events, chronic and acute stress may affect onset of IBS (4). The body’s multi-way system includes the nervous system in the brain and the gut (enteric nervous system). A busy lifestyle with psychological stress, anxiety and negative emotions impact gut behaviour. Combined with a lack of recovery, this leads to worsened gastrointestinal distress (5)(6).

Gut microbiota is a key component for good health. In patients with IBS or IBS-related gut

issues the intestinal flora, mucosa and bowel movements are often impaired. Chronic stress

changes the composition of the gut bacteria and increases the number of mast cells. Mast cells are associated with allergic reactions, but are also included in our immune system and fights pathogens amongst others. Furthermore, mast cell degranulation results in impaired gut barrier and deterioration of intestinal immune system (7).

Cortisol, dietary pattern, and toxins

Cortisol is a stress hormone in our bodies and is secreted as a reaction to stress. The levels are controlled through the HPA-axis, the body’s “stress system”. Healthy individuals with a normal HPA-axis have a normal cortisol secretion that follows a rhythm. In chronic stress, the axis is disrupted and leads to abnormal cortisol levels, change of the gut bacteria, damaged intestinal mucosa and increased gut permeability (7). In addition, individuals exposed to higher stress have a greater tendency to choose extra tasty foods which in turn, when consumed, promote unfavourable bacteria. These bacteria produce toxic substances and neurohormones that lead to continued negative eating patterns and mood (7).

Lifestyle-changes may improve gut-related issues

As you may now know, there are different types of stress affecting the body. This and how we feel may contribute to the onset of IBS. In addition to stress and gut microbiota, there are several other factors affecting gut issues, for example what you eat and your level of physical activity. Gut issues are very common and many people are suffering in silence. Together with Food Pharmacy we created Magbalans-metoden – a program where you, through education and practical tips, get help from the experts of Nordic Clinic on your journey to a healthy gut and increased quality of life. Read more about the program here (Note! The program is in Swedish). 

Har du problem med magen? Just nu anordnar vi ett program för dig med magbesvär. Start 6 mars 2023, anmälan här.

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This article was originally published as a guest editor post at foodpharmacy.se

By: Graeme Jones, clinical physiologist and CEO at Nordic Clinic Stockholm. 

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References

1. Colon irritabile, IBS (Irritable Bowel Syndrome) [Internet]. Internetmedicin. [cited 2023 Feb 14]. Available from: https://www.internetmedicin.se/behandlingsoversikter/gastroenterologi/colon-irritabile-ibs-irritable-bowel-syndrome/

2. Saha L. Irritable bowel syndrome: Pathogenesis, diagnosis, treatment, and evidence-based medicine. World J Gastroenterol. 2014 Jun 14;20(22):6759–73.

3. Gazouli M, Wouters MM, Kapur-Pojskić L, Bengtson MB, Friedman E, Nikčević G, et al. Lessons learned — resolving the enigma of genetic factors in IBS. Nat Rev Gastroenterol Hepatol. 2016 Feb;13(2):77–87.

4. Császár-Nagy N, Bókkon I. Hypnotherapy and IBS: Implicit, long-term stress memory in the ENS? Heliyon. 2023 Jan 1;9(1):e12751.

5. Halpert A, Dalton CB, Palsson O, Morris C, Hu Y, Bangdiwala S, et al. What Patients Know About Irritable Bowel Syndrome (IBS) and What They Would Like to Know. National Survey on Patient Educational Needs in IBS and Development and Validation of the Patient Educational Needs Questionnaire (PEQ). Official journal of the American College of Gastroenterology | ACG. 2007 Sep;102(9):1972.

6. Schaper SJ, Stengel A. Emotional stress responsivity of patients with IBS – a systematic review. Journal of Psychosomatic Research. 2022 Feb 1;153:110694.

7. Madison A, Kiecolt-Glaser JK. Stress, depression, diet, and the gut microbiota: human–bacteria interactions at the core of psychoneuroimmunology and nutrition. Curr Opin Behav Sci. 2019 Aug;28:105–10.

8. Collins SM. A role for the gut microbiota in IBS. Nat Rev Gastroent