DOES STRESS CAUSE IBS?

“Your IBS Symptoms are NOT caused by ‘too much stress’ or ‘psychological problems’.”

Many doctors still call your IBS a “functional disease”. This means they can’t see anything when they do a colonoscopy, they can’t find an abnormal blood test, so it’s a disease with no “signs” they can see of what causes it. As a result, speculation and theories abound. While some have pieces of the puzzle, most are off base. Some are totally out in left field. Until recently, researchers have simply been looking in the wrong places, and not closely enough to see the evidence of inflammation in the small intestine. This is where the “problem” originates, not in the colon. Plus you have to look at special tissue samples to see the inflammation of IBS. IBS is actually a “new” subtle form of inflammatory disease of the bowel. This was first proven by actual direct examination of the tissue of the small intestine, where food is “processed” immunologically, back in 2002. The discovery has been strengthened many times since yet it is widely ignored in the United States where thinking is stuck on the old ways of looking at IBS. THIS IS EXPLAINED IN SECTION 6 titled “NEGATIVE TESTS DO NOT REVEAL THE INFLAMMATORY RESPONSE IN IBS?”

One standard way of explaining our IBS symptoms is that we have a lot of stress and anxiety compared to “normal people”. I was told this countless times in response to my questions.

Stress and anxiety do make the gut and nervous system more active. That’s a given. Simplified, the proposition is that people with IBS appear to “over-respond” to stress at times. Instead of getting “butterflies” in our gut we get our IBS symptoms. Therefore, IBS and the symptoms are caused by “stress”. Often they tell us the best treatment is to “reduce your stress levels” or “learn to cope with stress better”. However, let’s suppose I have a wound already on my body somewhere. I can tolerate it. Except when I rub salt on it. Then the pain becomes unbearable. Does that mean the salt is the cause of problem? No, it aggravates a wound already present. A lot of researchers realized this after some time.

So this theory was never much help to me while lying in agony and no bowel control on the bathroom floor at 3 a.m. unable to leave the safety and privacy of the bathroom. I am also getting cold and hot flashes, sweats, I get dizzy, and my brain is so foggy I have to concentrate just to lift myself. In 30 years “relaxation techniques”, a laundry list of drugs, and countless “trigger avoidance lists” changed nothing. My symptoms got worse while all my doctors kept telling me they would NOT get worse. So yes, I understand what it is to lose faith, to question the advice, and then be treated as an unwelcome guest.

It’s also not easy to relax being stuck in the office bathroom at 2 p.m. with my fellow employees outside the door waiting and listening. Or worse thinking it’s funny to bang on the door “You’re in there too long!” hah.hah.hah. Sure, I have too much “stress”. But only since this IBS appeared. I was just fine an hour ago! We especially don’t get stress relief from prescriptions for antispasmodic drugs and anti-diarrhea drugs accompanied by a pat on the shoulder and the sage advice “Look Mike NoLomotil, just don’t stress over your IBS. After all it’s inconvenient, sure, I know, but it does not lead to colon cancer or ‘real’ diseases like inflammatory bowel diseases.” Well, its just stress to you, sir, having me here in your exam room again maybe, and ineffective instructions merely worsened my stress.

So for years I poured on the Lomotil; the Bentyl with Phenobarbital; the Immodium; antidepressants, you name it…until my meals looked more like this!

We know these drugs are no help whatsoever for our other symptoms while we are sweating it out with ringing ears and a foggy brain on our bathroom floor (or maybe it’s a rest stop in the interstate). Or worse, in between rest stops on the interstate. Stuck in traffic at rush hour? Plane being held up on the runway? Ever have to sit PRAYING that SEATBELT SIGN is going to go out? First date? LAST DATE? In the bridal party and just heard “Dearly beloved…” when the cramps and sweating begin? It’s no wonder that IBS is related to stress and even depression if you look at out lives.

Yes, its true, IBS is “stress related”. IBS is even associated with patients suffering psychological problems with anxiety and depression. Therefore, anti-depressants may be prescribed. Some researchers have cautioned for decades this approach to IBS is putting the cart before the horse, yet the practice of viewing IBS patients in this way is widespread. We are the most talked about “head cases” in the waiting room after our third or fourth visit. I know. As a therapist or a clinic manager I have been “back there” countless times after IBS patients leave an appointment as the staff sighs in relief you are gone.

In healthcare, we do not like to confront our failures any more than plumbers do. In simple terms, most of us who are stressed, anxious, depressed, or worse feel this way because of our IBS symptoms. We were not anxious and then developed IBS as a result. I certainly was anything but stressed out, anxious and fearful at 12 years old when mine began! I was a happy kid! The latest research confirms this approach to be incorrect in (2) different ways. This adds to our new insights into the Irritable Bowel Syndrome and its symptoms.