Medically reviewed by Matthew J. Hamilton, MD
The link between stress and inflammatory bowel disease (IBD) is not a new concept—the discussion of how emotional life events affect IBD was first discussed back in 1930. We’ve learned a lot since then, including how stress affects your body, and what you can do about it.
Here’s what you should know.
Stress can increase your risk of flares. Living with a chronic condition like IBD where an unexpected flare-up can strike at any time can be stressful. Yet, stress can actually make flares worse. “Perceived stress, or when you feel like you’re in a high stress situation, like a high level of work stress or family stress, is one of the primary triggers that have been identified for a flare,” says Megan Riehl, PsyD, a clinical psychologist and assistant professor of medicine in the Division of Gastroenterology at the University of Michigan Health System in Ann Arbor.
Stress can result in the need for more potent medications. “Stress can make it more difficult to follow your treatment plan—meaning you might be less likely to take your medications as prescribed,” says Dr. Riehl, “and you may end up actually needing more potent medications.”
Stress can lead to IBD-related anxiety and depression. “Managing the relapsing-remitting nature of the disease—where you can be doing really well for a while then a specific stressor triggers a flare, or you can flare for no reason—dealing with the complexities of that is something that can create added anxiety and depression,” says Riehl.
Stress can affect your emotional health. “Stress can lead to more isolation, so you’re not as actively involved with family or friends,” explains Riehl. “It can make you less productive at work, leading to more missed days of work.” And living with IBD can lead to issues with body image or intimacy, which can also impact your emotional health.
The Importance of Stress Management
In order to take steps to keep stress at bay and stay healthy, it’s important to establish your personal tolerance to stress. Everyone handles stress differently—situations like changing jobs or buying a new house may stress some people out, where others might not bat an eyelash.
“When you have insight into what stressors are going on in your environment, that can really help you utilize your healthy coping resources,” says Riehl. That includes a range of strategies, from following a healthy lifestyle by eating a healthy diet, exercising regularly and getting quality sleep each night; to using relaxation techniques like meditation and visualization; to making sure you take time for yourself each and every day; to cultivating and leaning on your support system.
“Also try to be aware of when your body is carrying more tension or when you’re having more IBD symptoms, and then assess how you’re doing with self-care and stress management.”
Signs You Should Seek Help for Stress
There may be times when your stress coping techniques just aren’t cutting it and you need help overcoming the stress in your life. “If an acute stressor becomes more chronic, that can be a big red flag that you may need to make some adjustments in scheduling or ask for additional help and support,” says Riehl. If that’s the case for you, “Seek help sooner rather than later.”
Medical reviewer and Oshi physician-partner Matthew J. Hamilton, MD is an Assistant Professor of Medicine at Harvard Medical School and a specialist in Gastroenterology, Hepatology, and Endoscopy at Brigham and Women’s Hospital Crohn’s and Colitis Center in Boston. He is a leading member of the research team at the BWH Crohn’s and Colitis Center, and has garnered national recognition for his research into the underlying inflammatory processes of IBD.
Oshi is a tracking tool and content resource. It does not render medical advice or services, and it is not intended to diagnose, treat, cure, or prevent any disease. You should always review this information with your healthcare professionals.