When Stressing Leads to Flaring

A recent study has found psychological stress may be linked to IBD flare-ups,  with the study concluding, "The main takeaway is that psychological stress impedes the body's ability to fight off gut bacteria that may be implicated in Crohn’s disease."¹

For most of us with IBD, this is nothing new. Many report extreme stress can trigger a flare. A study of over 1000 patients living with IBD found that three-quarters of them believed that stress exacerbated their disease.²

Although this study is likely not to be a huge shock for those of us who have Crohn's or UC, it does beg the question: Although studies are really helpful, what on earth can we do about it?

Why IBD patients may have higher stress levels

Studies have already shown people whose IBD is ongoing (and not stable or in remission) are more likely to report more stress with things like work, family, and finances all being part of it.³

This might be because people are worried about managing work deadlines when unwell, or find it stressful to navigate relationships, as well as the financial burden of living with a long-term condition. In turn, stress is also a part of mental health problems and these are more likely in those living with IBD. There could also be other things that play a part. For example, much has been written about IBD and the gut-brain axis, that when the gut is inflamed symptoms such as brain fog and anxiety increase.

How can we reduce stress with Crohn's or UC?

Unfortunately, a lot of the reasons IBD experience stress can't be helped or prevented – living with a chronic illness is stressful enough! However, there are things that could potentially help manage it. We often talk about mindfulness. One study looked at whether this could help people with ulcerative colitis and found it reduced the stress of those whose disease had flared and also decreased the number of people who have flare-ups.⁴Exercise is another recommended strategy to lower stress levels. Over 70% of IBD patients reported exercising helped them feel better, but it's important to note that over 20% of them found it made them feel worse.⁵

Another thing that may help patients with IBD is counselling – something that I've shared before and that I think all IBD patients should be offered. There is some thought that seeing a counselor may help with things like reducing fatigue and pain levels.⁶

Even if these tactics don't necessarily direct a change in disease activity, they could help IBD patients better manage when flare-ups arise and feel more in control of their situation, which is also really important.

Reducing stress is hard

Overall, stress will not cause everyone to flare, but most of us recognise it can be problematic and make symptoms potentially worse. It's not always possible to stop ourselves when we are stressed but potentially considering stress-management strategies may help us feel more equipped in dealing with flare-ups and potentially reducing the risk of exacerbating symptoms when we find ourselves in stressful times.