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Relieving Chronic Constipation

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How Stress Affects IBS With Constipation and What to Do About It

Medically Reviewed By William C. Lloyd III, MD, FACS
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If you have ever used the expression ‘butterflies in my stomach’ or been ‘worried sick,’ you understand your emotions can cause tummy woes. This is especially true if you are one of the millions of people living with irritable bowel syndrome (IBS).

IBS is the umbrella term for a group of symptoms including constipation, diarrhea, abdominal pain and cramping.  IBS symptoms tend to ebb and flow and can range from the mild to the severe.  Exactly what causes IBS is not fully understood, but physical and emotional stressors likely play an important role.

The IBS-Stress Connection

The gut or gastrointestinal (GI) tract including the colon has nerves that connect to the brain. These nerves can cause contractions or spasms in the gut during times of emotional or physical turmoil. (Think about that knot you always get in your stomach when you are nervous.)

People with IBS are hypersensitive to the effects of stress – and this manifests in GI symptoms including constipation. In fact, more and more evidence suggests that IBS is a combination of an irritable bowel and irritable brain.

Stress not only increases the chances of developing IBS, but it also makes existing IBS symptoms worse. There’s more: IBS can be the chicken or the egg in this relationship. Having IBS can leave you feeling stressed, creating a vicious cycle of pain, bloating constipation or diarrhea.

Break the stress-IBS cycle by reigning in your stress.  Here’s how:

Make Healthier Choices

When you are stressed, you are less likely to eat a healthy diet and engage in regular exercise. You are also more prone to partake in less healthy habits including drinking too much alcohol and/or smoking to cope with the stress. Eating a healthful diet that is rich in fiber, exercising and drinking enough water throughout the day will improve IBS-related constipation as well as your overall health.

Seek Help

People with IBS are more likely to experience anxiety and depression, according to the Anxiety and Depression Association of America. Counseling can help identify more effective coping mechanisms, which can help reduce IBS symptoms. Cognitive behavior therapy may help change your reaction to stressors. It may be particularly effective for people with IBS, according to research.

Medication can help too. Antidepressants that reduce stress and anxiety also help alleviate IBS symptoms. Selective serotonin reuptake inhibitors, in particular, can help relieve IBS constipation, according to gastroenterologists from the University of North Carolina at Chapel Hill School of Medicine.

Take Time Out

Whether deep breathing, practicing yoga or meditating, taking a time-out can help change how you react to stress in your life. When you are stressed, it affects the colon, which needs to be relaxed to remain regular. This is why some people with IBS are prone to bouts of constipation. One study showed that mindfulness meditation reduces the severity of IBS symptoms. Mindfulness meditation involves staying in the present moment by becoming aware of your surroundings, while letting go of your thoughts about the past and the future.

Treat the IBS

Talk to your doctor to make sure you are doing all that you can to treat your IBS. While there is no cure, symptoms can be managed. Treatment may include changes in diet, medications and/or probiotics to rebalance the bacteria in the gut flora. IBS causes stress in and of itself so reducing symptoms can also help to reduce some disease-related stress.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2021 Feb 19
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.

  1. International Foundation for Functional Gastrointestinal Disorders, Inc.What is IBS?
  2. Qin HY, et al. “Impact of psychological stress on irritable bowel syndrome.” World Journal of Gastroenterology. 2014 Oct 21;20(39):14126-31.
  3. The Anxiety and Depression Association of America. IBS.
  4. Tang Q, et al.  Cognitive-behavioral therapy for the management of irritable bowel syndrome.  World Journal of Gastroenterology. Dec 14, 2013; 19(46): 8605–8610.10.3748/wjg.v19.i46.8605
  5. The University of North Carolina at Chapel Hill School of Medicine. The Use of Antidepressants in the Treatment of Irritable Bowel Syndrome and Other Functional GI Disorders.
  6. Gaylord SA, et al. Mindfulness training reduces the severity of irritable bowel syndrome in women: results of a randomized controlled trial. American Journal of Gastroenterology. 2011 Sep;106(9):1678-88. doi: 10.1038/ajg.2011.184.
  7.  The National Institute of Diabetes and Digestive and Kidney Diseases. IBS.