The Role of Stress in IBD

Stress can be triggered when you’ve set expectations that are too high to be comfortably meet. Whatever the stressor is, it’s real to you and your body reacts to it. From butterflies in your stomach to recurring bathroom visits, it doesn’t take suffering from inflammatory bowel disease (IBD) to know that stress causes an upset stomach.

The role of stress 

Cortisol, the “stress hormone” gets a bad wrap but you need it for survival. In times of stress, cortisol increases blood sugar mobilization, raises blood pressure, suppresses the immune system, and decreasing gut function — all helping you get the heck out of a dangerous situation. But when stress and cortisol levels stay elevated for too long, especially if you’re sensitive to it, your health gets hit. 


Stress and IBD

Stress and anxiety don’t cause IBD but during times of physical or emotional stress, more flare-ups can occur. One reason is due to the gut-brain connection and another may be related to the relationship between stress and inflammation. 

What’s a gut-brain?

Your gut and brain have a tight knit communication system, called the gut-brain axis. This system acts cyclically, providing feedback from your gut to your brain, and brain back to the gut. It’s thought to play a role in stress-related IBD symptoms. 

Science says 

One study found that the incidence of emotional disorders is higher in Crohn’s’s Disease and Ulcerative Colitis when compared to the general population. This was predicted to be caused by an increase in intestinal permeability (how fast things move through your gut), bacterial imbalance, and cytokines (immune system troopers). 

Chronically high cortisol is linked to immunosuppression (decreased immune function). So much so that events such as bereavement, depression, and marital separation have been shown to reduce lymphocytes and macrophages (your immune system “military troops”). 

A recent review concluded that inflammation is a pathway of stress-related diseases. This includes conditions such as IBD which involves chronic inflammation of your digestive tract.

There is increasing evidence that psychological stress is linked with inflammatory bowel disease but due to limited high-quality data regarding the effects on IBD, it makes it difficult to provide specific recommendations. 


IBD is a multi-factorial systemic disorder which involves the immune, genetic, and environmental factors. Since psychological stress plays an important role in gut disease, it’s worth giving stress management techniques a try. 


Manage stress in your own way 

Living with a chronic disease is stressful in and of itself. Implementing these stress management techniques may help you reduce IBD symptoms, and at the least, improve your quality of life.


Plan ahead to get ahead 

You can always count on life changing. Stressful situations can’t always be avoided. But sticking to a regular schedule the best you can will keep your strength up for “times of battle”. Discover your health musts and you’ll be armed to adjust to whatever life throws your way. Consider what your emergency health “go-tos” are. For instance, focus on getting regular and healthy fuel, taking your prescribed medications, and prioritizing the sleep. 


Check out: 15 Tips for How to Get a Good Night’s Sleep with IBD


You may want to consider buying a calendar, adding events in your phone, or trying a program like Nori Health, to help hold you accountable.


We all need somebody to lean on 

Sometimes you may feel like you’re the only one suffering from a chronic disease. You aren’t! Finding a support network of people similar to you, a medical team, and friends and family, will help you through tough times. Don’t feel comfortable going in person or don’t have access? Try one online such as the Crohn’s’s & Colitis Foundation or seek anonymous AI coaching support from Nori

Managing a chronic illness is not easy. If you feel like you’re drowning in the stress of your condition, talk to your physician about getting extra help from a therapist or counselor. 


Zone into zen 

Just like you would exercise a muscle to help strengthen and train it, it’s important to “exercise” your mind to help you handle stress more effectively. This includes getting physical exercise or movement which can help reduce stress. Train your mind to be quiet by taking a few minutes to go for a mindful walk, meditate, or simply sit and breath. 

There are some stressors that you can’t control. Remind yourself that you’re doing the best you can with the situation at hand. Learn to embrace the power of acceptance



This article has been written by Lisa Booth, registered dietitian and nutritionist, and co-founder of Nori Health. Content is based on her professional knowledge, and our collection of 100+ scientific research study papers.