The Stress Response and IBS

As the stress response is the way that our bodies respond to internal or external changes, it has the capability of affecting IBS symptoms. This response, also known as the fight-or-flight response, appears to have developed so as to allow us to respond to life-threatening situations in a way that would maximize our chances for survival. The stress response is a complicated process. It involves our nervous and endocrine systems and it stimulates changes in a variety of body processes, including blood pressure, heart rate, muscle tension and bowel functioning. It is the changes in bowel functioning that tie the stress response and irritable bowel syndrome (IBS) together.

The Brain-Gut Connection

In response to a perceived stressor (external or internal), various parts of the brain begin to communicate with one another, including the sensory cortex, the thalamus and the brain stem. This process then triggers a response along two major bodily paths. The first is the hypothalamic-pituatary-adrenal axis, resulting in an increase in hormonal secretions, particularly the hormone cortisol. The second path is the autonomic nervous system, which releases adrenaline (epinephrine) and noradrenaline (norepinephrine) causing cardiovascular, muscular and digestive system changes. These two pathways directly affect the network of nerves found within the bowel, known as the enteric nervous system. This process, which starts with a perceived stressor, followed by a brain response, and resulting in stimulation along the two pathways down to the gut, illustrates the importance of looking at the stress response in trying to understand the dysfunction that manifests as IBS symptoms.

Physical Changes in the Stress Response

The stress response triggers the following physiological changes:

• Heart rate increases
• Increased respiration
• Increased muscle tension
• Inhibition of the immune system
• Delay in stomach emptying
• Increase in the speed of colonic contractions
• Relaxation of bladder muscles

Research on the Stress Response and IBS

In an attempt to find effective treatments for the symptoms of IBS, researchers have been investigating the various substances that are released during the stress response. One substance that appears to have major significance in the stress response is corticotropin-releasing-factor (CRF). CRF is a family of peptides (molecules that link amino acids) that are found in both the brain and the gut. In the brain, CRF receptors are found in the areas related to digestion, emotions and the autonomic nervous system. In the gut, CRF act within the colon to increase mucous and water secretion, affect the speed of colon contractions (motility), and appear to be related to the experience of abdominal pain. It is hoped that a better understanding of the role of CRF will lead to refinements in the development of medications which target IBS symptoms.

_Sources:

_{Benson, H.The Relaxation Response (2000). New York: HarperTorch.}

_{Monnikes, H., et.al. "Role of stress in functional gastrointestinal disorders. Evidence for stress-induced alterations in gastrointestinal motility and sensitivity." Digestive Diseases 2001 19:201-211.}

_{Mayer, E.A., et.al. " Stress and the Gastrointestinal Tract" American Journal of Physiology - Gastrointestinal and Liver Physiology 2001 4:G519-G524.}

_{Tache, Y. "Stress and Irritable Bowel Syndrome: Unraveling the Code" International Foundation for Functional Gastrointestinal Disorders Fact Sheet. 2007.}