Why does my gut react when I’m stressed?
If you’re struggling with IBS, you’ll probably be well aware it can show up at exactly the wrong time – right before an important meeting, an exam, a journey, a meal out or when you’re meeting friends.
There’s a reason for this.
Your gut and brain are constantly communicating with each other through what we call the gut-brain axis. When you’re stressed or anxious, this communication system can influence how your digestive system functions and how strongly you experience sensations from your gut.
That’s not to say that IBS isn’t real or that it’s “all in your head”. IBS is a real condition involving the interaction between the gut, nervous system and the brain..
So what is the gut-brain connection?
The gut-brain connection describes the two-way communication between your digestive system and your brain.
Signals travel between them through the gut-brain axis helping to coordinate digestion, movement through the bowel and the way we experience sensations from the gut.
This helps explain why your stomach can sometimes react before you even realise you’re worrying about it.
You’ve probably noticed this about yourself – maybe your stomach starts churning when you’re nervous, or you suddenly need the toilet before something important.
For someone with IBS, these responses can feel much more noticeable.
How can stress affect IBS?
When we’re stressed, the body’s fight, flight or freeze response becomes more active. This can affect digestion and, for people with IBS, may influence symptoms such as bloating, abdominal discomfort, urgency, bowel changes and sensitivity to gut sensations.
This can create a two-way feedback loop:
Stress or anxiety → changes in the gut → gut sensations → your brain notices and interprets them → worry or alarm → increased stress response → further changes in the gut.
But the communication doesn’t only travel from the brain to the gut. When your gut feels unsettled, those signals are sent back to the brain. Your brain then interprets that information and if the sensation feels threatening, it can trigger more worry or anxiety.
Can anxiety make IBS worse?
For some people, anxiety becomes closely tied to their IBS.
Thoughts such as “What if I need the toilet?”, “What if I can’t get home?” or “What if I have an accident?” can make going out feel impossible.
Over time, you might start planning journeys around toilet availability, checking where the nearest toilet is, avoiding certain foods, eating less before going out, cancelling plans or avoiding situations altogether.
These behaviours are completely understandable. They’re attempts to keep yourself safe and prevent something embarrassing or frightening from happening.
The problem is that avoiding situations can reinforce the message that they are dangerous, keeping the gut–brain anxiety loop going.
This is one of the areas where CBT can be really helpful.
Why do IBS symptoms sometimes feel so unpredictable?
IBS is multifaceted and symptoms can be influenced by a number of factors, including food, stress, sleep, hormonal changes, illness and changes in routine.
So stress isn’t necessarily the cause of IBS, and IBS isn’t “all in your head”. It’s more accurate to think of it as a two-way conversation between your gut and brain, where changes in one can influence the other.
This also helps explain why IBS can feel so different from one person to another and why treatment needs to be personalised.
So what can actually help?
Gut-directed hypnotherapy
Gut-directed hypnotherapy is a specialised form of hypnotherapy that focuses on the gut-brain relationship.
It uses guided relaxation, focused attention and therapeutic suggestions designed specifically around IBS and the way the gut and brain communicate.
For some people, this can be a useful part of managing IBS symptoms and reducing the impact they have on everyday life.
CBT for IBS
CBT can help with the thoughts, feelings and behaviours that can become wrapped up with IBS.
For example, someone might gradually become caught in a cycle of worrying about symptoms, monitoring their stomach, avoiding situations and then feeling even more anxious when they have to face them.
I often work with clients to understand these patterns and gently challenge the thoughts and behaviours that are keeping the cycle going. The aim is to reduce the fear and anxiety around your symptoms, rebuild confidence in your body and help you get back to doing the things that matter to you.
Why combine CBT and gut-directed hypnotherapy?
Combining the two approaches makes sense because IBS isn’t simply about physical symptoms.
We know there can be worry, avoidance, fear of symptoms and changes to everyday behaviour.
Gut-directed hypnotherapy focuses specifically on the gut-brain relationship, while CBT can help you understand and change the thoughts and behaviours that may have developed around your IBS.
Together, these approaches can address both the symptoms and the way IBS has begun to affect your life.
What about diet?
Diet can be an important part of managing IBS, and approaches such as the Low-FODMAP diet can be helpful for some people. But IBS isn’t just a food problem. Dietary changes are therefore one possible part of IBS management rather than the only approach available.
What if IBS is affecting my life?
I hear all the time how IBS has gradually started to take over people’s day. Sometimes it isn’t even the symptom itself that’s the hardest part. If this all sounds familiar there are ways of working with both the physical symptoms and the anxiety and avoidance that develop around them.
When should I seek medical advice?
If you’re having new, persistent or unexplained digestive issues, it’s important to speak with your GP. CBT and hypnotherapy aren’t a substitute for medical diagnosis or treatment, but they can complement appropriate medical care for people who have IBS.
Could CBT or gut-directed hypnotherapy help with IBS?
I use CBT and gut-directed hypnotherapy to help clients understand the gut-brain connection, reduce anxiety around their symptoms and develop more helpful ways of responding to IBS.