About 5 to 10% of the U.S. population suffer from irritable bowel syndrome (IBS), according to Gastroenterologist Dr. Shashank Sarvepalli. The problem with this disorder may seem to lie solely in the gastrointestinal (GI) tract, but the brain also plays a role.

Dr. Sarvepalli calls this the mind-gut connection, and it explains why IBS symptoms might get worse during periods of stress.

What is IBS? 

The criteria for diagnosing IBS is abdominal pain at least once a week for three months related to defecation and changes in frequency or form of stool.

“Basically, anyone who meets that definition has IBS,” Dr. Sarvepalli says, “but the causes of IBS are numerous.”

Dr. Savrepalli points to the mind-gut connection.

The mind-gut connection

In a normal state, the spine and central nervous system receive signals from the GI and report that everything is fine. But in a stressed state, areas of the central nervous system misinterpret mundane signals from the GI tract as warning signs. 

This leads to a phenomenon called visceral hypersensitivity where the brain becomes more sensitive to input from the GI tract. This creates a cycle where IBS worsens stress and stress worsens IBS.

Dr. Sarvepalli explains that the vulnerability that comes with IBS can pair with the vulnerability of anxiety and depression and worsen the symptoms of these mood disorders. 

While IBS has no known cure, Dr. Sarvepalli offers ways to manage symptoms.

Managing IBS symptoms

Because of the mind-gut connection, IBS treatment often includes stress management. While reducing stress in the moment is important, preventing high levels of stress is key.

“You really have to get to the reason why you’re stressed,” Dr. Sarvepalli says.

Meditation and diaphragmatic breathing, where the stomach expands fully with each breath, are ways to lower your stress baseline over time. Diaphragmatic breathing also gently massages your internal organs, which can relieve stomach pain and reduce bloating.

Because the mind-gut connection is a cycle, pay attention to your diet as well. Dr. Sarvepalli recommends the low FODMAP diet, which aims to restrict fermentable carbohydrates.

“It sounds kind of complicated,” Dr. Sarvepalli says. “But it comes down to avoiding certain foods that will increase gas production.” 

Common IBS triggers include garlic, onion, beans, dairy, apples, and asparagus. When beginning the low FODMAP diet, start by eliminating all foods considered high FODMAP and introduce one food at a time to determine what triggers your IBS.

Medication may help if stress management and diet do not control your symptoms.