IBS: Managing the emotional side - Caidr
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IBS: Managing the emotional side

Updated 04.04.2022
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Irritable bowel syndrome (IBS) is a very common ailment, and every sufferer has their own particular set of symptoms and triggers. As it commonly starts in your 20s and 30s, it will be most people’s first experience of dealing with a long-term condition. Physical symptoms – abdominal pain, bloating or altered bowel habit – can dominate consultations with your doctor, and, indeed, can impose on daily life. But sometimes the mental health side of IBS can get sidelined, when attention to your psychological needs can actually improve symptoms. Recognising that there is a huge mental health burden is the first step, and taking measures to protect yourself is the next. Here we dig into these in more detail, to keep yourself as well as you can.

Mind and body as one entity

As a doctor, I regularly talk to my patients about the mind-body crossover, where physical and mental health are intricately linked, and you can’t treat one without the other. IBS can often go hand-in-hand with anxiety, depression and other psychological conditions – it's sometimes unclear which comes first. Even without a formally diagnosed mental health condition, the toll IBS symptoms can take on daily living can impact on your quality of life, affecting family life and possibly forcing you to take time off work. In the face of this, mood can plummet, and that, in turn, makes the symptoms worse. If you have any mental health conditions diagnosed alongside IBS, it’s a good idea to check in with your doctor or mental health team to make sure these are addressed, as this will help your IBS.

Managing your mental health

IBS is a condition that’s sensitive to stress, causing a new flare-up or existing symptoms to become worse. If you feel you are in a place to try self-help options, try out breathing techniques, mindfulness and meditation, and controlling external factors where possible, and explore what works for you. Sometimes life throws us situations that we aren’t able to control, and we may need to consider other ways to help ourselves. There’s evidence that Cognitive Behavioural Therapy (CBT) tailored to IBS sufferers can have specific benefit: a study by Kings College London and the University of Southampton found that this to be significantly more effective than standard treatment such as medications. But it’s not widely available yet. Even if your area doesn’t offer specific IBS-centred CBT, standard CBT and other talking therapies can be a good resource to equip you with the tools to manage stress, anxiety and low mood. This will help manage triggers for IBS and the psychological fallout of having a long-term physical condition.

Exercise can help

There’s evidence that increasing exercise levels can have positive long-term effects on IBS symptoms. Burning off excess stress hormones and releasing feel-good endorphins help boost mental health, too. My view is that the general rules of: eat well, sleep well, move well are good simplistic principles for healthy living. If you are in the midst of a nasty flare-up, now is not the time to go for a run. But over a period of ten or twelve weeks, introducing regular gentle exercise two or three times a week is a good place to start, and you build frequency and intensity from there. Explore whether for yourself whether this improves your physical and mental health – a diary might work for you, if you want to chart your progress.

When to seek further help

Mental health is something that varies day-to-day, and even hour-to-hour. So many factors influence it. If the symptoms of chronic illness or effects of IBS are leading to a severe worsening of your mental health, there are some things that would require a more urgent discussion with your doctor. If you are having any thoughts of self harm or suicide, your doctor would want to know. If it is outside of office hours, you can find a safe place and emergency support at your local emergency department. If things are getting desperate, don’t go through this alone. Family friends are a good starting point, but if you need some professional input then be sure to reach out. * Written by Dr Tom Bracewell, Caidr's Chief Medical Officer and practising GP

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