I’m a Dietitian: Why Diet Isn’t the Key to Managing My IBS

November 4, 2024

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After years of living with the uncomfortable symptoms of irritable bowel syndrome (IBS), I began to wonder if I was going about my approach to it the wrong way. As a dietitian, I considered food first, and I spent a shocking amount of time trying different diets: low FODMAP, low carb, intermittent fasting, cleanses — you name it, I’ve likely tried it. Spoiler alert: Finding the perfect diet was not the key to unlocking better digestive health for me, and this is true for so many of my clients, too. It wasn’t until I began to notice the connection between stress and IBS that I started to heal.

Of course, nutrition is a factor in better digestion, but for many, hyper fixating on everything you eat creates more stress, which, in turn, can worsen symptoms. This was certainly true for me. It took years of trial and error to finally reach my lightbulb moment: Stress management, not nutrition, was the best thing I could do to reduce my IBS symptoms.

What is IBS?

IBS is an umbrella term for a chronic condition involving a range of symptoms from constipation to diarrhea (or sometimes both). It’s often diagnosed when other gastrointestinal conditions and disorders have been ruled out. Essentially, we don’t fully understand why some people develop IBS. We do know that multiple lifestyle factors play a role in preventing and managing symptoms over time. Aside from diet, things like exercise, sleep, medications, and stress all impact our gut health, so treatment typically involves those and other lifestyle factors.

Although you may always have IBS, your symptoms can improve drastically with the right changes for you. If you haven’t been diagnosed with IBS, but you wonder if you have it, consult with a gastroenterologist and a dietitian.

How stress and IBS are connected

Stress is something we all experience. Our bodies are designed to experience moments of stress, and we have built-in ways of reacting both physically and mentally. Some stressors are positive; for example, exercise is a form of stress on the body. But when stress is constant without relief, it can become harmful. We all have different triggers for chronic stress in our lives, and it can show up in several ways. Symptoms of chronic stress can include:

Stomachaches or other GI distress
Racing heartbeat
Headaches or other aches and pains
Jaw clenching
Anxiety or irritability
Trouble sleeping
Skin rashes

Chronic stress can be a cause of IBS, and it also can aggravate it.

The gut-brain axis

When we feel stressed, the nerve connecting our brain to our stomach is activated. This is the same pathway that causes the feeling of butterflies in your stomach when you’re nervous or excited. However, if you’re experiencing chronic stress or anxiety, you could experience gut health symptoms like bloating, gas, abdominal pain, or diarrhea.

When we’re stressed, the gut-brain connection can shut down the part of our nervous system responsible for digesting and breaking down food. As a result, you might end up with undigested food (which causes diarrhea), or fermented food particles (which cause gas). Folks with constipation-prone IBS may experience a halting of digestion.

Sleep habits

High stress impacts our sleeping habits — both in the quality of sleep we get and the total hours of sleep per night. Unfortunately, this “wired-but-tired” reaction can reinforce itself; the less sleep we get, the more stressed we might feel, which can worsen sleep habits the following night. Poor sleep quality impacts our digestion significantly, and research has found a connection between IBS and sleep disorders.

Microbiome changes

We know that chronic stress can change our microbiome — the home to more than four trillion gut bugs that affect everything from digestion to mood and immunity. The hallmark of a healthy gut is a diverse microbiome, meaning a large variety of gut bugs. Our microbiome shifts toward less diversity and more harmful gut bacteria under longer durations of stress. When we have more “bad” bugs, we’re more likely to experience digestive distress in addition to other potential negative side effects, like decreased immune health and weight gain.

Stress management techniques that work

We can’t avoid all stress, but there are techniques we can employ to relieve it, so it doesn’t become chronic and adversely affect our health. Plus, as in my experience, managing stress can go a long way toward keeping IBS symptoms at bay.

Therapy. Therapy can give you the tools you need to understand your triggers and cope in a positive way, so you feel less stressed.
Activity. Structured exercise is great, but increasing lighter activity, like walking, can also make a huge difference in your IBS symptoms.
Deep breathing. One of the quickest ways to soothe stress is deep breathing. There are many techniques, so try a few to see what works best for you. Do it in moments of acute stress, and preventatively throughout the day.
Quality sleep. Setting a bedtime, turning off devices an hour before bed, making your bedroom cool and dark, and employing other good sleep hygiene habits can boost your sleep quality and quantity, helping you to feel calmer and less reactive.
Reducing (or cutting out) alcohol. Alcohol is a toxin that gets filtered via digestion and through our liver. Gastrointestinal issues are often common with alcohol consumption, especially when you consider the stress alcohol places on our bodies.
Reducing (or cutting out) caffeine. Caffeine is a stimulant, and multiple cups of coffee or energy drinks can worsen IBS symptoms. Plus, depending on how late you drink it and how well your body metabolizes it, caffeine can disrupt your sleep even hours later.