Friday, September 15, 2023

Does Stress Cause Colitis Flare Ups

What Happens When Youre Stressed

Top 5 Tips for a Colitis Flare Up – #2

When you are stressed, your body kicks in to prepare and protect you from threats or danger. This automatic response is known as the stress response or fight-or-flight reaction. It is designed to kick your body into high gear so you can either face the threat head on or flee from it. Your strength and stamina increase, your focus is enhanced, and your reaction time speeds up.

When the stress response kicks in, your brain floods your body with hormones, including adrenaline and cortisol. These hormones trigger your body to get ready for action. They get your heart beating faster and send a rush of blood to areas of your body needed most in an emergency such as your muscles and other organs.

In addition, these hormones affect your respiratory system. When the stress response is triggered, you begin to breathe faster. This gets more oxygen into your bloodstream and quickly out to your body. Your blood vessels constrict, your blood pressure rises, and more oxygen-rich blood is diverted to your muscles. This gives you an extra boost of strength to take action.

Other organs also kick into overdrive. Your liver also goes into action producing more blood sugar, which gives you a surge of energy. Your stomach produces more acid. Your muscles tense. Your brain shifts blood flow and activity to survival areas of the brain like the amygdala. Stress also revs up your immune system. This helps your body avoid infections and helps wounds heal faster if your injured.

Symptoms Of Ulcerative Colitis

The main symptoms of ulcerative colitis are:

  • recurring diarrhoea, which may contain blood, mucus or pus
  • needing to empty your bowels frequently

You may also experience fatigue , loss of appetite and weight loss.

The severity of the symptoms varies, depending on how much of the rectum and colon is inflamed and how severe the inflammation is. For some people, the condition has a significant impact on their everyday lives.

The Autonomic Nervous System

The sympathetic and parasympathetic autonomic nervous systems serve the entire gastrointestinal tract and are closely connected with the enteric nervous system . Together, these systems govern secretion, motility, sphincter control, and microcirculation in the gut . Under stress conditions, the ENS produces large neuropeptides, which in turn affect intestinal immunity and inflammation. Geboes et al. found that there are mixed abnormalities in all CD and UC patients for different cell types of the ENS . Another study showed that patients with UC have markedly lower autonomic functions in comparison to those with CD and healthy controls .

Stress can activate the sympathetic autonomic system, leading to increased production of major adrenal medulla hormones, mainly catecholamines, such as epinephrine and norepinephrine. Catecholamines mediate increases of central and peripheral inflammatory cytokines and activation of the inflammatory nuclear factor B signaling pathway in response to stress . In addition, the vagus nerve, which has anti-inflammatory effects, is inhibited by stress, leading to an increased systemic inflammatory response to endotoxin and intestinal inflammation .

Also Check: How To Lower Blood Pressure When Stressed

Ways To Manage Symptoms And Flares Of Ulcerative Colitis

Digestive Health Services

A flare of ulcerative colitis can be painful and embarrassing not only for you, but for those around you. Once you have one flare, are you going to have more? That anxiety can make you feel even worse and trigger one. Lets investigate 6 ways to manage symptoms and flares of ulcerative colitis.

Take Some Deep Breaths To Calm Your Gut

Common Causes of Loose Stools

Breathing deeply can help reduce UC gut pain and cramping, says Sara Kinsinger, PhD, director of behavioral medicine for the digestive health program at Loyola University Health System in Maywood, Illinois.

Deep breathing elicits a parasympathetic relaxation response that physiologically helps the body relax by increasing blood flow and oxygen to the gut, she says.

Experiment with different deep breathing techniques, including diaphragmatic breathing and alternate nostril breathing, to learn what helps you relax.

Also Check: What Causes Stress And Anxiety

Ulcerative Colitis Vs Crohns Disease Vs Irritable Bowel

Other gut diseases can have some of the same symptoms.

  • Ulcerative colitis affects only your large intestine and its lining.
  • Crohns disease causes inflammation, but it affects other places in your digestive tract.
  • Irritable bowel syndrome has some of the same symptoms as UC, but it doesnt cause inflammation or ulcers. Instead, its a problem with the muscles in your intestines.

Response To Acute Stress In The Presence Of Chronic Stress

The physiological and immune response to acute experimental stress is exaggerated by the presence of chronic psychological stress . Individuals with high chronic stress levels, such as those caring for a long term dependent or women with a strong family history of breast cancer, showed greater and more prolonged increases in sympathetic activation in response to acute stressors than controls. This was associated with a greater increase in NK cell numbers, albeit with an attenuated increase in their activity, in the chronically stressed subjects than in controls.

Read Also: Why Do I Feel So Stressed And Depressed

Response To Acute Experimental Stress In The Presence Of Chronic Inflammatory Disease

The immune response to acute experimental stress is also altered by the presence of chronic inflammatory disease . Patients with systemic lupus erythematosus showed an increase in IL-4 producing peripheral blood mononuclear cells, as assessed by staining of intracellular cytokines, in response to the TSST, where as control subjects did not. The stress induced redistribution of the leucocyte subsets was also altered in patients with SLE, with an attenuated increase in the number of NK cells and their cytolytic activity in comparison with healthy controls.

Implications For Therapy Of Ibd

How does an Ulcerative colitis flare up actually come about?

If psychological stress is indeed a pathogenic factor in IBD, then stress reduction therapy may have therapeutic benefit. However, despite recent advances in our understanding of the relationship between psychological stress and IBD, most stress reduction therapy remains unformalised, and studies of its efficacy in patients with IBD are few. There are a wide variety of psychotherapeutic interventions which could be assessed making standardisation difficult. Due to the nature of the intervention, performing the trials in a blinded controlled manner is also difficult and, as already discussed, with placebo rates of up to 40% genuine therapeutic effects can be hard to detect.

In summary, further trials are required before a view can be taken as to whether any form of stress reduction therapy may have benefit for patients with IBD. However, given the considerable evidence both in humans with IBD and in animal models of IBD that stress can increase disease activity, perhaps such studies should now be attempted.

Also Check: How To Get Rid Of Stress

Manage Your Anxiety Manage Your Colitis

Managing symptoms of psychological stress and anxiety, unfortunately, won’t cure your ulcerative colitis, but it may help alleviate some of its symptoms and reduce the frequency of ulcerative colitis incidents. Put simply, reduce your stress levels, reduce your discomfort caused by colitis.

It’s virtually impossible to avoid psychological stress and stressful situations at all times completely, so it’s unreasonable and unrealistic to think that you can manage your ulcerative colitis by keeping stress and anxiety out of your life. You can, however, realistically keep stress levels down by eating well and avoiding foods that trigger your ulcerative colitis, like whole grains, nuts, seeds, and fibrous fruits. It is also helpful to take any prescribed medications as directed, sleep well, exercise, have a strong support system, and commit to taking time to relax, through meditation, or just a few dedicated minutes each day for self-care. Yoga can be especially effective because, in addition to relieving symptoms of stress and anxiety, yoga has also been shown to relieve symptoms of ulcerative colitis.

Cognitive behavioral therapy can also be extremely helpful. Using CBT techniques, a psychologist or therapist can help you learn to observe your negative thoughts and then change or reframe them. Instead of “Oh no, here we go againâ¦,” you might think, “I’m going to face this flare-up more calmly, so it will be less severe than last time.”

Talk With Others Who Understand

Another great tool for managing stress is connecting with others, and especially those who understand what youre going through. Joining an ulcerative colitis support group, whether in-person or virtual, can help address your stress levels and improve your quality of life.

MyCrohnsAndColitisTeam is the social network for people with Crohns disease or ulcerative colitis and their loved ones. On MyCrohnsAndColitisTeam, more than 139,000 members come together to ask questions, give advice, and share their stories with others who understand life with inflammatory bowel disease.

Are you living with stress and ulcerative colitis? Share your experience in the comments below, or start a conversation by posting on your Activities page.

Also Check: How To Stop Overeating From Stress

Could My Symptoms Be Ibs

Irritable Bowel Syndrome is a different condition from IBD, although some of the symptoms are similar. Like Crohn’s and Colitis, IBS can cause abdominal pain, bloating and bouts of diarrhoea or constipation. However, it does not cause the type of inflammation typical of Colitis, and there is no blood loss with IBS.

Some people with Colitis may develop IBS-like symptoms, for example experiencing diarrhoea even when their Colitis is inactive. These symptoms may need slightly different treatment from their usual IBD symptoms. IBS is more common in people with IBD than in the general population.

If you develop diarrhoea with bleeding and abdominal pain, your doctor may suspect you have Colitis, particularly if you are a young adult or have a family history of Crohn’s or Colitis. You will need tests and physical examinations to confirm a diagnosis. See Tests and Investigations for IBD.

You may need to have tests repeated from time to time to check on your condition and how your treatment is working.

Some drug treatments may also require a series of blood tests and, occasionally, x-rays or scans to check for any potential side effects. Your specialist will avoid giving you any unnecessary tests or investigations.

You may need more regular colonoscopies when you have had Ulcerative Colitis for a long time to check for any signs of cancer.

Was There A Subset Of Patients Who Responded To Mbsr Treatment Post Hoc Analysis

Crohns disease and Colitis symptoms: Study could reveal ...

In order to determine if there was a subset of UC patients who might benefit from MBSR, we performed a post hoc analysis taking baseline characteristics into consideration, as factors that may be contributing significantly to MBSR response. Subjects were split into tertiles . Subjects in the MBSR group with the most severe, gastrointestinal symptoms at baseline demonstrated a positive MBSR effect, compared to those exhibiting less gastrointestinal severe symptoms , an effect that was not observed in the control group. Likewise, MBSR subjects with the highest tertile of PSQ scores at baseline demonstrated a reduced flare-up rate compared to control group subjects also in the highest tertile . Similar to the PSQ data, flare-up rate among MBSR subjects in the top tertile of cortisol at baseline was reduced, compared to controls with comparable baseline cortical levels .

Fig. 3

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Effects Of Stress On The Systemic Immune System In Humans

The effects of psychological stress on the systemic immune and inflammatory system are complex, and depend on both the duration and intensity of the stressor. Both chronic stress and acute stress are associated with alterations in systemic immune and inflammatory function which may have relevance to the pathogenesis of IBD.

Eating Healthy Diet Will Surely Ease Flare

Eating healthy diet will absolutely ease flare-up of ulcerative colitis. Always confirm your diet is healthy and avoid consumption processed foods. Also, you must avoid sweet and spicy foods in your diet, as they cause irritation to your colon. Your diet ought to be composed of vegetables as a serious supply of super molecule. The vegetables ought to be recent and leafed inexperienced, as they are a decent supply of naphthoquinone. Naphthoquinone deficiency is associated to redness being severe. Additionally, avoid consumption beef however instead supply super molecule from chicken and turkey or baked fish. Beef causes stress in your colon.

Recommended Reading: How To Handle Extreme Stress

Why Working With A Qualified Care Team Is So Important When It Comes To Managing Ulcerative Colitis

People being treated for UC typically arent getting dietary or lifestyle advice, which is a huge disservice, says Cohen. But managing ulcerative colitis and preventing flare-ups can be done! You just might need a little help from the experts.

Because UC isnt one-size-fits-all and triggers are highly individual, enlisting the help of a care team like the clinicians at Parsley Health is wise. Providers can provide individualized supplement protocols based on lab testing, customized eating plans for periods of remission and flares, and communicate with your current GI doctor if necessary to streamline care.

How Ulcerative Colitis Is Treated

Cause of IBD Inflammation and Flare up (Not Food Related)

Treatment for ulcerative colitis aims to relieve symptoms during a flare-up and prevent symptoms from returning .

In most people, this is achieved by taking medication such as:

  • aminosalicylates
  • corticosteroids
  • immunosuppressants

Mild to moderate flare-ups can usually be treated at home. However, more severe flare-ups need to be treated in hospital to reduce the risk of serious complications, such as the colon becoming stretched and enlarged or developing large ulcers. Both of these can increase the risk of developing a hole in the bowel.

If medications aren’t effective at controlling your symptoms, or your quality of life is significantly affected by your condition, surgery to remove your colon may be an option.

During surgery, your small intestine will either be diverted out of an opening in your abdomen , or used to create an internal pouch that’s connected to your anus .

Read more about:

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What Is The Best Diet For Ulcerative Colitis

Theres no single diet that works best for ulcerative colitis. If the disease damages the lining of the colon, your body might not absorb enough nutrients from food. Your healthcare provider may recommend supplemental nutrition or vitamins. Its best to work with your provider and nutritionist to come up with a personalized diet plan.

Tips For Managing Anxiety When You Have Ulcerative Colitis

Learning how to cope with daily stressors will help manage UC-related anxiety.

Sam Cleasby was 23 years old when she was diagnosed with ulcerative colitis an inflammatory bowel disease that causes chronic inflammation and sores in the gut. Medication kept her flare-ups under control for nearly a decade. But in 2013, Cleasby required surgery to keep her disease under control. First, doctors removed her colon. Then they created an ileostomy, in which a piece of the small intestine is pulled through an opening in the abdomen so digested food can pass through a pouch called an ostomy bag, which she wears on the outside of her body. Later, they removed her entire large intestine.

Though I had times when life was tough and I was sad, frustrated, or angry, I didnt actually struggle with anxiety and my mental health until after surgery, says Cleasby, founder of the blog SoBadAss, who says she also suffers from post-traumatic stress disorder . It wasnt the surgeries themselves but the loss of control that was the source of my panic attacks and anxiety, explains Cleasby.

In addition to coping with their illness, people with UC have to manage doctors appointments, medication, and changes to their lifestyle and eating habits, says Mira Zein, MD, a psychiatrist with Stanford Health Care in California. Flare-ups can also put a damper on socializing.

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Set Goals And Boundaries

A great way to manage stress is to set goals and priorities for yourself for both the short and long term. Decide which tasks on your plate need to get done today versus those that can wait until tomorrow or next week. Be open to delegating tasks on your to-do list. Accept or ask for help from friends and family. Also, take some time to reflect on the things that you did get done today or this week. The National Institute of Mental Health suggests, at the end of each day, to focus on what you accomplished rather than what you did not get done.

Another technique that can help you manage your stress is setting boundaries. Set clear boundaries and communicate those boundaries to the people in your life. You only have the time and energy for so much in a day, but sometimes it can feel like you need to be available for everything and everyone.

Practice saying no to additional obligations or things that you dont want to do. Saying yes to things you dont have time for can cause internal conflict and induce feelings of anger, resentment, and frustration. Setting boundaries and putting your needs first is a good way to manage your stress and keep it from getting out of control.

One MyCrohnsAndColitisTeam member wrote about lovingly setting boundaries, I have been pushing myself too hard. I know better. Family and life has been too demanding! I need to revisit my notes on lovingly setting boundaries.

Identify Habits That Might Cause Stress


Identify your habits, healthy and unhealthy, that may impact your ability to manage stress. Several lifestyle habits could contribute to stress. If you engage in any of these, you may want to reconsider them for the sake of your stress management:

  • Drinking too much caffeine
  • Smoking cigarettes
  • Using illegal substances

Kicking my drinking/smoking habits. Obviously, alcohol has a very negative effect on my digestion, wrote one MyCrohnsAndColitisTeam member. Aside from contributing to stress, alcohol and cigarettes may also impact UC symptoms directly.

Its a good idea to evaluate your practice of any of these habits and whether you feel like you can stop them. Your doctor may be able to help you identify resources for quitting smoking or drinking, or eating a more balanced diet.

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