IBS and the Stress Response

Why stress makes IBS symptoms worse

You have probably experienced first-hand the relationship between IBS and stress. This has a lot to do with the way that our bodies respond to internal or external changes. This stress response, also known as the fight-or-flight response, appears to have developed so as to allow us to respond to life-threatening situations in a way that would maximize our chances of survival.

Young woman holding painful abdomen on sofa
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The stress response is a complicated process. It involves our nervous and endocrine systems and it stimulates changes in a variety of body processes, including blood pressure, heart rate, muscle tension, and bowel functioning. It is the changes in bowel functioning that tie the stress response and IBS together.

The Brain-Gut Connection

In response to a perceived stressor (external or internal), various parts of the brain begin to communicate with one another, including the sensory cortex, the thalamus, and the brain stem. This process then triggers a response along two major bodily paths. The first is the hypothalamic-pituitary-adrenal axis, resulting in an increase in hormonal secretions, particularly the hormone cortisol.

The second path is the autonomic nervous system, which releases adrenaline (epinephrine) and noradrenaline (norepinephrine) causing cardiovascular, muscular and digestive system changes. These two pathways directly affect the network of nerves found in the bowel, known as the enteric nervous system.

This process, which starts with a perceived stressor, followed by a brain response, and resulting in stimulation along the two pathways down to the gut, illustrates the importance of looking at the stress response in trying to understand the dysfunction that manifests as IBS symptoms.

Physical Changes of the Stress Response

The stress response triggers the following physiological changes:

  • Heart rate increases
  • Increased respiration
  • Increased muscle tension
  • Inhibition of the immune system
  • Delay in stomach emptying
  • Increase in the speed of colonic contractions
  • Relaxation of bladder muscles


In an attempt to find effective treatments for the symptoms of IBS, researchers have been investigating the various substances that are released during the stress response. One substance that appears to have major significance in the stress response is corticotropin-releasing-factor (CRF).

CRF is a family of peptides (molecules that link amino acids) that are found in both the brain and the gut. In the brain, CRF receptors are found in the areas related to digestion, emotions and the autonomic nervous system. In the gut, CRF act within the colon to increase mucous and water secretion, affect the speed of colon contractions (motility), and appear to be related to the experience of abdominal pain.

It is hoped that a better understanding of the role of CRF will lead to refinements in the development of medications that target IBS symptoms.

2 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Qin HY, Cheng CW, Tang XD, Bian ZX. Impact of psychological stress on irritable bowel syndrome. World J Gastroenterol. 2014;20(39):14126-31. doi:10.3748/wjg.v20.i39.14126

  2. Beurel E, Nemeroff CB. Interaction of stress, corticotropin-releasing factor, arginine vasopressin and behaviour. Curr Top Behav Neurosci. 2014;18:67-80. doi:10.1007/7854_2014_306

Additional Reading

By Barbara Bolen, PhD
Barbara Bolen, PhD, is a licensed clinical psychologist and health coach. She has written multiple books focused on living with irritable bowel syndrome.