Do You Have IBS Or Are You Just Stressed?

Photographed by Alexandra Gavillet.
Your body does really weird things when you're feeling stressed out, and most of the time, it's out of your control. You sweat, your heart races, and sometimes you have to poop — badly, like really badly. But, if stress makes you poop, and that happens to you a lot, does that mean that you have irritable bowel syndrome? Maybe.
IBS is a chronic bowel syndrome that affects your large intestines, and usually causes a whole cast of bowel problems: constipation, diarrhea, bloating, cramping, or a mix of alternating diarrhea and constipation. And all these symptoms come out to play when you're stressed.
"Stress can make symptoms of IBS worse," says Melissa Rosen, MD, gastroenterologist and clinical assistant professor of Medicine at NYU Langone Medical Center. The link between stress and IBS is a little mysterious, but Dr. Rosen says that doctors know that stressful events can exacerbate IBS symptoms. And "stressful events" can include running for a train, meeting an ex for the first time post-breakup, or just living your life.
Most people will experience these types of GI issues at some point in their life (perhaps after eating a particularly rich meal or going too long without water or fiber), but a person who has IBS gets them over and over again, regardless of what they're eating. According to Dr. Rosen, people usually see a doctor for IBS when they feel like they can't get their bowels under control. "We have a criteria for diagnosing IBS, because there's a range for how people experience it," she says.
So how do you know if you have IBS? There's not a definitive test that doctors use to diagnose it; it's a "diagnosis of exclusion," Dr. Rosen says. This means that gastroenterologists typically look to rule out other common GI issues that would cause your bowels to get out of whack, such as celiac disease, ulcerative colitis, and Crohn's disease, she says. A person with IBS usually has a healthy appearing colon, without evidence of any inflammation, even though their bowels can be really erratic and irregular. Your doctor might also run a few blood tests to check for anemia or thyroid issues that could be contributing to your GI symptoms, but for people with IBS, these tests usually come back normal.
Even though IBS is hard to pinpoint, it's still a very common syndrome. Between 10 and 15% of the population has IBS, and two in three IBS sufferers are female. "It is more common in women, and one theory is that hormonal fluctuations cause symptoms, because women have changes around their menses — but that's just one explanation," Dr. Rosen says. (And many people just poop a lot during their period.) There's definitely a link between mindset and IBS, and it's also possible that someone with IBS is just more sensitive to these varying symptoms, so they recognize them more, she says.
In other words? It's complicated.
If this sounds like you, it's a good idea to talk to your doctor about your bowels, so they can make sure you don't have a serious GI condition. Dietitians typically help IBS patients figure out what foods trigger their symptoms, and work to modify their diet so their bowels can flow a little better. "By incorporating dietary changes and figuring out their food triggers, patients often feel better," Dr. Rosen says.
But that's not all it takes, and Dr. Rosen says anxiety and stress management is a huge part of IBS treatment. "Whether it's needing management of anxiety with a therapist or exercise, it helps a lot," she says. "Exercise helps with your overall mood and energy, which, in turn, can alleviate IBS symptoms." Some IBS patients get stressed about having IBS, which causes a vicious cycle of symptoms. "Patients can spend all day wondering where the next bathroom is, or patients have trouble using the bathroom outside of their home, which can be anxiety-provoking, so it can feed on itself," she says. Anxiety and depression can worsen symptoms to a degree, so gastroenterologists will sometimes work with psychiatrists to prescribe an antidepressant, Dr. Rosen says.
And most importantly: "If you have symptoms, you shouldn't discount them," Dr. Rosen says. Whether or not you have IBS, your poop and your stress really matter and deserve to be taken seriously. They're the shit, just like you.

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