Early research suggests stress may worsen Crohn’s disease by increasing gut inflammation and interfering with the gut biome.

Crohn’s disease is a type of inflammatory bowel disease (IBD) that triggers irritation and inflammation in the digestive tract, typically affecting the end of the small intestine and the beginning of the colon. This can lead to symptoms such as stomach pain, diarrhea, and reduced appetite.

When someone with Crohn’s disease experiences chronic stress, it can make the symptoms more complicated and difficult to identify. This is because stress itself can lead to gastrointestinal (GI) symptoms, and high stress levels can both trigger and worsen existing Crohn’s disease symptoms.

Recognizing and managing stress is an important part of Crohn’s disease care.

Stress alone doesn’t cause Crohn’s disease, but it can worsen symptoms in people who already have the condition. Having Crohn’s disease can also cause additional feelings of stress which may, in turn, exacerbate symptoms.

Crohn’s disease is considered an autoimmune condition, where the immune system mistakenly attacks the healthy tissues of the digestive tract. Evidence suggests that its development is likely due to a complex interplay of genetic, environmental, and immune-related factors.

Does stress worsen Crohn’s disease symptoms?

Chronic stress can trigger or worsen Crohn’s disease symptoms, such as abdominal pain, diarrhea, and food sensitivities. It can also lead to an increased risk of mental health issues like anxiety and depression.

Signs your Crohn’s symptoms are getting worse may include:

  • increased abdominal pain
  • diarrhea
  • blood in the stool (rectal bleeding)
  • weight loss
  • fatigue
  • reduced appetite
  • fever
  • joint pain and swelling
  • skin problems (such as erythema nodosum or pyoderma gangrenosum)
  • changes in bowel habits
  • nutritional deficiencies
  • complications (strictures, fistulas, abscesses)

Animal research suggests that stress can contribute to a Crohn’s disease flare-up through several mechanisms:

  • Heightened inflammation: Stress triggers changes in hormones and the immune system, making your body’s defense system more active and causing more inflammation in your gut. This is especially problematic in Crohn’s disease, where inflammation is already the central problem. Stress can make this inflammation worse, leading to more severe symptoms.
  • Gut microbiome imbalance: The gut houses many different types of microorganisms, including helpful bacteria. When you’re stressed, this balance of microbes can get disrupted, which can make inflammation in Crohn’s disease worse.
  • Brain structural changes: Crohn’s disease may not be limited to the gut. For instance, early research has shown Crohn’s disease participants have different brain structures compared to non-Crohn’s participants. These structural differences might be related to stress and contribute to the development of anxiety and depression in individuals with Crohn’s disease.

Here are some tips for managing stress with Crohn’s disease:

  • Deep breathing: Practice deep, diaphragmatic breathing to help calm your body’s stress response. Focus on slow, deep breaths to signal your body to shift into relaxation mode.
  • Plan ahead: When going out, locate restrooms in advance, carry necessary supplies, and have an emergency plan to reduce anxiety about flare-ups.
  • Regular exercise: Engage in regular physical activity, which can release endorphins, improve mood, and reduce stress.
  • Mindfulness meditation: Dedicate a few minutes each day to mindfulness meditation. There are many apps and guided meditations available to help you get started.
  • Boundary-setting: Identify stressors in your life and determine whether you can reduce them or change the way you interact with them.
  • Consistent self-care: Maintain a healthy lifestyle by prioritizing exercise, adequate sleep, and a balanced diet. These habits are necessary for both physical and mental well-being.
  • Stress reduction techniques: Explore stress reduction techniques like yoga, progressive muscle relaxation, or tai chi. Find one that resonates with you and practice it regularly.
  • Time management: Organize and prioritize your tasks and responsibilities to reduce the feeling of being overwhelmed.
  • Medication adherence: Stay consistent with your prescribed medications because missing doses can worsen your symptoms. Consider using pill organizers or reminders to help you remember.

Early research has shown a possible association between stress and Crohn’s disease, and animal studies have shown an association between stress and increased gut inflammation and gut biome imbalance.

There may also be an association with Crohn’s disease and altered brain function. However, more research is needed to confirm these results.

If you have Crohn’s disease, recognizing and managing stress is important for improving your condition as well as your overall well-being. Don’t hesitate to reach out to a healthcare professional to explore techniques and treatments for reducing stress.