The vast majority of medical experts still do not fully understand irritable bowel disease. While most healthcare providers recognize its indications with relative ease, many continue to make great, even excessive efforts to rule out specific and better-defined digestive ailments before diagnosing their patients with IBS.
Even genuinely caring practitioners are often reluctant to cite IBS as a diagnosis. For a long time it has been considered an umbrella diagnosis used to appease patients with no observable illness; or those who refuse to accept the diagnosis that nothing is wrong.
Fortunately, this attitude has begun to change. New medical research, along with pressure from the alternative health and holistic community, has created awareness of this very real condition. This is a win-win. Doctors can acknowledge IBS, and patients who had not previously been taken seriously can get the medical attention they need and deserve.
However, even though it’s now recognized as a legitimate condition, the underlying causes still elude health experts. Most knowledgeable digestive health specialists agree on a multifaceted cause. Identifying the individual factors remains difficult, and is a matter for continued research.
That said, new insights into the origin of the condition are being made with increasing regularity.
Early Life Trauma as a Predictor of IBS
A recent study presented by researchers with the Mayo Clinic suggests the compound effect of psychological trauma over the course of a lifetime may be a significant contributor to the development of irritable bowel syndrome. While previous studies linked IBS and its painful flare-ups to generalized day-to-day stress, the strong correlation between the longer lasting stress of actual psychological trauma and the condition still came as a surprise to many experts. Upwards of 50 percent of patients with IBS were found to also have suffered physical, emotional or sexual abuse either as children or adults. 
A University of California study supports the association between early adverse life event trauma and IBS. IBS patients reported a statistically higher incidence of general trauma, emotional abuse, physical punishment and sexual “events” compared to the control group. An interesting yet troubling outcome of this study was that traumas occurred most frequently in women. 
PTSD, Sexual Trauma, and IBS
A review of trauma history among women veterans identified one in three suffers from IBS. This figure correlates closely to the percentage of women reporting trauma from a sexual assault while serving. The study also noted IBS occurred most often in individuals suffering from PTSD and depression. The physical and sexual traumas experienced by these women is independently associated with a higher risk of IBS. 
Combat and High-Pressure Training Increases IBS Risk
Thirty-seven male soldiers were tested during the fourth week of combat training. Researchers found the continued stresses and anxiety of combat training aggravated gastrointestinal symptoms associated with IBS, inflammatory immune activation and also increased permeability of the intestines.  Considering these effects occurred in only four weeks, the impacts of continued stress and life traumas provide a strong association with IBS.
Chronic Stress Linked to IBS
One study has evaluated the relation of chronic stress to IBS in one of the more high-pressure environments… medical school. This study examined 597 medical students and interns through an anonymous questionnaire. Among these students, IBS occurred nearly 32% of the time. IBS occurred most often in female students; and being female was a first predictor for IBS. High anxiety proved the next indicator associated with IBS occurrence. 
A German study compared University students with IBS symptoms to those without IBS symptoms. The students with the IBS symptoms had elevated levels of anxiety and chronic stress. “Work overload” and “social tension” appeared frequently on the responses from the students suffering from IBS.  Apparently, it’s not just a “medical school thing”.
The Other Side: Alleviating IBS
So far we’ve looked at the correlations of individuals under great stress and the likelihood of IBS. One study decided to take the opposite approach. If individuals had IBS, could they improve their symptoms through stress reduction?
Sixty-nine IBS patients were divided into two groups: a treatment group and a control group. This treatment group underwent psychological therapy and relaxation techniques. The group receiving treatment experienced symptom improvement, sensitivity and depression which continued through to the three month follow-up. The greatest improvements occurred for individuals identifying the lowest quality of life. 
You Don’t Need to Suffer
These studies continue to build the case for the relationship between trauma, stress and IBS. The more we discover, the more questions remain. While the connection appears clear, research continues to explore specific factors and the role they may play in the occurrence and severity of IBS.
Do you have stress-related IBS? What measures have you found beneficial to deal with it? Please leave a comment below and share your story with us.
-Dr. Edward F. Group III, DC, ND, DACBN, DCBCN, DABFM
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