IBS and the Highly Sensitive Person (Part 1)
How’s your #digestion? More specifically, are you #constipated like most women? Or do you have to run to the bathroom after eating certain foods like many of my clients?
Does your wardrobe currently consist of mostly stretchy pants?
Are you #bloated no matter what you eat? Or when?
I feel you, girl. I’ve been there.
Tummy troubles are the worst. Most of my clients struggle with #gut dysfunction on some level. Even if the issues don’t manifest as pain, if we run a GI Map, we find gut imbalance 100% of the time.
The microbiome is a strange and wonderful place. It’s only recently been discovered and studied (in the scientific grand scheme of things), and so new research is coming out all of the time. I like to study this stuff. It’s helpful for me and helpful for my clients.
I have to write a lot of papers for my master’s classes. I am probably weird, but I enjoy them. Multiple choice tests make me all sweaty. But research and writing is almost fun for me. I’ll take PubMed and Chai any day over Netflix and Chill.
One of the papers I had to research lately was on the gut. Specifically, IBS. IBS, or Irritable Bowel Syndrome, is a gastrointestinal disorder that causes abdominal pain, bloating, constipation, and diarrhea.
Why, I wondered, do so many women have IBS?
Women are created to be nurturers and caregivers, I believe. I also believe that women are stretched to the max these days, unable to perform our God-given jobs as nurturers and caregivers because we all have to be wage earners, homeschool teachers, and professionals. We can’t focus on the things that we know will inherently provide some earthly fulfillment (caring for others, raising children, keeping a home, nurturing relationships) and so we force ourselves into little boxes of work and life and despair quietly inside because it is never enough.
I know there are those who will disagree with me, and I respect that. I write this blog, and these are my opinions. I am not looking to start conflict, I only want to report on what I observe in the hundreds of women I have worked with and what I see in my own relationships. I also know that there are women who desire deeply to fulfill their drive to nurture, and are unable to due to life circumstances. And to you, I send hugs.
With that aside, I recently hypothesized that:
- This crazy, fast-paced, results-driven life create the persona of a Highly Sensitive Person
- Women have a greater tendency to be a Highly Sensitive Person
- IBS may be more prevalent in a Highly Sensitive Person
- Therefore, this could be a reason so many women have IBS
Are you a Highly Sensitive Person? Take the quiz here to find out.
Before we begin, the good news is that you can become less sensitive as your circumstances change. I have seen many a woman’s IBS simply disappear as she begins to properly nourish herself and manage her stress levels well.
The research certainly supports this, and I will share a little with you. Over the next few weeks, we will talk about the tummy a little bit more. Chime in and let me know what you think.
Irritable Bowel Syndrome As It Pertains to Highly Sensitive Persons
Irritable Bowel Syndrome is a functional disorder of the lower gastrointestinal tract that presents with abdominal pain and discomfort, changes in bowel habits (constipation and/or diarrhea), and changes in form and frequency of stool (1). The purpose of this review is to determine whether Highly Sensitive People are more susceptible to the effects of Irritable Bowel Syndrome (IBS). Highly Sensitive People (HSP) appear to notice more subtle differences in smells, tastes, colors, sounds, textures, heat, cold, pain, hunger, and the effects of medications and substances. They also have “the ability to quickly identify people’s emotional state and experience both pleasant and unpleasant emotions with intensity (1). Both personality traits and patterns of emotions affect autonomic, immune, inflammatory, and endocrine function, and these can contribute to the incidence of IBS in patients. Several studies have found that nearly one fifth of the population can be classified as highly sensitive people (2). IBS is a frequently diagnosed condition that has an estimated US prevalence of 10-15% (p. 261). The numbers, while not completely linear, suggest a correlation. I believe there is a strong link between HSP and IBS sufferers.
IBS is not associated with any actual anatomical irregularities. It instead is a problem with the HPA Axis. The HPA Axis is the term used to describe the complex association in communication among the hypothalamus, pituitary, and adrenal glands. When the hypothalamus and pituitary sense an incoming stressful event, the adrenal glands are stimulated to produce first adrenaline and then cortisol. These two stress hormones bolster the body to deal with the stressors that are perceived imminent. As IBS is not associated with any physical, structural anomalies, it could be argued that truly, IBS is “all in the head”. This is not a dismissive statement; both the hypothalamus and pituitary are housed in the cranial cavity. With IBS having perhaps a strong mental and emotional component, it would make sense that people who naturally are more susceptible to stressors would have correspondingly more susceptibility to IBS. This is not to negate the fact that there are indeed physical aspects to the disease. Namely, dietary intolerance, low grade inflammation and altered gut immune activation, intestinal permeability and alternation of the microbiome, and abnormalities in the autonomic nervous system (1).
Physical Stress Markers of Perceived Mental Stress
The literature backs up this hypothesis. In one study published in 2003, Dickhaus et al performed an experiment on 15 IBS patients and 14 healthy controls. Inclusion/ exclusion criteria were diagnosed Irritable Bowel Syndrome for the experimental group and no diagnosed IBS for the control group. Patients were subjected to either a mild stress condition of listening to two competing types of music or a control condition of relaxing nature sounds. Rectal balloons were inserted into the anuses of the patients and distended during the stress condition and the control condition. Outcomes measured were “intensity and unpleasantness of the visceral sensations, subjective emotional responses, heart rate, and neuroendocrine measures (norepinephrine, cortisol, adrenocorticotropic hormone [ACTH], and prolactin) were obtained during the study (3). The study resulted in IBS patients reporting more unpleasantness during the stress condition as opposed to the control condition. IBS patients reported greater ratings of anger, anxiety, and stress during the stress condition. Healthy controls reported nonsignificant subject measures on all accounts. Therefore, the researchers found that there is indeed an altered stress response in IBS patients. Limitations of this review were a small sample size and a rather odd way of inducing a physical stress response. As IBS symptoms seem to occur more with food choices, I would have had the patients eat a stomach-upsetting food like raw broccoli or onion and then measured stress response to the music.
If you’re still with me, thanks. What do you think? Are you a Highly Sensitive Person? Do you have tummy issues? Head over to FB and let’s talk about it.