“Stress is well known for exacerbating inflammatory bowel disease [IBD] symptoms,” says Jordan Axelrad, MD, MPH, an assistant professor of medicine at NYU’s Grossman School of Medicine and a gastroenterologist at NYU Langone Health’s Inflammatory Bowel Disease Center in New York City. “My patients always tell me that their symptoms feel worse when they’re stressed.” The main treatment for ulcerative colitis is medication to treat inflammation, including aminosalicylates, corticosteroids, and immune system suppressors. But lowering your stress levels could also help relieve some of your discomfort. Here are six ways to manage stress if you have colitis. Yoga classes are offered at many local gyms and recreational centers, as well as on YouTube and in Apple and Android apps.
2. Take Some Deep Breaths to Calm Your Gut
Breathing deeply can help reduce UC gut pain and cramping, says Sara Kinsinger, PhD, director of behavioral medicine for the digestive health program at Loyola University Health System in Maywood, Illinois. “Deep breathing elicits a parasympathetic relaxation response that physiologically helps the body relax by increasing blood flow and oxygen to the gut,” she says. Experiment with different deep breathing techniques, including diaphragmatic breathing and alternate nostril breathing, to learn what helps you relax.
3. Try Hypnotherapy to Prolong Clinical Remission
Hypnotherapy uses guided meditation and concentration to achieve a heightened state of awareness. “Gut-directed hypnotherapy can influence gut secretions, reduce pain, and prolong remission in those with UC,” says Dr. Kinsinger. A review published in June 2020 in The American Journal of Gastroenterology notes that while hypnotherapy may not relieve symptoms of UC, it may help improve your quality of life by reducing stress. “Go to a trained professional to receive hypnotherapy,” says Lilani Perera, MD, a gastroenterologist with Advocate Aurora Health in Grafton, Wisconsin. Adopting smart sleep habits can help you snooze sounder and keep UC symptoms at bay. Start by sticking to a consistent sleep-wake cycle and avoiding caffeine, bright lights, and screens before bedtime.
5. Exercise to Reduce Inflammation
A study published in June 2019 in the journal Acta Clinica Croatica found that moderate exercise is beneficial for people with IBD because it can improve quality of life and reduce disease activity. People with IBD “tend to avoid physical activity because of their abdominal pain or other discomfort,” says Dr. Axelrad. “However, I encourage them to push through, because physical activity can improve fatigue and some disease activity.” Crohn’s and Colitis UK advises against strenuous activity, though, since intense exercise has been shown to exacerbate inflammatory symptoms. If you want to start a fitness regimen, consider taking up brisk walking, cycling, swimming, or a sport such as soccer or tennis.
6. Try CBT to Cope With Life’s Stresses
Axelrad suggests trying cognitive behavioral therapy (CBT), which can help alleviate some of the negative thoughts and feelings you may have about your disease. Doing so can help ease IBD-related stress and improve your quality of life. In its 2019 guidelines, published in the journal Gut, the British Society of Gastroenterology recommended CBT be offered to people with IBD to help them cope with feelings such as anxiety and improve their symptoms. “It is important that [people with UC] meet with a psychologist at least once to address stress and [the] psychological impact of the disease,” says Dr. Perera. “We strongly recommend integrated care, including CBT, to address psychological needs in IBD.”
