Stress & Flares: An Epiphany

Hey there,

I've decided, based solely on my own experience with flares: stress is HIGHLY correlated with flares. Is it the CAUSE of our flares? Is it the CAUSE of IBD? Well, doctors like to tell us our "overactive immune system" due to "invading virus or bacterium," "genetics," "environmental factors." Or that they don't really know or that it's all of these factors in one big combo pack. Well I can tell you, every flare I've had since I was diagnosed in 2006 started around a very stressful time. My first flare, when I had no idea what was going on, started around when I was telling my friends and family I was gay. Talk about STRESS! Then every single subsequent flare I can pinpoint the above average stress I was enduring.

"What does this all even mean," you ask? "This is your own experience, you are NOT a doctor," and "We've heard this all before." Well, all of that is very true. But what I am suddenly realizing, like poof!, is that GI's don't give a crap about stress. At least mine don't. They don't talk about stress, they don't talk about diet. I BEG them to listen to me talk about how my flares happen around stressful times and what do they say? "Well reducing stress is good for your overall health," and then look at their watches: "Oops! Well would ya look at the time?!" And then just increase my prednisone, they double my injections, they put less time between infusions. How BORING!

When is GI going to listen and say yes, we believe stress (and likely diet but that's a different post altogether) is an enormous contributing factor to your flares (and to many people's flares) so while we have you on this X injection or Y infusion or Z pills, we also want to spend the other HALF of our energy teaching you and your body to metabolize stress in a healthy way. This way, we can seek to INCREASE the time between your flares and INCREASE your length of remission. They likely won't say this. They are not trained in this way. They have too many patients and cannot spend too much time LISTENING to one (me) complain about stress: "That's the job of a therapist but oh wait, your insurance doesn't cover mental health." LOL.

So what's the plan here? What's the plan for me and for many (not all) who realize that we have trouble processing anxiety and stress through the complicated and nuanced systems of our minds and bodies and it screams at our colons to ulcerate? I'm still figuring it out. I know I can't rely gastroenterology for that part, that's for sure. Is it functional medicine? Is it a psychiatrist who specializes in IBD? Does that even exist? When will the clinical guidance of the AGA include a HUGE section on talking to patients about stress: "Do you find yourself stressed around the start of flares? Well you must then be this type of IBD patient and boy do we have a plan for you! <3 <3 <3"

Is that just a dream? Do I sound stressed? Should I just inject my belly and stop talking?

In 11 years of this, my flares have always correlated with major stress (well, and occasionally with other illness/antibiotics, situations that bring their own stress). My GI sort of nods along but doesn't have time to process the stress with me (nor does he believe diet or probiotics make a difference).

Things I've found helpful: gentle exercise (walking and very low key yoga); talk therapy and tapping (which seems like NONSENSE but has some research to back it up); physical therapy/massage for other body pain that causes tension in my body overall; acupuncture for inflammation and stress.

The hard part is that doctors who say "manage your stress" sometimes make me feel like it's all my fault. I can't help external stressors: I have a demanding job, young kids, am far from family, living during a long pandemic in a strained public healthcare system that makes it hard to access primary care, etc. So I put some of my energy into working toward advocating for bigger systemic changes, too.

But yes, I think stress plays a HUGE role, and yes, so much of the management of stress (including seeking and paying for stress-relieving paramedical services) falls onto us as individuals.

My trigger is stress for sure, in fact my GI has joked that she absolutely forbids me from being stressed 🙃
She doesn't believe in food being a trigger though and for me this is also true, food makes not difference to me, good or bad.

Stress increases metabolic oxidation in the body, which leads to excess hydrogen peroxide release into the colon wall, which is likely the root cause of UC.

stress might trigger or exacerbate a flare but it's not the reason you have UC... otherwise everyone on the planet would have UC

most health conditions are made worse by stress

Here are some factors.
oldmike
https://www.ncbi.nlm.nih.gov/pmc/articles/pmc6821654/#:~:text=chronic%20stress%20can%20cause%20excessive,production%20of%20poisons%20(87).

I don't know if stress causes IBD, but I know it causes my flares.
GI docs should start with a prescription for therapy or at least mindfulness...

That's it. I'm starting a 30-day mindfulness challenge today. For real this time!
(I've been starting "tomorrow" for 2 weeks. HA)

You cannot go through life without stress.

Everyone has stress in their lives but not everyone gets IBD.

You can always learn techniques to better manage stress but never eliminate it completely (and if you did you'd probably get stressed from the lack of stress).

And then if you did eliminate it you could still flare from food poisoning, antibiotics, etc.

I was practising yoga 5-6 times a week when I got IBD. Lots of illness blaming and shaming in that community too.

Life is exhausting (and stressful) when you are constantly analysing or avoiding doing X Y Z for fear of a flare.

Just live your life.

Post Edited (poopydoop) : 4/15/2022 1:40:22 AM (GMT-6)

damo123, that is an outstanding argument and reply on the matter. Thanks for posting this.

I NEVER said stress has nothing to do with UC.

Stop putting a spin on my posts that isn't there.

I said that stress does not CAUSE UC otherwise everyone on the planet would have UC.

I said you can learn techniques to manage stress but never eliminate it.

Do you think refugees/war victims/etc will feel fine if they just learn to manage stress?

Are you supposed to feel nothing if someone you care about is sick or in danger?

It's allowed to have feelings and it doesn't help to blame yourself (or others) for feeling natural responses to stressors.