How to live with IBD especially during the Holidays

             Irritable Bowel Disease (IBD) is a disorder that involves chronic inflammation of the tissues in the digestive tract. However, there are two classifications of IBD, Ulcerative colitis (UC) and Crohn’s Disease (CD). Ulcerative colitis involves inflammation and sores along the lining of the large intestine, while Crohn’s disease is inflammation of the lining of the of the digestive tract and mostly affects the small intestine. IBD symptoms depend on the severity of the inflammation present and where it occurs, however symptoms include diarrhea, fatigue, abdominal pain and cramping, blood in the stool, reduced appetite, and weight loss. Although the exact cause of IBD is unknown, it is suggested that diet and stress play a vital role in the aggravation of IBD, not exactly the actual cause.

              Knowingly, stress in a way directly aggravates the dreadful pain that comes with being diagnosed with IBD. This is because stress directly affects the gut-brain-axis. Now, you may wonder what exactly induces this stress during the holiday season when one should be particularly joyful. Well, for individuals diagnosed with IBD, stress usually arises during family gatherings when there is no accommodation for dietary needs and let’s not forget family chaos that may occur during the festive holidays. Pain associated with stress is demonstrated to change the gut microbiome according to Tiffany Taft, a research associate professor of medicine for the Gastroenterology and Hepatology division at Northwestern University Feinberg School of Medicine. The pain would usually be brought on because an individual with IBD rather “suck it up” and eat foods they know will cause them to feel sick, instead of asking for a change in the holiday food menu. This leads to the overall steaming question well how individuals can live with IBD as the holidays approach. Studies have suggested that stress can amplify pain which then alters the motility of the gut in different ways that can either speed up or slow down, while also changing the composition of the gut microbiome. This would usually result in frequent bathroom trips, while for others it may increase stomach pain and bloating.

              So, how can individuals with IBD make it through the holly jolly season? A recent study suggests that cognitive behavioral therapy, mindfulness, and hypnotherapy can be beneficial. For many gastroenterology doctors a registered dietician isn’t usually available on staff their doctors have found a new way to fill in the gap through an app. It is known that some apps are FDA approved and require a doctor’s prescription, while other apps could be downloaded on your own. Suzanne Smith, a nurse practitioner from UCLA’s Integrative Digestive Health and Wellness program suggests that the gut-brain-axis is disrupted prompting “ the brain and the gut to be sync and communicating, however it’s almost as if the brain is misinterpreting the signal.” Studies have suggested that “quieting” the nervous system with mindfulness and relaxation techniques may be the key to limit the anxiety and “halt” the feedback loop which cause the unpleasant feelings that are luminated by IBD. In a study that was conducted in 2020, an 8-week Mindfulness Based Stress Reduction course resulted in “71% of patients” having improved GI symptoms. Another route of treatment was hypnosis which helped “quiet the nervous system.” The Meta Me and Nerva App, both which could be accessed without a prescription resulted in a “70% improvement in symptoms” for patients using the Nerva App. This hypnosis technique included a combination of relaxation to help “reset communication between the gut and the brain.” During this technique what usually occurs is that long, slow breaths are taken to help activate the parasympathetic nervous system (PNS) followed by a body scan. A voice over then communicates with the patient while guiding patients into an apothecary personalized to scents chosen by the patient. These therapeutic strategies may be a lead treatment in helping reduce the anxiety brought on by symptoms of IBD, especially during a stressful time in the year in which could be a joyful or less anxious time of the year. A route worth looking into is how to accommodate individuals who don’t have access to health care within this study as it pertains to how socio-economic status plays a huge role in the progression of a more holistic approach of practicing medicine especially during the holidays.

1.     Aubrey, Allison. “For Stomach Pain and Other IBS Symptoms, New Apps Can Bring Relief.” NPR, NPR, 16 Oct. 2022, https://www.npr.org/sections/health-shots/2022/10/16/1129325699/ibs-irritable-bowel-syndrome-symptoms-treatment.

2.     “Inflammatory Bowel Disease (IBD).” Mayo Clinic, Mayo Foundation for Medical Education and Research, 3 Sept. 2022, https://www.mayoclinic.org/diseases-conditions/inflammatory-bowel-disease/symptoms-causes/syc-20353315.

3.     November 21, 2022 | By Win Reynolds. “How People Living with IBS Can Stomach the Holidays.” Northwestern Now, 18 Nov. 2022, https://news.northwestern.edu/stories/2022/11/ibs-stress-stomach-the-holidays/.