Even people who don't have IBD will get an upset stomach when stressed or nervous. That whole "butterflies in the stomach," and urgent need to "go" is actually pretty natural and normal. In fact, a gastroenterologist once told me that the gut is the center of the body and the gauge of our emotions. Even people without IBD or IBS, he told me, will have an increase in bowel movements and diarrhea when stressed.
So, throw a little IBD on top of the stress and what's a patient to do?
First, learn to recognize when the amount of stress entering your life is inordinate and excessive. I used to have a hard time realizing how much stress I was experiencing in a situation until the stressful situation had passed and my body reacted - usually badly with diarrhea and a wicked headache. But, by really tuning in and learning to "listen" to my body I can now realize my body's signs which tell me I am under a larger than normal amount of stress. Some signs I now recognize include:
1. my cheeks will get hot and flushed, almost as if I have a fever
2. I might feel lightheaded
3. I might feel queasy or nauseous
4. I can feel slightly claustrophobic, and if I don't get some control over the stress before it becomes overwhelming then...
5. I will end up with diarrhea and have to use the bathroom repeatedly (every 10 or 20 minutes).
I try not to get to #5. Instead, once I realize that I'm seriously stressed I try to combat it before it hits my gut. If the stress is coming from something that needs to be done I have finally learned how to delegate, all or some of the tasks, and to not feel guilty about it, or reorganize, or cancel plans, if needed. If it's a situational type of stress like having to get on an airplane or having a meeting in public I try to maintain as much control as possible. In the case of traveling by air - I gather together my iPod, books, magazines, reserve an aisle seat near the back of the plane where the bathroom is, eat a bland diet for a few days before I leave so as not to aggravate things, and do a little extra meditation and rhythmic breathing (for more information read Elizabeth's post on How to Travel Successfully with IBD). In the case of a lunch meeting or meeting at a client's office - I always drive my own car, arrive a few minutes early to identify the bathroom situation, never eat anything risky, and make sure I'm fully prepared for the meeting so there is no need for fear or apprehension to creep in.
Second, learn how to help yourself relax. When you get stressed or tense (as my dad calls it) do you know what helps you to calm down and feel more relaxed? Take a few minutes and think about this. . . maybe even wright down on a piece of paper three (3) things you can do that helps you to de-stress. It might be sitting outside in the sunshine for 10 minutes and breathing deeply; or listening to your favorite music; reading a book; taking a short or long walk; going for a jog; having a cup of tea; or working it out physically at the gym or on the tennis court. Some people even find visualizations helpful - for example, close your eyes, focus on the tension in your body and try to "see" where it is - your arm, your head, your stomach - and then use whatever means you want to get rid of it - take your hand and pretend to grab hold of the tension and throw it away, or stomp on it, whatever works for you to combat and release that stress from your body.
Learn what will help you to identify and then release your stress. Write down your options so that when you feel the stress or tension moving into your mind or your body you can go to your list and pick a way to combat it before it gets a firm grip and takes over.
Lastly, have trust in yourself and the fact that you can have control over your own life. The world we live in today is fast paced, never stopping, and stress seems to lurk around every corner. We have lists of things to get accomplished constantly running in our minds, we have to work, run the errands, chauffeur the kids, do the laundry, make dinner, be the referee, the caretaker, etc., etc. And it seems daunting and ridiculous to think that we can actually find any time in all of that to sit down and make a list of stress-reduction techniques, let alone actually find the time to use them to reduce our stress. But, you can. . . if you really want to. It took me a good long time before I realized that I could have some control over my life and that I didn't need to be ruled by stress and my feeling of always taking care of other people before I could take care of myself. I had to get good and sick and live in an IBD flare-up for nearly a year before I was sick enough and desperate enough to make the changes I needed to make to put myself first (don't wait until you get to that point yourself).
And you know what? I have put myself first and nobody behind me has suffered. They may have had to learn that my life has become re-prioritized, and that I can't do everything for everyone anymore. But, overall, I'm happier and as a result my husband and step-son are happier, my friendships are stronger, and my work is better.
Getting a grip on stress can make you feel powerful in many aspects of your life. So, give yourself some control over your stress today.
You can read more of my tips and how I learned to cope with stress in my book, Living with IBD & IBS: A Personal Journey of Success - www.ibdandibs.com