How Chronic Stress Causes IBS (And How To Heal From Both)

Can IBS be caused by stress?

Chronic stress can contribute to digestive problems like bloating, constipation, or diarrhea through the gut-brain axis, a communication network between the nervous system, immune system, and the trillions of bacteria living in your intestines (called the microbiome).

When stress becomes chronic from overwork, caregiving, or just managing everything life throws at you, your body goes into protective mode. Your brain keeps signaling your adrenal glands to pump out cortisol. Your sympathetic nervous system stays on high alert. And your gut responds: motility speeds up or slows down (hello, diarrhea or constipation), sensitivity increases (cue the pain, bloating, and urgency), the intestinal barrier breaks down, and beneficial bacteria decline while inflammatory species take over.

This creates a feedback loop. Stress disrupts the gut. A disrupted gut sends stress signals back to the brain. Over time, neither system can function properly anymore. If this process goes on long enough, it can lead to the development of Irritable Bowel Syndrome (IBS), a chronic functional disorder of the digestive system that can manifest as stress induced bloating, diarrhea, or constipation.

A 2020 study found that burnout, but not general job strain, was specifically associated with IBS in working adults, reinforcing that it is the emotional toll of chronic stress (not just workload) that disrupts the gut-brain axis. So if you're asking "can IBS be caused from stress?" the answer is yes.

Understanding this feedback loop between the nervous system and gut microbiome explains why many of the treatments for burnout just don't seem to work. Most burnout recovery focuses on the mental side: therapy, meditation, boundary-setting. Those things help, but they don't fix what's broken in your body. If you want to actually recover, you need to rebuild the systems that stress has damaged. The gut is one of them.

Women experience both burnout and digestive issues at higher rates, and their stress-gut connection tends to be more reactive. Here's why.

Why Women Are More Susceptible to Burnout and to IBS

Burnout, chronic stress, and gut problems overlap more often in women. Research consistently shows that women are more likely to experience both chronic stress and irritable bowel symptoms, and they often experience them together. The reasons for this are both cultural (women often have more demands placed on them), and biological.

Women's nervous systems respond to stress more intensely and stay activated longer than men's, especially under chronic conditions. The hypothalamic-pituitary-adrenal (HPA) axis, which controls cortisol release, tends to remain more active in women after a stressful event. That means prolonged exposure to inflammation, disrupted gut motility, and shifts in the microbiome. Hormones amplify this effect. Estrogen and progesterone modulate pain sensitivity, intestinal movement, and immune reactivity. This means that fluctuations across the menstrual cycle can increase gut sensitivity, change transit time, and alter microbial balance. That's why symptoms like bloating or irregular bowel movements often worsen right before or during a period.

Women are also up to twice as likely to be diagnosed with IBS compared to men. IBS is a disorder of the gut-brain-immune axis, and in women, that axis is more reactive. Women with IBS tend to have higher visceral sensitivity (more pain from the same gut stimuli), increased intestinal permeability under stress, and greater shifts in gut bacteria due to hormonal and immune fluctuations. For many women, what starts as stress or overwork becomes a whole-body experience: unpredictable bowel movements, new food sensitivities, chronic bloating.

The gut and brain communicate constantly through the gut-brain axis, a network mediated by the vagus nerve, the immune system, and the trillions of bacteria living in the intestinal tract. When the microbiome is healthy, it helps regulate cortisol levels, inflammatory signaling, neurotransmitter production (including serotonin and GABA), and vagal tone, which keeps the nervous system adaptable under stress. But chronic stress disrupts this system. It lowers microbial diversity, increases inflammatory bacteria, and impairs gut barrier function. The result is more inflammation, more sensitivity, and less capacity to recover. A damaged gut keeps the body stuck in a state of burnout.

Specific bacterial strains are associated with greater psychological resilience. People with higher levels of Lactobacillus, Bifidobacterium, and Akkermansia species tend to show lower stress reactivity, better emotional regulation, and reduced symptoms of anxiety and depression. These microbes interact with immune cells, produce short-chain fatty acids like butyrate, and send signals directly to the brain. A healthy microbiome helps modulate the very systems that burnout disrupts. Without restoring this microbial ecosystem, mental and physical resilience remains compromised.

This creates the feedback loop of stress causing gut symptoms, which in turn increase stress. For women, whose nervous systems may already respond more strongly to stressors, this cycle can become entrenched. That's why so many high-performing women who push through burnout find themselves not just exhausted, but also bloated, inflamed, and unable to tolerate foods they used to eat without issue.

Fortunately, there are solutions to burnout, IBS, and stress induced digestive problems. Resetting the microbiome can relieve all of these symptoms while also restoring the body's ability to tolerate stress, improving sleep, supporting hormone balance, and reducing systemic inflammation.

East Asian Medicine offers a precise way to do this through herbal formulas, acupuncture, and breathwork, time tested therapies that can restore stress resilience.

Rewiring the Brain Gut Axis with Chinese Herbal Medicine

Chronic stress and burnout reshape the gut environment: depleting beneficial species, inflaming the intestinal lining, and altering communication with the brain. Probiotics offer reinforcements, but if the terrain remains hostile, those reinforcements struggle to survive or establish themselves.

Traditional Chinese Medicine (TCM) herbal formulas work differently. They change the terrain itself by nourishing the intestinal lining, reducing inflammation, shifting microbial populations, and recalibrating gut-brain signaling. Below are three examples of TCM formulas studied for their effects on the microbiome that can help with recovery from burnout and stress induced digestive problems:

Soothing Chronic Stress with Xiao Yao San

Used for centuries to treat emotional distress accompanied by digestive symptoms, Xiao Yao San (逍遙散) has been shown to directly modulate gut bacteria associated with both inflammation and depression.

A 2025 study shows that Xiao Yao San reduces Desulfovibrio (linked to gut inflammation, IBS, and depression), Parasutterella (associated with metabolic and mood disorders), and Lachnoclostridium and Erysipelatoclostridium (both pro-inflammatory). At the same time, Xiao Yao San increases Dubosiella (a short-chain fatty acid producer that improves gut lining and immune balance), Akkermansia (linked to mucosal repair and metabolic health), and Alloprevotella (supports anti-inflammatory gut signaling).

The ability of Xiao Yao San to reshape the gut microbiome in beneficial ways accounts for its ability to alleviate depression, stress and digestive problems by regulating the brain gut axis.

Tong Xie Yao Fang: For Diarrhea-Predominant IBS

Tong Xie Yao Fang (痛瀉要方) is a formula traditionally used for stress-induced diarrhea, urgency, or abdominal cramping. In research, Tong Xie Yao Fang has demonstrated effects on key microbial players, increasing Akkermansia (which supports mucin layers and intestinal barrier function, healing and preventing "leaky gut") while decreasing Clostridium (linked to excess bile acid and excess serotonin production in the colon). The formula also contains herbs like Bai Zhu (白術 Rhizoma Atractylodis Macrocephalae), which increase Lactobacillus and Bifidobacterium, important species that have been linked to better gut health and better mental health.

Rebuilding the Gut Microbiome with Si Jun Zi Tang

When the gut has been depleted by antibiotics, restrictive diets, or long-term stress, TCM turns to tonifying formulas like Si Jun Zi Tang (四君子湯), which can improve the functioning of the digestive system and treat chronic fatigue. This formula has been shown to increases Bifidobacterium pseudolongum, Lactobacillus johnsonii, and Akkermansia—species linked to improved immune regulation, barrier integrity, and neurotransmitter modulation. Si Jun Zi Tang also lowers Colibacillus, a bacterial group that contributes to inflammation and loose stools. When this is the right formula, better digestion, more energy, and increased resilience to stress are the results.

Personalized TCM Herbal Medicine For Stress and IBS

The three formulas listed here are examples, not universal protocols, and they will not work for everyone. East Asian Medicine works by tailoring treatment to the specific pattern and presentation of each person. There are hundreds of TCM herbal combinations, and the appropriate formula depends on your the unique makeup of your gut microbiome, the state of your nervous system, and your specific symptoms. If you're interested in exploring TCM herbal medicine for digestive problems, IBS, burnout, stress, or any chronic condition, you should seek out a qualified TCM practitioner, or an AI-assisted self-care tool such as Klaros.

Acupuncture & Qigong for Chronic Stress and IBS

The effects of TCM herbal formulas on the gut microbiome are enhanced by combining them with acupuncture, breathwork (or qigong 氣功), or both to regulate the nervous system.

Acupuncture works by directly stimulating the nervous system to shift the body out of chronic stress response. Studies show that acupuncture activates brain regions involved in autonomic regulation and pain processing, promoting parasympathetic tone and stabilizing gut motility.

Research also shows that acupuncture can increase levels of beneficial short-chain fatty acids (SCFAs) like butyrate, which support gut lining integrity and reduce inflammation. Acupuncture also normalizes microbial diversity in cases of both constipation and inflammatory bowel conditions.

Qigong offers a sustainable, self-directed way to reinforce the gut-brain reset. As a practice of breath and mindful movement, Qigong calms the hypothalamic-pituitary-adrenal (HPA) axis and helps recondition the nervous system's response to stress.

Research demonstrates that Qigong reduces symptoms of depression and anxiety, lowers cortisol, and improves somatic regulation. For patients recovering from burnout, this somatic retraining can be essential for re-establishing digestive rhythm and nervous system resilience.

Combining all three modalities (TCM herbal medicine, breathwork, and acupuncture) offers the most robust outcomes for patients. Herbs rebuild terrain, acupuncture resets neuroimmune signaling, and Qigong retrains the stress response. Together, they address the microbiome, nervous system, and immune balance from multiple angles, creating the conditions for lasting recovery from burnout and gut problems.

How to Recover From Burnout, Chronic Stress and IBS

Burnout and digestive dysfunction are both manifestations of a dysregulated brain-gut axis. The way to recovery involves restoring the gut microbiome and resetting the nervous system to increase resilience.

East Asian Medicine offers a precise, systemic approach to recovery from digestive problems and burnout. Herbal formulas regulate specific bacterial populations. Acupuncture protocols restore vagal tone and reduce gut inflammation. Breathwork therapies like Qigong retrain nervous system responses to stress. Together, these interventions interrupt the loop that keeps burnout and IBS in place.

If you've been stuck between flare ups of stress, fatigue, and frustration and are tired of trying supplements and restrictive diets, East Asian Medicine offers an effective alternative approach to chronic stress and digestive issues, one that is rooted in centuries of tradition and decades of modern research.

Medical Disclaimer

The information provided in this article is for educational purposes only and is not intended to diagnose, treat, cure, or prevent any disease. It should not be interpreted as medical advice or a substitute for individualized care from a qualified healthcare professional. Always consult your licensed practitioner before making any changes to your health regimen.

About the Author

Dr. Joshua Park, DSOM, L.Ac

Dr. Park is a licensed acupuncturist with a doctorate in East Asian Medicine, specializing in gut health and burnout recovery for women. He is the clinical director of Empowered You Acupuncture in Orange County, California, and is an adjunct professor at Virginia University of Integrative Medicine. His clinical approach combines classical Chinese herbal formulas with current research on the gut microbiome to help patients recover from digestive problems and chronic stress.

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