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Does stress cause Crohn’s and colitis flares? Here’s what the research says…

Does stress cause Crohn’s and colitis flares? Here’s what the research says…

Updated on
November 12, 2023
Medical reviewer
Medically reviewed by
Brittany Rogers, MS, RDN
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Written by
Romanwell Dietitians

Have you ever noticed an increase in symptoms after a stressful event? If so, you’re not alone.

Many people with Crohn’s disease or ulcerative colitis report an increase in symptoms surrounding a stressful event or situation in their lives. But what does the research say about the connection between stress and symptoms? 

In this article, we summarize the research on stress and IBD and share some tips for how you can reduce your stress, symptoms and likelihood of flares.

What is a Crohn’s disease or ulcerative colitis flare?

A flare or flare-up is when you have an increase in symptoms. Flares can occur when you have active disease (also referred to as active inflammation), or when you’re in remission without inflammation. 

Can stress cause a Crohn’s or colitis flare up?

In a recent study of 417 people with IBD, people who experienced a life event in the previous 3 months were 1.8x more likely to flare than those who did not experience a life event. Similarly, people who experienced new perceived stress were 3x more likely to flare than those who didn’t experience new stressors.

Another study of 552 people with IBD found that people who had a high perceived stress level were 2.4x more likely to flare than those with lower perceived stress.

While more research is needed, it appears that high perceived stress, new sources of stress, and the occurrence of life events may increase your risk of having a Crohn’s or colitis flare.


How to reduce your stress levels

Addressing stress may help reduce your risk for flares. Some ways to reduce stress include:

How mindfulness-based therapy can improve IBD outcomes

Mindfulness-based therapy focuses on helping you be more mindful and aware of the present moment and bring more attention to your thoughts, bodily sensations, and emotions.

Examples of mindfulness-based therapy include:

  • Body scanning
  • Mindful breathing
  • Guided meditation
  • Thought management
  • Cognitive behavior therapy
  • Mindfulness-based stress reduction

Mindfulness-based activities have been suggested in research studies to

  • Significantly decrease fecal calprotectin and c-reactive protein levels
  • Double the odds of reporting better subjective wellbeing in Crohn’s disease
  • Decrease the occurrence of bowel symptoms in people with Crohn’s disease

Get support to reduce your stress

If you’re in the middle of a flare or have noticed that stress triggers your symptoms, working with an IBD registered dietitian and gut psychologist can help.

Our IBD nutrition program focuses on addressing both your food and lifestyle triggers and can help you decrease your risk for future flares. Request a free consultation to learn if our program is right for you.


We can help you reduce your symptoms without a restrictive diet
Pay as little as $0 per appointment with insurance
brittany rogers rd


  1. Wintjens DSJ, de Jong MJ, van der Meulen-de Jong AE, Romberg-Camps MJ, Becx MC, Maljaars JP, van Bodegraven AA, Mahmmod N, Markus T, Haans J, Masclee AAM, Winkens B, Jonkers DMAE, Pierik MJ. Novel Perceived Stress and Life Events Precede Flares of Inflammatory Bowel Disease: A Prospective 12-Month Follow-Up Study. J Crohns Colitis. 2019 Mar 30;13(4):410-416. doi: 10.1093/ecco-jcc/jjy177. PMID: 30371776.
  2. Bernstein CN, Singh S, Graff LA, Walker JR, Miller N, Cheang M. A prospective population-based study of triggers of symptomatic flares in IBD. Am J Gastroenterol. 2010 Sep;105(9):1994-2002. doi: 10.1038/ajg.2010.140. Epub 2010 Apr 6. PMID: 20372115.
  3. Naude C, Skvarc D, Knowles S, Russell L, Evans S, Mikocka-Walus A. The effectiveness of mindfulness-based interventions in inflammatory bowel disease: A Systematic Review & Meta-Analysis. J Psychosom Res. 2023 Jun;169:111232. doi: 10.1016/j.jpsychores.2023.111232. Epub 2023 Mar 14. PMID: 36990003.
  4. Gerbarg PL, Jacob VE, Stevens L, Bosworth BP, Chabouni F, DeFilippis EM, Warren R, Trivellas M, Patel PV, Webb CD, Harbus MD, Christos PJ, Brown RP, Scherl EJ. The Effect of Breathing, Movement, and Meditation on Psychological and Physical Symptoms and Inflammatory Biomarkers in Inflammatory Bowel Disease: A Randomized Controlled Trial. Inflamm Bowel Dis. 2015 Dec;21(12):2886-96. doi: 10.1097/MIB.0000000000000568. PMID: 26426148.
  5. Lyall K, Beswick L, Evans S, Cummins RA, Mikocka-Walus A. Mindfulness Practice Is Associated With Subjective Wellbeing Homeostasis Resilience in People With Crohn's Disease but Not Ulcerative Colitis. Front Psychiatry. 2022 Feb 28;13:797701. doi: 10.3389/fpsyt.2022.797701. PMID: 35295784; PMCID: PMC8918514.

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