7 Natural Ways to Manage Ulcerative Colitis-Related Stress

7 Natural Ways to Manage Ulcerative Colitis-Related Stress

7 Natural Ways to Manage Ulcerative Colitis-Related Stress
Getty Images
Life with ulcerative colitis (UC) can be stressful because of the condition's unpredictable symptoms and the disruption they can cause, among other issues. And stress from any source can influence the course of UC by triggering symptoms and flares. Some research suggests that stress may even trigger the onset of the condition in certain people.

The nervous system and the gut influence each other, says Stephen E. Lupe, PsyD, a gastrointestinal psychologist and the director of behavioral medicine in the department of gastroenterology, hepatology, and nutrition at Cleveland Clinic in Ohio. The gut sends out messages that the brain interprets, but sometimes, the nervous system starts to become abnormally hypersensitive to those signals, he says. “If someone’s experiencing a lot of symptoms … [it] causes a stress reaction, which then makes the symptoms worse,” he says.

Although a busy schedule can put self-care activities on the back burner, prioritizing stress management is especially important if you have UC, says Lupe.

 Stress-reduction techniques engage the calming parasympathetic — or “rest and digest” — part of the autonomic nervous system (ANS). “This generally helps with GI functioning and how our [ANS] interprets the sensations that come up from the gut. We see a decreased pain response, a decrease in inflammatory hormones being released, and decreased dysfunction in the body.”

Here are some natural ways to manage UC-related stress that you might want to try.

1. Hypnotherapy

Gut-directed hypnotherapy has been in the news recently as a potential complementary treatment for IBD — and small, preliminary studies suggest that it may alleviate inflammation and symptoms in some people, and may even sustain remission in UC.

In gut-directed hypnotherapy, a guided session helps you get into a state of highly focused concentration and relaxation. The therapy, which can be done with a trained practitioner or via prerecorded audio tracks, uses guided imagery, muscle relaxation, and other techniques to help you manage your responses to IBD symptoms that are otherwise out of your control.

As previously mentioned, research on hypnotherapy for IBD is limited, and more studies are needed to confirm the results of previous trials.

 But gut-directed hypnotherapy has been found to be highly effective in irritable bowel syndrome (IBS), and one study on people with IBD who experience IBS-like symptoms (diarrhea, abdominal pain) while in remission found that the treatment was effective for them as well. While the study was small, it suggests that hypnosis could potentially complement traditional medical treatments in the estimated 35 percent of people with IBD who also experience IBS-like symptoms.

“The brain gets better at figuring out where to place its attention,” says Lupe. “It seems to be activating parts of the brain involved in filtering out some of the noise and decreasing some of the sensitivity in the … nervous system, so that the signals may still be there but not as loud. And it results in deep relaxation, which can help the body function better.”

2. Journaling

You may already be tracking your UC symptoms and diet with a journal. But writing down your emotions and thoughts — journaling in the more traditional sense — may also boost your mental health. Journaling, especially if you’re working with a mental health professional, can help you identify negative thoughts and behaviors, recognize your UC triggers, and prioritize your concerns to find solutions.

When we journal, it’s easier to accept our emotions, says Lupe. “You don’t react to them like they’re happening, but instead as thoughts.” For people with UC who are constantly anticipating pain, journaling may lessen the intensity of the stress response that can be partially responsible for triggering symptoms, he says.

3. Acupuncture

A form of traditional Chinese medicine, acupuncture is the practice of inserting tiny needles into specific points on the body to promote the flow and balance of energy. Research has found that acupuncture may be effective at treating several types of chronic pain.

 Study findings also suggest that the technique may reduce inflammation and the pain related to it, but high-quality trials are needed to better understand how this works.

Acupuncture might also relieve the symptoms of IBD, which could, in turn, ease your stress levels and disrupt the feedback loop between the two. One research review of four randomized controlled trials that enrolled a total of 228 people with IBD found that acupuncture significantly improved symptoms and also reduced the levels of certain inflammatory markers in the blood. Researchers noted that larger, better-designed studies are needed to confirm these findings, however.

Acupuncture has also shown promise in reducing stress in general; one study of 35 healthy volunteers indicated that it can trigger parasympathetic nervous system dominance — putting the body in a state of rest — and a reduction in physical signs of stress.

For now, there’s not enough evidence to prove that acupuncture is an effective treatment for UC stress or symptoms of the illness. But acupuncture is a low-risk option so long as it’s practiced by a trained (and in most states, licensed) practitioner, so it might be worth trying.

4. Meditation

Mindfulness meditation helps you to focus on what’s happening in the present moment and accept your emotions and bodily sensations without judgment.

If you’re struggling to cope with stress, you may want to try mindfulness-based stress reduction (MSBR); programs include in-person and virtual sessions or self-guided, smartphone app-based exercises that teach you to increase mindfulness and relieve stress through yoga and meditation.

 You can also practice mindfulness alongside cognitive behavioral therapy in mindfulness-based cognitive therapy (MBCT) with a licensed mental health practitioner.

Meditation isn’t about “turning off” your mind, says Lupe. “With meditation, you’re seeing your thoughts and sensations and emotions and not reacting to them,” he says. Allowing them to pass without judgment or attachment can help put some distance between you and stress related to UC symptoms, so that it may have less of an impact on your health.

One research review of studies on people with IBD found that mindfulness-based interventions such as meditation, MSBR, and MBCT were more effective than methods used by control groups. In the short-term, such interventions reduced stress and C-reactive protein, an inflammatory marker in the blood, while increasing mindfulness and health-related quality of life scores. Decreased stress and increased mindfulness was also found on long-term follow-ups.

5. Exercise

You probably already know that regular physical activity can relieve stress, improve mood, and reduce mild anxiety and depression symptoms. This is partly due to the boost exercise gives your overall health and the release of feel-good endorphins when you work out.

 Despite this, “exercise is probably the least utilized [treatment] we have for anxiety, depression, and stress,” says Lupe.
Exercise produces a cascade of benefits for the body, Lupe says, including decreased inflammation and increased circulation.

 It can also help maintain a healthy weight and support immune function.

 These effects are especially important for people with UC, since the immune system plays a central role in promoting the inflammation that causes symptoms and flares.

One research review notes that exercise reduces the risk of flares and fatigue in people with IBD.

 Other research has indicated that moderate-intensity physical activity is associated with generally positive effects on IBD symptoms and inflammation, while high-intensity or lengthy workouts can cause digestive symptoms or inflammation; more research is needed to confirm these findings, however.

While finding the motivation to work out can seem impossible, particularly if you’re experiencing a flare, starting small — taking a short walk, for example — and going at your own pace can help.

6. Deep Breathing

Taking deep belly breaths is a surprisingly simple and effective way to ease stress and lower your heart rate and blood pressure.

 This kind of deep breathing, which uses the diaphragm muscle, improves digestion by engaging the parasympathetic nervous system, and it can even reduce bathroom urgency and cramping.

Deep breathing also massages the internal organs around the diaphragm, including the gastrointestinal tract. This can help with pain, diarrhea, and constipation. Taking a deep breath during moments of UC-related stress can also calm the body’s fight-or-flight response.

“Deep breathing activates the parasympathetic or rest-and-digest part of the nervous system,” says Lupe. “It’s taking us out of that threat mode, which can decrease the perception of sensations.”

Focusing your attention on your breathing can also help you relax and cope with pain and nausea, he says.

7. Grounding Techniques

When you have UC, you may spend a lot of time worrying about the future — like whether you’ll struggle to find a restroom at the concert you’re going to next weekend, for example. But anxiety can activate the sympathetic nervous system and put you into fight-or-flight mode, exacerbating symptoms, says Lupe.

If you find your anxiety is taking over, Lupe says it’s helpful to ground yourself in the present moment. He suggests looking around at your surroundings and bolstering your sense of safety by noting five things you can see, four things you can hear, three things you can touch, two things you can smell, and one thing you can taste. “That can get us out of reacting to our thoughts,” says Lupe.

Finally, if your UC symptoms are so overwhelming that they’re getting in the way of your daily activities, find a professional to speak with — whether that’s a therapist or a member of your healthcare team. “A lot of times we won’t talk to people, including even the people who love us. But just talking about what’s going on and being able to feel supported helps,” says Lupe.

The Takeaway

  • Stress is common in people with ulcerative colitis (UC) and can worsen symptoms of the illness by triggering a stress response cycle controlled by the gut-brain connection.
  • Practicing stress management techniques activates the body's calming parasympathetic nervous system, inducing a relaxation response, which can decrease symptoms and signs of inflammation.
  • There are a number of natural, complementary treatments that may ease UC-related stress, including gut-directed hypnotherapy, journaling, acupuncture, and mindfulness-based meditation.
  • Simple lifestyle adjustments like moderate exercise, deep belly breathing, and grounding techniques are also recommended to reduce stress.
EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Resources
  1. Osso M et al. Stress and IBD: Breaking the Vicious Cycle. Crohn’s & Colitis Foundation. August 7, 2024.
  2. The Gut-Brain Connection. Cleveland Clinic. September 20, 2023.
  3. How the Parasympathetic Nervous System Can Lower Stress. Hospital for Special Surgery. August 29, 2021.
  4. Forte G et al. Heart Rate Variability and Pain: A Systematic Review. Brain Sciences. January 24, 2022.
  5. Sic A et al. Chronic Stress and Headaches: The Role of the HPA Axis and Autonomic Nervous System. Biomedicines. February 13, 2025.
  6. Lores T et al. Virtual Adjunctive Gut-Directed Hypnotherapy for People With Crohn's Disease: A Randomized Controlled Pilot and Feasibility Trial. Complementary Therapies in Clinical Practice. November 2023.
  7. Salwen-Deremer JK et al. A Cross-Institution Protocol for Virtual, Transdiagnostic, Group Gut-Directed Hypnotherapy. Gastroenterology. May 2024.
  8. Adler EC et al. Gut-Directed Hypnotherapy for Irritable Bowel Syndrome: A Systematic Review and Meta-Analysis. Neurogastroenterology & Motility. April 3, 2025.
  9. Hoekman DR et al. Hypnotherapy for Irritable Bowel Syndrome-Type Symptoms in Patients With Quiescent Inflammatory Bowel Disease: A Randomized, Controlled Trial. Journal of Crohn’s and Colitis. November 27, 2020.
  10. Keefer L et al. A Rome Working Team Report on Brain-Gut Behavior Therapies for Disorders of Gut-Brain Interaction. Gastroenterology. January 2022.
  11. Journaling for Emotional Wellness. Stanford Medicine Children’s Health.
  12. Nunes-Harwitt M. No Rules Just Write: A New Approach to Journaling. University of Rochester Medical Center. April 1, 2025.
  13. Acupuncture for Pain Relief: How It Works and What to Expect. Harvard Health Publishing. August 25, 2025.
  14. Grisham J. Acupuncture for Neuropathy, Cancer Pain, Anxiety, and More. Memorial Sloan Kettering Cancer Center. July 22, 2024.
  15. Yang X et al. Assessment of Anti-Inflammatory Efficacy of Acupuncture in Patients With Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis. Complementary Therapies in Medicine. June 2023.
  16. Li L et al. Regulation of Autonomic Nervous System by Acupuncture: A Heart Rate Variability Study on Physical Stress. Frontiers in Human Neuroscience. November 10, 2025.
  17. State Licensure Requirements Interactive Map. National Certification Commission for Acupuncture and Oriental Medicine. February 23, 2021.
  18. Mindfulness Meditation. Johns Hopkins Medicine.
  19. Mindfulness Based Stress Reduction. Duke Health & Well-Being Programs.
  20. Harris K et al. Mindfulness-Based Stress Reduction (MBSR) for Chronic Pain Management in the Community Pharmacy Setting: A Cross-Sectional Survey of the General Public’s Knowledge and Perceptions. Pharmacy. September 21, 2023.
  21. Mindfulness-Based Cognitive Therapy (MBCT). Vanderbilt University Medical Center.
  22. Chems-Maarif R et al. Defining Mindfulness: A Review of Existing Definitions and Suggested Refinements. Mindfulness. January 17, 2025.
  23. Naude C et al. The Effectiveness of Mindfulness-Based Interventions in Inflammatory Bowel Disease: A Systematic Review & Meta-Analysis. Journal of Psychosomatic Research. June 2023.
  24. Exercise and Stress: Get Moving to Manage Stress. Mayo Clinic. September 19, 2025.
  25. 8 Ways Exercise Helps Your Joints. Arthritis Foundation.
  26. Benefits of Exercise. MedlinePlus. September 15, 2025.
  27. Overview of Ulcerative Colitis. Crohn’s & Colitis Foundation.
  28. Rozich JJ et al. Effect of Lifestyle Factors on Outcomes in Patients With Inflammatory Bowel Diseases. The American Journal of Gastroenterology. June 2020.
  29. Griffin AC et al. mHealth Physical Activity and Patient-Reported Outcomes in Patients With Inflammatory Bowel Diseases: Cluster Analysis. Journal of Medical Internet Research. September 24, 2024.
  30. Exercise. Crohn’s & Colitis Australia.
  31. Diaphragmatic Breathing. Cleveland Clinic. March 30, 2022.
  32. Addressing the Psychological Impacts of Inflammatory Bowel Disease. University of Pennsylvania. December 17, 2025.
  33. Belly Breathing: Breathing More Deeply Can Bring Significant Health Benefits. Mayo Clinic Press. December 20, 2024.
  34. Merlin Q et al. Psychophysiological Effects of Slow-Paced Breathing on Adolescent Swimmers’ Subjective Performance, Recovery States, and Control Perception. Journal of Functional Morphology and Kinesiology. January 25, 2024.
  35. Martin A. Try These Relaxation and Pain Relief Techniques From the Comfort of Home. University of California San Francisco. Winter 2023.
  36. Sympathetic Nervous System (SNS). Cleveland Clinic. June 6, 2022.
  37. 13 Grounding Techniques for When You Feel Overwhelmed. Cleveland Clinic. November 25, 2024.
  38. 15 Mental Health Tips for People With IBD. National Association for Continence.

Yuying Luo, MD

Medical Reviewer

Yuying Luo, MD, is an assistant professor of medicine at Mount Sinai West and Morningside in New York City. She aims to deliver evidence-based, patient-centered, and holistic care for her patients.

Her clinical and research focus includes patients with disorders of gut-brain interaction such as irritable bowel syndrome and functional dyspepsia; patients with lower gastrointestinal motility (constipation) disorders and defecatory and anorectal disorders (such as dyssynergic defecation); and women’s gastrointestinal health.

She graduated from Harvard with a bachelor's degree in molecular and cellular biology and received her MD from the NYU Grossman School of Medicine. She completed her residency in internal medicine at the Icahn School of Medicine at Mount Sinai, where she was also chief resident. She completed her gastroenterology fellowship at Mount Sinai Hospital and was also chief fellow.

Colleen de Bellefonds

Colleen de Bellefonds

Author
Colleen de Bellefonds is a freelance journalist and editor who covers science, health, and parenting. Her reporting and writing regularly appears online for Well+Good, The Bump, and What to Expect, as well as in U.S. News & World Report, Women's Health, Self, and many other publications. She lives in Paris with her husband and two kids.