The Connection Between Inflammatory Bowel Disease and Colorectal Cancer
- New research published in the Journal of Crohn’s and Colitis suggests that psychosocial factors are linked to IBD flare-ups, something actress “Greys Anatomy” star Amy Brenneman, 60, understands all too well.
- The actress, who is also a mom of two and loving wife to director Brad Silberling, explained about 15 years ago that she had been “suffering from ulcerative colitis” for approximately five years, which she underwent surgery to fix.
- “When you have Crohn’s and colitis, inflammation in the intestines over time can lead to abnormal growths that can develop into colon cancer,” Dr. Berkeley Limketkai, the director of clinical research at UCLA’s Center for Inflammatory Bowel Diseases, tells SurvivorNet.
- Regular exercise, a balanced diet, and managing stress are what SurvivorNet experts recommend for people regardless of their health, but especially for cancer warriors and survivors.
Following Brenneman’s experience with IBD, she has become an advocate for the Crohn’s and Colitis Foundation of America (CCFA) and also works to reduce the stigma associated with mental illness and depression.
Read MoreThe study authors conclude, “In this large prospective IBD cohort study we demonstrated a significant burden of several psychosocial factors.
“Anxiety, depression, somatization, and sleep disturbances were associated with an increased clinical flare risk. Depression and lack of exercise were associated with an increased hard flare risk in UC [ulcerative colitis] patients. These findings emphasize the need for a holistic IBD treatment approach.”
Expert Resources On Coping With Emotions & Stress
- Can Stress Reduction Actually Reduce Cancer Risk For High Risk Women? Some Fascinating Study Results
- Responding to Stress: How to Cope With Complex & Changing Emotions
- How to Fix Relationships When Depression Hits – A Survivor’s Guide
- Treating Depression After a Cancer Diagnosis
- Mental Health and Cancer — The Fight, Flight or Freeze Response
- Fear, Anger, Anxiety: You’re Entitled To Your Emotions
The new findings were presented at the European Crohn’s and Colitis Organization (ECCO) 2025 Congress by gastroenterology researcher and study presenter Lauranne A.A.P. Derikx, PhD.
As per Medscape, Derikx said, “Despite clinical remission, there is a significant burden of psychosocial comorbidity in IBD patients.
“Anxiety, sleep, and somatization were associated with an increased risk of clinical flare, and depression and lack of exercise were associated with an increased risk of hard flare. Altogether, this supports a holistic approach in IBD patients.”
To obtain their findings, researchers monitored 830 people with Crohn’s and 811 with ulcerative colitis or an unclassified IBD— in an effort to compare how psychosocial factors affect IBD flare-ups.
At the two year follow-up, during the study, 36% had a clinical flare-up, 13% experienced a hard flare, the researchers explain, revealing that moderate anxiety did increase flare-up risk in Crohn’s disease, as well as severe anxiety.
Depression, both moderate and severe, was also linked to a heightened flare risk in ulcerative colitis and IBDU. Flare risk also increased with poor sleep quality among those living with Crohn’s disease.
Amy Brenneman’s IBD Journey
“Private Practice” actress, who is also a mom of two and loving wife to director Brad Silberling, told The View back in 2010, that she had been “suffering from ulcerative colitis” for approximately five years, which she underwent surgery to fix.
In a 2011 interview with WebMD, Brenneman admits to working with a nutritionist who helps her eat healthier diet, stay hydrated, and stay away from seeds, nuts, and raw foods.
As for exercise, she added, “I’ve always been fit. I’m lucky … I have an internal clock, and I know when to move my body. And I have a wonderful trainer.
“I wandered into this hardcore Pilates place [last year], and she worked me out. Also, one of the great releases for me is to go running.”
She also told WebMD that she initially tried to avoid getting surgery for her ulcerative colitis, which prompted her to lose weight too much weight. Brenneman ultimately underwent two surgeries in 2010.
Brenneman also admitted her experience has taught her not to overwork herself, explaining further, “I schedule things a week or two out front. Then, as I get closer to the day … and if it’s not putting people out … if I don’t feel like it, I won’t go.
“I try to stay in touch with my intuition as to how my day should go. There are lots of things we don’t have control over. But I don’t shame myself over it … I try to have compassion for myself.”
Understanding Inflammatory Bowel Disease (IBD)
According to Johns Hopkins Medicine, “IBD is the common name used to describe two chronic diseases of the intestinal tract ― Crohn’s disease and ulcerative colitis ― that cause inflammation in the intestines.
“Crohn’s disease can affect any part of the gastrointestinal tract from the mouth to the anus. Ulcerative colitis can affect any part of the large intestine. A third category, indeterminate colitis inflammatory bowel disease, refers to IBD that has features of both Crohn’s disease and ulcerative colitis.”
Symptoms of IBD, which can consist of various issues in the colon rectum, and other areas of the body, may be on and off, and some people living with this may experience flare-ups and long time-frames without symptoms.
IBD symptom may be:
- Abdominal pain
- Diarrhea
- Bowel movement urgency
- weight loss
- rectal bleeding
- anemia
- fever
- anxiety and depression
Johns Hopkins Medicine explains, “The condition can also cause swelling or masses, due to inflammation in the intestines. A doctor may notice these on X-rays and other tests during evaluation of symptoms. If inflammation is not controlled over time, IBD can damage the intestines.”
Learning About Ulcerative Colitis & How It’s Discovered
According to the National Institute of Diabetes and Digestive and Kidney Diseases, ulcerative colitis is a “chronic disease in which abnormal reactions of the immune system cause inflammation and ulcers on the inner lining of your large intestine.”
“Ulcerative colitis can begin gradually and become worse over time. However, it can also start suddenly,” the institute explains.”Symptoms can range from mild to severe. In between periods of flares, times when people have symptoms, most people have periods of remission, times when symptoms disappear. Periods of remission can last for weeks or years. The goal of treatment is to keep people in remission long term.”
Blood tests, stool tests, and an endoscopy of the large intestine is used to decipher whether a patient as ulcerative colitis.
During an endoscopy, a doctor will insert a thin, flexible tube with a camera attached down your throat and into the esophagus.
“An endoscopy is a telescope. It’s an upper endoscopy, or to use a very long word, esophageal, gastro doo endoscopy, where EGD, it’s when a telescope is put down your mouth by a physician, typically a gastroenterologist, and it allows you visualization of that inside of the esophagus,” Dr. Whit Burrows, a thoracic surgeon with the University of Maryland Medical System, explains to SurvivorNet.
“The normal esophagus on endoscopy would look like your lips or the inside of your cheeks when you open your mouth.”
Crohn’s Disease, Inflammatory Bowel Disease, and Colon Cancer Risk
Ulcerative colitis and Crohn’s disease are different types of inflammatory bowel diseases that affect colon cancer risk differently. Colitis is a lifelong condition that causes inflammation of the lining of the colon, which can accumulate and damage the colon. Crohn’s disease is also a lifelong condition, but it can cause chronic inflammation in any part of the GI tract from the mouth to the anus. For some people, that may be the colon, but most commonly, it’s the small intestine and the beginning of the large intestine. Both colitis and Crohn’s can cause intense abdominal pain and diarrhea, among other symptoms. Treatment can sometimes put these conditions into remission.
“When you have Crohn’s and colitis, inflammation in the intestines over time can lead to abnormal growths that can develop into colon cancer,” Dr. Berkeley Limketkai, the director of clinical research at UCLA’s Center for Inflammatory Bowel Diseases, tells SurvivorNet.
“If you have these conditions, you can keep inflammation under control and lower your risk by sticking to your treatment plan and staying up to date on recommended screenings.” Dr. Limketkai said.
Colitis causes inflammation in the colon; it raises the risk of colon cancer risk for everyone who has it. That risk increases the longer someone has colitis. As a part of routine care, people who have had colitis for eight years or more may get a colonoscopy to screen for colon cancer every one to three years, depending on their level of inflammation.
RELATED: Colon Cancer Screening is Extremely Important; Guidelines Now Say to Start at Age 45 if There Is No Family History
The Importance of Living a Healthy Lifestyle
A healthy diet can go a long way in reducing inflammation, which can help reduce cancer risk. Normally, when the body recognizes something that could be potentially dangerous (such as alcohol), inflammation helps the immune system fight them off.
However, if your body has high levels of inflammation, that’s where there can be health issues. Chronic inflammation is linked to several diseases including heart disease, diabetes, arthritis and Alzheimer’s. It can also lead to cancer.
Sugar, The Western Diet And Cancer Prevention
“What we really want people to focus on is something called an anti-inflammatory diet,” Krista Maruschak, a registered dietitian at the Cleveland Clinic Cancer Center, previously told SurvivorNet.
“When I say anti-inflammatory diet, this is really a whole meal pattern that’s going to decrease somebody’s risk for cancer in the future. Inflammation in the body can cause a whole host of health conditions and co-morbidities, and inflammation is really increased by what we call a pro-inflammatory diet.”
Maruschak continued, “Things that are pro-inflammatory in your diet are going to be refined carbohydrates as well as high fat, saturated fat meats, processed meats, things like that.”
Krista Maruschak explains how cutting “pro inflammatory” foods can decrease cancer risk
SurvivorNet’s general recommendations for a healthy lifestyle are the same whether you have cancer or not.
Dr. Ken Miller, the Director of Outpatient Oncology at the University of Maryland Greenebaum Cancer Center, has some guidelines for cancer survivors who are concerned about a recurrence:
1. Exercise at least two hours a week, and walking counts.
2. Eat a low-fat diet. The Women’s Intervention Nutrition Study, which looked at early-stage breast cancer patients, found that a low-fat diet was associated with reduced risk for cancer recurrence, particularly in those with estrogen receptor-negative cancers. Other studies have found that foods with high glycemic index that are digested quickly and cause a spike in blood sugar may lead to tumor growth in lung cancer patients.
3. Eat a colorful diet with lots of fruits and vegetables. The American Cancer Society recommends aiming for two to three cups of vibrant vegetables and fruits each day.
4. Maintain a healthy weight. Studies have shown that being obese can increase your risk for several types of cancer.
Does Stress Cause Cancer?
Researchers have been looking to answer whether stress causes cancer for years. However, according to the U.S. National Institutes of Health (NIH)’s National Cancer Institute (NCI), “the evidence that stress causes cancer is weak.”
Most studies to date have highlighted a link between stress and cancer, not a cause. This means that the evidence does not show that the cancer diagnoses in people with chronic stress are because of the stress. They could, instead, stem from some other variable, like genetic inheritance or known cancer-causing behaviors that tend to go hand in hand with stress.
“It may be that stress leads people towards unhealthy behaviors that are more directly associated with cancer,” Dr. Allyson Ocean, Associate Professor of Clinical Medicine at Weill Cornell Medical College/ New York Presbyterian Hospital, told SurvivorNet in an earlier interview.
Smoking, unhealthy eating, and drinking too much alcohol are just several examples of stress-related behaviors that have known associations with cancer.
When someone experiences stress, be it emotional, physical, or mental, the body responds by releasing the stress hormones epinephrine (adrenaline) and norepinephrine (noradrenaline). These hormones increase blood pressure, heart rate, and blood sugar levels, all of which are vital for the human “fight or flight” response. They make it possible to escape danger and perform physical feats in times of duress.
However, when these hormones are released constantly over an extended period of time, rapid heart rate and heightened blood pressure can become a problem. Risk factors for heart conditions, weight gain, and diabetes may rise.
“With regard to cancer, there is little convincing evidence that chronic stress causes cancer initiation,” Dr. Lorenzo Cohen, Professor and Director of the Integrative Medicine Program at MD Anderson Cancer Center, told SurvivorNet, “[But] there is extensive evidence that chronic stress can promote cancer growth and progression.” This, he said, is due to the fact that the constant release of epinephrine and norepinephrine “leads to diverse biological effects of key cancer pathways, including the stimulation of cancer invasion, suppressed immune function, and even reduced efficacy of chemotherapeutic agents.”
How To Turn Stress Into Strength
The suppressed immune function that Dr. Cohen mentioned may make it difficult for your body to attack cancer cells on its own.
“We know that there have been several studies that have looked at healing and recovery after cancer surgery or have looked at recurrence,” Dr. Heather Yeo, Associate Professor of Surgery and Healthcare Policy and Research at Weill Cornell Medical College, assistant attending surgeon at NewYork-Presbyterian/Weill Cornell Medical Center, and medical advisor to SurvivorNet previously explained.
“And we know that when your immune system is down, there’s an excess of stress hormones going on. Your body has a hard time recovering, and cancer takes advantage of that.”
No, stress does not cause cancer.
However, stress can cause various chain reactions of unhealthy phenomena, in turn creating a more hospitable environment for cancer to develop and spread.
That’s why it’s so important whether you’ve been diagnosed with cancer already or are looking to prevent a future diagnosis to take care of your body and mind.
Physical activity can work wonders. “Exercise, which is recommended to reduce stress levels, has been associated with a decrease in recurrence rates for certain cancers like colorectal cancer and breast cancer,” Dr. Ocean told us. Other ways to mitigate stress include getting enough sleep, eating healthily, and practicing mindfulness.
Meditation has also been proven to decrease psychological stress in those who are dealing with cancer. Survivor Shannon Masur, who previously spoke to SurvivorNet about her colon cancer and Lynch Syndrome, told us she knew very little about meditation at first but that it ultimately helped her to let go of her fears.
“I had never meditated before,” Shannon said.
“I thought it would be such a challenge, but it really wasn’t, and just having that sense of calmness that comes into me when I’m meditating has been really, really helpful for me.”
Contributing: SurvivorNet Staff
Learn more about SurvivorNet's rigorous medical review process.
