- Stress and Your Gut
- Inflammatory Bowel Disease
- Irritable Bowel Syndrome
- Gastroesophageal Reflux Disease
- Peptic Ulcer Disease
- All Digestive Conditions
- How Do You Manage Stress?
- Tips to Reduce Anxiety or Worry and De-Stress
- First published in the Inside Tract® newsletter issue 162 – July/August 2007
- Photo: .com | caio_triana
- 1. Mayer, EA. The neurobiology of stress and gastrointestinal disease. Gut 2000;47;861-869.2. Mawdsley JE, Rampton DS. Psychological stress in IBD: New insights into pathogenic and therapeutic implications. Gut 2005;54:1481-1491.3. Spence MJ, Moss-Morris R. The cognitive behavioural model of irritable bowel syndrome: a prospective investigation of patients with gastroenteritis. Gut 2007;56:1066-1071.4. Naliboff BD, Mayer M, et al. The effect of life stress on symptoms of heartburn. Psychosomatic Medicine 2004;66:426-434.5. Mayer, EA. The neurobiology of stress and gastrointestinal disease. Gut 2000;47;861-869.6. Mawdsley JE, Rampton DS. Psychological stress in IBD: News insights into pathogenic and therapeutic implications. Gut 2005;54:1481-1491.
- Stress and the sensitive gut
- Stress Affecting Your Gut? These 4 Tips Can Help
- Practice yoga
- Try mindful meditation
- Eat prebiotics and probiotics
- Kick the smoking habit
- How Stress Affects Digestion
- What Happens When Your Body Is Stressed?
- 6 Ways to Manage Stress
- How Stress Affects Your Digestive System
- How does stress impact our digestive system?
- How does our body react to stress?
- What happens to the digestive system when we are stressed?
- What are the digestive symptoms we are likely to experience?
- The brain in the gut or Enteric Nervous System
- How can we help ourselves?
Stress and Your Gut
Unreasonable deadlines. Being stuck in traffic. Having too much to do and not enough time to do it in. Most of us are familiar with these kinds of daily stresses that get our heart racing, our breath quickening, and our stomach churning. Of course, just having a digestive condition can be a source of anxiety in itself. Studies show that a major stressful event long-since passed could still be affecting your gut even now. Being stressed-out also causes many of us to overeat and drink too much alcohol, both of which affect our gut.
What is the real effect of stress on our gut? Many studies show that stressful life events are associated with the onset of symptoms, or worsening of symptoms, in several digestive conditions, including inflammatory bowel disease (IBD), irritable bowel syndrome (IBS), gastroesophageal reflux disease (GERD), and peptic ulcer disease.1
Inflammatory Bowel Disease
For inflammatory bowel diseases like Crohn’s disease and ulcerative colitis, a study concluded that chronic stress, adverse life events, and depression could increase the risk of relapse in patients. This study identified a variety of mechanisms by which stress affects both the systemic and gastrointestinal immune and inflammatory responses. They note that translating these findings into therapeutic interventions based on stress reduction remains a challenge, as clinical trials monitoring the effects of existing stress reduction techniques on IBD have not shown promising results.2
Irritable Bowel Syndrome
In a prospective cohort study looking at almost 600 people whose gastroenteritis was caused by the bacterium Campylobacter, researchers found that the patient’s ability to handle stress before the infection was a pivotal factor in whether they went on to develop IBS. Those with higher levels of perceived stress, anxiety, and negative illness beliefs at the time of infection were at a greater risk to develop IBS. By contrast, depression and perfectionism did not seem to increase the risk of IBS. 3
Gastroesophageal Reflux Disease
In one study done at a medical centre for women’s health, researchers noted that there was no increased frequency of acid reflux when patients were under acute stress.4 However, in practice, chronically anxious patients were more likely to notice worsening of their symptoms during a stressful event.5 In other words, their attitude affected their perception of symptom severity.
Peptic Ulcer Disease
Most ulcers result from infection with bacteria called Helicobacter pylori (H. pylori). Contrary to old beliefs, neither eating spicy food nor living a stressful life cause ulcers. H. pylori bacteria weaken the protective mucous coating of the esophagus, stomach, or duodenum, which then allows acid to get through to the sensitive lining beneath. Both the acid and the bacteria irritate the lining and cause a sore, or ulcer. However, some evidence suggests that ongoing stress leads to mucosal lining inflammation, thereby allowing gastric juices to irritate the sensitive stomach lining underneath.5
All Digestive Conditions
Stress increases gut motility and fluid secretion. This is why you might get a bout of diarrhea or repeated urges to urinate during or following a stressful event. Stress can both delay emptying stomach contents and speed up passage of material through the intestines.5 This combination of activity leads to abdominal pain and altered bowel habits. Additionally, acute psychological stress decreases a person’s pain threshold.6
How Do You Manage Stress?
The two extremes are that some people can handle major upsets without batting an eye, while others become distressed at the slightest deviation from their normal routine. It is important to remember that in small doses, stress can be a good thing. It can give you the push you need, motivating you to do your best and to stay focused and alert. Problems accumulate only when stress is constant.
The specific signs and symptoms of stress vary from person to person, but the potential to harm your health, emotional well-being, and relationships with others is real. Stress affects the mind, body, and behaviour in many ways apart from the digestive tract, including weight fluctuations, head and muscle aches, mood changes, and altered mental function.
You must find your own way to deal with stress in your life. Pre-planning some events might be worthwhile to reduce your overall stress level. By understanding how you deal with stress, you can make lifestyle changes that will lower your stress level, help you better cope with stress, and recover from stressful events more quickly.
Tips to Reduce Anxiety or Worry and De-Stress
Become a better breather. Stress can cause shallow breathing, which means that your body won’t get enough oxygen to fully relax. Learn to breathe more slowly and deeply from your abdomen. One way to do this is to imagine that you have a small beach ball behind your belly button, which you slowly inflate and deflate.
Watch your ‘self-talk’. Much of our anxiety is self-induced, meaning that we often get ourselves wound up worrying about worst-case scenarios or blowing small incidents out of proportion.
Monitor your negative thoughts to see how often you fret about things such as losing your job, or making mistakes. If you find yourself obsessing, try to substitute a negative thought with a positive, but realistic one. For example, instead of thinking, “I know something will go wrong during my presentation”, tell yourself, “No matter what happens, I can handle it.”
Get physical. Exercise is a well-known tension reducer and can help relieve symptoms. The paradox is that strenuous, high-impact exercises might induce GERD symptoms, so take care to increase exercise slowly and assess your body’s tolerance to this as you do.
Become a better time manager. Many of us underestimate the amount of time it will take to do something, which means we’re often running late. Try keeping a time management log for a week to get a better idea of how much time various tasks actually take, and then learn to prioritize them so that you’re getting the most important things done first. A good rule of thumb is to give yourself 20% more time than you think you need to do the task.
Learn to say no. Thinking you can ‘do it all’ creates unnecessary pressure. Learn how to set boundaries for yourself. Politely – yet firmly – turn down additional responsibilities or projects that you don’t have the extra time or energy for. Don’t feel obliged to give long, detailed explanations as to why. A simple, “I’d love to help you out, but I’m booked up,” will usually do in most cases.
Take time out for yourself. Our minds and bodies require a certain amount of variety, or else our overcharged nervous systems will keep speeding right into the next day. Try to take at least one day off each week to do something you really enjoy, whatever that may be. Remember to include things like getting enough sleep, exercising your faith, having a leisurely bath, listening to music, playing with a pet, having conversations with friends, or anything that gives you pleasure.
Have a good belly laugh. Laughter is a natural stress reliever that helps to lower blood pressure, slow your heart and breathing rate, and relax your muscles. How do you tickle your funny bone? Catch comedies, have a chuckle with a friend, and make an effort to look on the lighter side of life.
Choose foods carefully. Some foods can increase your stress level while others can help reduce it. Generally, fatty, sugary, and/or processed foods seem to increase stress in most people while lean meat, whole grains, and fresh fruits and vegetables seem to decrease stress. Choose foods wisely and in addition to reducing stress, your body will love you for it!
Photo: .com | caio_triana
1. Mayer, EA. The neurobiology of stress and gastrointestinal disease. Gut 2000;47;861-869.
2. Mawdsley JE, Rampton DS. Psychological stress in IBD: New insights into pathogenic and therapeutic implications. Gut 2005;54:1481-1491.
3. Spence MJ, Moss-Morris R. The cognitive behavioural model of irritable bowel syndrome: a prospective investigation of patients with gastroenteritis. Gut 2007;56:1066-1071.
4. Naliboff BD, Mayer M, et al. The effect of life stress on symptoms of heartburn. Psychosomatic Medicine 2004;66:426-434.
5. Mayer, EA. The neurobiology of stress and gastrointestinal disease. Gut 2000;47;861-869.
6. Mawdsley JE, Rampton DS. Psychological stress in IBD: News insights into pathogenic and therapeutic implications. Gut 2005;54:1481-1491.
Stress and the sensitive gut
Updated: August 21, 2019Published: August, 2010
Psychotherapy may help ease persistent gastrointestinal distress.
Functional gastrointestinal disorders affect 35% to 70% of people at some point in life, women more often than men. These disorders have no apparent physical cause — such as infection or cancer — yet result in pain, bloating, and other discomfort.
Multiple factors — biological, psychological, and social — contribute to the development of a functional gastrointestinal disorder. Numerous studies have suggested that stress may be particularly important, however. The relationship between environmental or psychological stress and gastrointestinal distress is complex and bidirectional: stress can trigger and worsen gastrointestinal pain and other symptoms, and vice versa. This is why psychological therapies are often used in combination with other treatments — or even on their own — to treat functional gastrointestinal disorders.
The enteric nervous system as a second brain
Life-sustaining functions, such as breathing, heartbeat, blood pressure, and body temperature, are regulated through the autonomic nervous system. This complex network of nerves extends from the brain to all the major organs of the body and has two major divisions. The sympathetic nervous system triggers the “fight or flight” response. The parasympathetic nervous system calms the body down after the danger has passed. Both the sympathetic and parasympathetic nervous systems interact with another, less well-known component of the autonomic nervous system — the enteric nervous system, which helps regulate digestion.
The enteric nervous system is sometimes referred to as a “second brain” because it relies on the same types of neurons and neurotransmitters that are found in the central nervous system (brain and spinal cord). After sensing that food has entered the gut, neurons lining the digestive tract signal muscle cells to initiate a series of intestinal contractions that propel the food farther along, breaking it down into nutrients and waste. At the same time, the enteric nervous system uses neurotransmitters such as serotonin to communicate and interact with the central nervous system.
This “brain-gut axis” helps explain why researchers are interested in understanding how psychological or social stress might cause digestive problems. When a person becomes stressed enough to trigger the fight-or-flight response, for example, digestion slows or even stops so that the body can divert all its internal energy to facing a perceived threat. In response to less severe stress, such as public speaking, the digestive process may slow or be temporarily disrupted, causing abdominal pain and other symptoms of functional gastrointestinal disorders. Of course, it can work the other way as well: persistent gastrointestinal problems can heighten anxiety and stress.
Psychotherapy options for gastrointestinal distress
Reviews suggest that several types of psychotherapies may help ease persistent gastrointestinal distress — or at least help people learn to cope with such symptoms. Although this research has limitations — in particular, many studies have been criticized for using a waiting-list control, which does not allow investigators to account for the therapeutic effects of receiving medical attention — the evidence suggests that the following psychotherapies may provide some relief for many people with severe functional gastrointestinal disorders.
Cognitive behavioral therapy (CBT). This standby of psychotherapy helps patients to change counterproductive thoughts and behavior and learn coping skills to better manage stress and anxiety. CBT may be most useful in helping patients to cope with persistent gastrointestinal distress, rather than reducing pain.
Relaxation therapy. This encompasses a number of techniques designed to help people relax and reduce reactivity to stress. Techniques include progressive muscle relaxation, visualization, and restful music. It is effective for gastrointestinal disorders when it is combined with CBT.
Hypnosis. Gut-directed hypnotherapy — which combines deep relaxation with positive suggestions focused on gastrointestinal function — may be helpful for people whose symptoms occur even without obvious stress.
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Stress Affecting Your Gut? These 4 Tips Can Help
When was the last time you checked in with yourself, particularly when it came to your stress levels?
No matter the stressor, it’s important to consider the impact of stress on your health and well-being. After all, too much stress can take a mental and physical toll on your body — this includes wreaking havoc on your gut and digestion.
The effect stress has on your gut depends on the length of time you’re experiencing stress:
- Short-term stress can cause you to lose your appetite and your digestion to slow down.
- Long-term stress can trigger gastrointestinal (GI) issues, like constipation, diarrhea, indigestion, or an upset stomach.
- Chronic stress over extended periods of time may lead to more serious issues, like irritable bowel syndrome and other GI disorders.
One of the keys to better digestion is regular stress management. Reducing stress can lower inflammation in the gut, ease GI distress, and keep you nourished, since your body can focus on absorbing the nutrients you need.
If you find your stress levels are affecting your digestion, below you’ll find four tips to help improve your gut.
To boost and support digestion, make sure you’re getting enough physical activity on a consistent basis, like walking and running.
Exercises like Hatha or Iyengar yoga, which focus on alignment and posture, may also alleviate gastrointestinal symptoms and improve stress outcomes.
Try mindful meditation
Scientific research also suggests that a mindful meditation practice, where you develop an increased awareness of your daily life, may help.
Meditation along with deep breathing techniques may lower inflammation, a marker of stress in the body. In turn, this may relieve an overstressed digestive system.
Before your next meal, try sitting up straight away from distractions, and take 2 to 4 rounds of deep breathing. Breathing in for a 4-count, holding for 4, and exhaling for a 4-count.
Do this each time you sit down to enjoy a meal to help your body relax and get ready for digestion (i.e. rest and digest mode).
Eat prebiotics and probiotics
When it comes to your diet, reach for foods that promote good gut bacteria, like prebiotics and probiotics.
Fruits and vegetables with inulin, like asparagus, banana, garlic, and onions, contain prebiotics. Fermented foods, like kefir, kimchi, kombucha, natto, sauerkraut, tempeh, and yogurt all contain probiotics.
Prebiotics and probiotics can alter the bacteria makeup in the gut microbiome and create the ideal environment for more good bacteria to flourish and support digestion.
Kick the smoking habit
If you reach for a cigarette when your stress levels are on the rise, it’s time to rethink this coping technique.
Heart disease and respiratory diseases are most commonly associated with cigarette smoking but research also shows that the bad habit can affect your digestive system as well.
Smoking can increase your risk of developing peptic ulcers, GI diseases, and related cancers. If you smoke, consider making a plan and consulting your doctor or healthcare practitioner to help you cut back or give up smoking completely.
McKel Hill, MS, RD, is the founder ofNutrition Stripped, a healthy living website dedicated to optimizing the well-being of women all over the globe through recipes, nutrition advice, fitness, and more. Her cookbook, “Nutrition Stripped,” was a national best seller, and she’s been featured in Fitness Magazine and Women’s Health Magazine.
How Stress Affects Digestion
Have you ever have to make a “gut-wrenching” decision under pressure? Or were you ever so anxious that you had butterflies in your stomach? If so, then you know how stress can affect your digestive system.
The brain and the gut are connected and constantly in communication. In fact, more neurons reside in the gut then in the entire spinal cord, according to research published in the book Neuroscience.
“Stress can affect every part of the digestive system,” says Kenneth Koch, MD, professor of medicine in gastroenterology and medical director of the Digestive Health Center at Wake Forest University Baptist Medical Center in Winston-Salem, North Carolina.
The gut is controlled in part by the central nervous system in the brain and spinal cord. In addition, it has its own network of neurons in the lining of the gastrointestinal system, known as the enteric or intrinsic nervous system. In fact, the system of nerves in your gut is so influential that some researchers consider the gut a second brain, as noted in an article published in Scientific American.
The enteric nervous system, along with its 100 million nerve cells that line your gastrointestinal tract from your esophagus to your rectum, regulates digestive processes like:
- The release of enzymes to break down food
- The categorization of food as nutrients or waste products
Stress can significantly impact the way your body carries out these processes.
What Happens When Your Body Is Stressed?
When presented with a potentially threatening situation, the sympathetic nervous system — a part of the body’s autonomic nervous system, which regulates bodily functions like the heartbeat, breathing, and blood pressure — responds by triggering a “fight-or-flight response,” releasing the stress hormone cortisol to make the body alert and prepared to face the threat.
Stress causes physiological changes, like a heightened state of awareness, faster breathing and heart rates, elevated blood pressure, a rise in blood cholesterol, and an increase in muscle tension.
When stress activates the flight-or-flight response in your central nervous system, Dr. Koch says that it can affect your digestive system by:
- Causing your esophagus to go into spasms
- Increasing the acid in your stomach, which results in indigestion
- Making you feel nauseous
- Giving you diarrhea or constipation
In more serious cases, stress may cause a decrease in blood flow and oxygen to the stomach, which could lead to cramping, inflammation, or an imbalance of gut bacteria. It can also exacerbate gastrointestinal disorders, including:
- Irritable bowel syndrome (IBS)
- Inflammatory bowel disease (IBD)
- Peptic ulcers
- Gastroesophageal reflux disease (GERD)
“Although stress may not cause stomach ulcers or inflammatory bowel disease, it can make these and other diseases of digestion worse,” Koch says. So it’s important to take measures to be in control during stressful situations and find ways to keep yourself calm.
6 Ways to Manage Stress
There are both psychological and physical ways to manage stress. But the same stress relieving technique might not work for everyone. Here are six options you can try:
1. Get Regular Exercise
Physical activity relieves tension and stimulates the release of chemicals in your brain called endorphins, which act as natural painkillers. Endorphins improve sleep, which can help relieve stress, according to the Anxiety and Depression Association of America.
“It’s one of the best ways to manage stress and maintain healthy digestion,” Koch says. A study published in 2014 in the journal Cognitive Behavioural Therapy examined the relationship between aerobic exercise and attentional focus during exercise on 33 patients with post-traumatic stress disorder (PTSD) and found that 89 percent of patients reported improvements in PTSD and anxiety sensitivity.
2. Consider Psychotherapy
Cognitive behavioral therapy (CBT) is a technique that has been proven to help reduce anxiety and stress by helping you learn to replace negative, distorted thoughts with positive ones. A study published in 2017 in the Journal of Consulting and Clinical Psychology looked at the effectiveness of CBT on quality of life, anxiety, and depression in those with IBD. Patients with IBD who reported low quality of life were randomly assigned a CBT intervention along with standard medical care for three and a half months. When compared with a control group, people with IBD who received CBT reported higher quality of life and lower levels of depression and anxiety.
3. Choose Stress-Busting Foods
A review published in May 2017 in the journal Neuroscience and Biobehavioral Reviews found that eating disorders and obesity can be associated with psychological stress. Cortisol, a hormone released by the adrenal glands, also increases appetite. Stress can affect food preferences, too. Studies have shown that “physical or emotional distress increases the intake of food high in fat, sugar, or both,” according to Harvard Medical School.
But there are certain foods that have been shown to reduce anxiety. Salmon contains omega-3 fatty acids, which are natural mood boosters. Almonds are chock full of magnesium, a mineral that helps manage cortisol levels. And oranges and other citrus fruits contain vitamin C, which can lower blood pressure, according to research published in January 2017 in the journal Scientific Reports.
This mind-body practice combines physical poses with breathing techniques and meditation. According to a study published in 2018 in the International Journal of Preventive Medicine, women who engaged in hour-long Hatha yoga classes three times a week for 12 sessions achieved significant reductions in stress, anxiety, and depression. Research also shows that yoga can lower blood pressure and heart rate.
There are many meditation techniques that can help you focus your mind on an object, activity, or though to help you achieve calmness. Although the goal of meditation is not stress reduction, that is a side effect of this ancient practice.
A review published in 2018 in The Lancet Public Health looked at the effects of a mindfulness-based intervention on resilience to stress in college students. Eight weekly Mindfulness Skills for Students (MSS) interventions were randomly administered to students for 75 to 90 minutes, focusing on mindfulness exercises and periods of self-reflection. At the end of the intervention, students in the MSS group reported lower levels of stress.
6. Develop Time-Management Skills
An important part of stress reduction is self-care. For many, this involves managing your time as effectively as possible. A study published in 2017 in the journal Electronic Physician looked at the relationships between time management, anxiety, and academic motivation in 441 nursing school students using self-reported questionnaires and scales. Students who did a poor job managing their time had higher levels of anxiety and less academic motivation than individuals who were better time managers.
You can improve your time-management skills by:
- Knowing your deadlines
- Planning ahead
- Setting goals
- Avoiding procrastination
Additional reporting by Nicol Natale.
How Stress Affects Your Digestive System
You may not know it but, stress can affect more than your level of happiness – it can negatively impact your health and more specifically your digestive system. Your brain and your digestive system are very closely related. In fact, some say that your “gut” has a “mini brain”. You know the expression trust your “gut feelings”? This has more truth than you would think. Your stomach and intestines actually have more nerve cells than your spinal cord!
Your gut is connected to your brain through the vagus nerve – a nerve that runs from your brain stem to your abdomen. This enteric nervous system is made up of millions of nerves that control digestion. When you introduce stress into your system, you activate the “fight or flight” response. This response tells your central nervous system to shut down blood flow; which can shut down or slow digestion. Stress can also cause an inflammation in your gastrointestinal system or even cause your esophagus to go into spasms and increase acid in your stomach, causing indigestion.
Prolonged stress can cause even more problems: diarrhea, bloating, cramping, constipation or other digestive issues. When a person is constantly experiencing stress it can become more serious. IBS and peptic ulcers are both related to stress.
Stress can also cause weight gain. One of the major stress hormones released when you are in a stressful situation is cortisol. This hormone boosts abdominal fat and along with insulin, is responsible for stress-related food cravings. There is actually a theory called “reward-based stress eating”. The theory is that when we experience stress and turn to high-calorie foods or “comfort foods” for comfort, we cause our brain to make chemicals called endogenous opioids. These are neurotransmitters that help protect against the harmful effects of stress by slowing down the brain process. When we repeat this process we stimulate reward pathways that lead to changes in the brain and cause chronic overeating.
If you want to improve your health and/or lose weight in the New Year, consider looking into ways to reduce your stress! Exercise, meditation, and yoga are all great stress reducers.
How does stress impact our digestive system?
How does our body react to stress?
Is it really any coincidence that London seems to be full of stressed people suffering with digestive problems and lack of sleep?
The pace of life, the volume of people and the daily demands in a busy city are a good example of what happens when we are exposed to constant stressors.
In actual fact, it makes no difference what is causing the stress, the real problem is the chain reaction of stress hormones released in the body as it physically prepares to fight against, or flee from any perceived threat:
- Blood is diverted to the brain, heart, lungs and muscles, which will need to work well to get you out of danger
- The heart beat speeds up to pump blood more effectively round the body to these areas
- Blood is diverted away from the digestive tract, as stopping for a picnic shouldn’t really be on the agenda when there’s a life and death situation going on
- Breathing speeds up to get oxygen supplies to the muscles as quickly as possible
- Sweat levels go up to stop the body from overheating
- Blood sugar levels go up dramatically so that glucose is available to feed the brain and muscles
- Blood vessels constrict.
The overall effect is higher blood pressure, digestive problems, anxiety, tense muscles and palpitations. If your body is flooded with stress hormones continuously, these symptoms worsen.
What happens to the digestive system when we are stressed?
Under normal circumstances our digestive system should be able to go about its daily task of mixing, contracting and absorbing, to help break down our food and begin extracting the nutrients and vitamins that we require for good health.
However, when stress hormones are flooding our body, our digestive system effectively shuts down, causing our digestive muscles to contract more or less frequently, our gastric secretions and stomach acid levels to increase or decrease and our healthy gut bacteria to change composition.
At the very time we need to slow down, breathe, rest and digest, we bolt our food, eat on the run and make life even harder on our digestion.
What are the digestive symptoms we are likely to experience?
- Fewer digestive secretions are made to help us digest food (causing more wind, bloating and nausea)
- Stomach acid levels can increase (causing acid reflux, pain and inflammation)
- The digestive contractions can increase or decrease (diarrhoea, constipation, spasm, etc.)
These symptoms also leave us open to compromised immunity (with at least 70% of our immune cells in our gut), infection, and further impact on our mood.
The brain in the gut or Enteric Nervous System
The important link between the gut and the brain also needs to be mentioned. We have all heard of ‘gut feelings’ or ‘having butterflies’ in certain situations.
This is thought to be due to the Enteric Nervous System (ENS) or the ‘brain in the gut’ linking digestive function to mood and vice versa. The ENS is two thin layers of more than 100 million nerve cells lining our gastrointestinal tract from oesophagus to rectum.
A highway of nerves runs directly from our actual brain to our digestive system, and messages flow in both directions between the two.
Did you know?
95 percent of the body’s serotonin (a hormone that helps control mood, sleep, appetite) is found in the digestive system, not the brain.
The ENS may trigger big emotional shifts experienced by people coping with irritable bowel syndrome (IBS) and functional bowel problems such as constipation, diarrhoea, bloating, pain and stomach upset.
“For decades, researchers and doctors thought that anxiety and depression contributed to these problems. But our studies and others show that it may also be the other way around,” explains Jay Pasricha, M.D., director of the Johns Hopkins Center for Neurogastroenterology, whose research on the enteric nervous system has gained international attention. Researchers are finding evidence that irritation in the gastrointestinal system may send signals to the central nervous system (CNS) that trigger mood changes.
“These new findings may explain why a higher-than-normal percentage of people with IBS and functional bowel problems develop depression and anxiety,” Pasricha says. “That’s important, because up to 30 to 40 percent of the population has functional bowel problems at some point.”
How can we help ourselves?
If you notice any change in digestive function, do consult with your GP or healthcare provider. They will be able to ask certain questions and arrange any applicable tests to help determine the cause. If stress is considered to be the main culprit, addressing the source of the stress should naturally be a priority.
‘Talking therapies’ which involve working with a qualified therapist to find better ways to deal with stress should not be underestimated. Methods such a CBT, which addresses intrusive and unwanted thought patterns can be particularly helpful, and have been shown to improve symptoms of irritable bowel syndrome by up to 70 percent in some people, over a period of a few months.
Listen to your gut
Given the link between the gut and the brain we can be wired to react to certain foods, and may feel better avoiding them. Have you ever felt tired, nauseous, or a little “fuzzy” after a meal? If so, your enteric nervous system may be reacting to something you ate. Pay attention to how you feel after eating. If it helps you to keep track, try writing a food diary for a few weeks or consult with a nutritional therapist. (www.bant.org.uk)
The body is always working towards balance and this is a sensible way to approach what we eat. The digestive system appreciates a healthy, whole food, well-balanced diet. When under stress we may instinctively reach for extremes in sugar, fat, caffeine, alcohol and processed foods but this can just exacerbate the stress cycle and digestive dysfunction.
If our Sympathetic Nervous System (the part of nervous system in charge of ‘fight or flight’) has been in overdrive, we need to counterbalance the effects by switching on our Parasympathetic Nervous System (the part of the nervous system in charge of ‘rest and digest’).
Copyright© 2007 Pearson Education, Inc, publishing as Benjamin Cummings
One of the ways we can do this is to aim for the experience of mindful eating rather than refuelling. In other words, rather than grabbing food and eating on the run, we endeavour to take time to sit down, relax and enjoy our food.
Chew, chew and chew some more
If we could only change one thing, my recommendation would be to chew, chew and chew some more. As our digestion expert Ali says, ‘Don’t bolt your food down. If it hardly touches the sides as it goes down, the chances are the digestive system won’t be ready for it and all sorts of mayhem will break out. Try chewing each mouthful 20 times for a while and surprise yourself with how much better your digestive tract feels.’
The process of chewing not only helps to break down food into digestible particles but also produces digestive enzymes through saliva. The more we chew, the easier on our stomach and small intestine and the better we are likely to digest, avoiding unpleasant symptoms.
Avoid drinking with meals
When we drink fluid with a meal we dilute our natural digestive enzymes and potentially wash down the food before it has been properly broken down. To maximise digestive potential, stick to drinking 20 or 30 minutes before or after a meal.
Moderate exercise is one of the best ways to manage stress and maintain healthy digestion. Physical activity relieves tension and stimulates the release of those feel good chemicals called endorphins which naturally improve our mood.
According to studies a post-meal walk can speed up the rate at which food moves through the stomach as well as decreasing blood sugar and lowering cardiovascular risk.
People who have stress-related digestive problems often benefit from relaxation therapies such as yoga, meditation, hypnosis, progressive muscle relaxation, and even soothing music. IBS sufferers have been found to experience a significant reduction in pain and bloating through practising these techniques.
Bowel Essence and Bitters
As an IBS sufferer, two of my favourite ways to tackle digestive dysfunction are flower essences and bitters.
I was introduced to Bowel Essence during a particularly stressful time in my life and was advised that this flower essence combination may help relieve emotionally triggered digestive issues. Its significant impact surprised me and, needless to say, it has been a constant companion ever since!
Bitter herbs were also a revelation to me in their ability to improve digestive function, assimilation and elimination. Anyone suffering with digestive issues can benefit from including bitter foods in the diet, such as chicory, dandelion root coffee, artichoke, watercress, rocket, etc.
A tincture of bitters such as Digestisan in a little water, 20 minutes or so before meals, can also be such a helpful formula for those needing the extra digestive support.
You have been hearing for years that stress isn’t good for you, and that it can lead to heart attacks, strokes, and cancer. What you may not realize is that stress has a hugely negative effect on your digestive system. It’s not just the big stressful events, like moving or losing your job, that can wreak havoc on your digestion, but the everyday stressors of life can also make you run for the Rolaids.
Can stress really have that big of an effect on your digestion? The answer is yes. Your body does not easily manage stress and digest food simultaneously. You are wired this way for some good reasons.
The physiologic stress response is your body’s survival mechanism, also known as the fight or flight response. When you are being attacked, your body is not concerned with digesting food. Instead, it will garner all of its energy to focus on the attack at hand. Depending on the severity of the attack, this may cause your digestion to completely shut off, leaving the food in your gut un-metabolized.
In the case of a less severe attack, your digestive system still slows way down and could cause you to suffer in a number of ways. Low-grade stressors that can impact your metabolism include a poor diet, certain medications, work-related anxiety, a lack of sleep, or negative thoughts, just to name a few.
Read on to learn about 4 ways that stress impacts your digestion!
1. Stress Affects Gut Peristalsis
When you eat, you want your food to be in your digestive system for a certain length of time. This allows your gut to absorb the nutrients it needs, and, at the same time, allows it to get rid of any waste. As we’ve seen, when you are stressed, digestion can literally shut down. This can lead to constipation. Constipation interrupts the detoxification process that naturally happens during normal digestion. This can lead to a whole host of problems including gas, bloating, stomach pain, and weight gain.
Stress can also have the opposite effect on your digestive tract. For some constitutions, it can cause food to move too quickly through your system, not leaving enough time for the nutrients to be absorbed, which leads to nutritional deficiencies.
From a Mind Body Nutrition perspective, the digestive system is your body’s barometer–it tells you how you are handling life. You need to get to the root of what is causing your stress in order to heal your symptoms. For example, if you are dealing with constipation, it might help to ask yourself where in life you are unable to let go. What thoughts or experiences are you having that are causing you to contract? Are you holding on to something that you need to let go of? Questions like these can help you find the root cause that your constipation is stemming from.
2. Stress Causes Heartburn
Heartburn affects 20% of our population, and the biggest selling over-the-counter medications are digestive aids. That means that there are way too many people dealing with daily digestive discomfort.
The physiologic stress response can cause the sphincter that closes off the esophagus from the stomach to spasm. When this happens, stomach acid can make its way back up into the esophagus, causing it to burn the esophageal lining. Over time, this can leave you in a lot of pain – and more prone to disease. Taking heartburn medication will be a temporary relief, as it decreases or stops the production of stomach acid all together. Once you stop taking the medication, however, chances are the heartburn will return, unless you have uncovered the reason that you have heartburn in the first place. Many people associate heartburn with poor diet, smoking, and drinking alcohol, but your negative self-talk and your fast paced schedule can also be to blame.
Dynamic Eating Psychology teaches that your digestive symptoms can open the door to where in life you need to heal. For example, if you constantly have heartburn, and you aren’t eating the common food triggers, you can ask yourself where in life have you been “burned.” Could you be holding a grudge, a resentment, or a fear?
This type of emotional stress can really “eat you up” from the inside, and lead to physical discomfort. If you are questioning whether your thoughts can affect your physicality, then think of something that makes you angry and notice how your heartbeat instantly rises. These negative emotions can create a constant low level of stress, which often presents as heartburn. Conversely, taking the time to notice feelings, process them, and then let them go, can lead us back into emotional balance, which will have a profound effect on how we digest both food and life!
3. Stress Affects Gut Immunity
Did you know that roughly 60-80% of your body’s immunity is housed in your gut? This makes your digestive system the largest immune organ in your body. Considering that if you spread the area of your digestive system out, it would more than cover a tennis court, it’s time to pay this part of the body some due respect!
You can have pounds (yes, pounds!) of bacteria in your gut. Some of it is good bacteria, and some of it is not so good. Your good bacteria helps you to fight off viruses, helps you to digest your food, and helps to produce chemical reactions to help your brain and body function properly. This good bacteria is vital to your body’s immune function.
When you are in a stress response, the chemical reaction that is produced by the sympathetic nervous system wipes out a large proportion of your good gut bacteria. Over time, this can lead to a weakened immune system, and overall inflammation of the body.
You can strengthen your immune system by taking a probiotic supplement; eating foods that naturally contain probiotics, such as kefir, kimchi, and yogurt; and limiting foods with refined sugar. Sugar feeds the bad bacteria in your gut, which can lead to not only a weaker immune system, but low energy, low mood, digestive disorders, weight gain, and more.
4. Stress Can Weaken Your Digestive Metabolism
Another way the stress response can affect your digestive system is by decreasing overall blood flow to the body. When you are stressed, your blood flow is redirected to the brain and to the limbs, as the body perceives you are under attack. You need the blood directed to those parts of your body for quick thinking and fighting or fleeing. If your body is stressed while you are eating, due to eating too fast, eating in a negative emotional state, or eating too much, then it can cause your metabolism to slow down.
Stress chemistry produces two hormones that are part of this whole process – cortisol and insulin. These hormones that are released when you are stressed tell the body to store weight, store fat, and not build muscle.
What can you do to avoid this happening in your body? Slow down and breathe! The best state for your body to metabolize food is when it’s present and relaxed.
The next time you notice your digestive system shouting out for attention through the symptoms of constipation, heartburn, a stomach bug, or a few extra pounds, honor this intricate, wise and helpful system, and you may be rewarded with many years of good health ahead!
If you want to further explore your own relationship with stress and eating, consider our program Transform Your Relationship with Food.
Our brain and gut are more in sync than you may realize. For instance, the very thought of food can cause the stomach to produce digestive juices or the thought of giving a big presentation may cause constipation or uncontrollable bowels.The brain and gut are in constant communication. This direct relationship causes our gastrointestinal system to be sensitive to emotions and reactions such as stress.
When we are stressed, our brain sends signals for chemicals such as adrenaline, serotonin (a hormone that affects mood and is found in the digestive system) as well as the stress hormone cortisol to be released. These hormones can cause adverse reactions.
Stress negatively affects our digestive system in many ways. It can cause a decrease in blood and oxygen flow to the stomach, cramping, an imbalance in gut bacteria and inflammation. These symptoms can further develop into gastro intestinal (GI) disorders such as irritable bowel syndrome (IBS), irritable bowel disease (IBD), peptic ulcers or gastroesophageal reflux disease (GERD).
There are several things you can do to reduce stress and improve gut health. Practicing stress-management techniques such as exercising regularly, avoiding stressors, socializing, getting sufficient sleep or relaxing can greatly minimize your levels of stress.
In addition to practicing stress reduction techniques, you can support your digestive health by drinking less alcoholic beverages or consuming less sugar- as too much sugar can cause an imbalance in the ratio of good and bad bacteria in the stomach. Increasing your intake of foods that promote digestive health such as those rich in probiotics or foods that aid the body in producing digestive enzymes is also helpful.
The gut is often referred to as “the second brain” of the body. If you are experiencing consistent complications of the digestive system, your body is probably trying to tell you that there may be a bigger problem. Make an appointment with a gastroenterologist who specializes in the treatment of gastrointestinal, liver, and pancreatic disorders to examine your symptoms.
Jamaica Hospital’s Division of Gastroenterology consists of board-certified gastroenterologists who provide high quality and expert care to patients who suffer from such conditions in both inpatient and outpatient settings. To schedule an appointment, please call 718 206 6742 or 718 206 7001.
All content of this newsletter is intended for general information purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a medical professional before adopting any of the suggestions on this page. You must never disregard professional medical advice or delay seeking medical treatment based upon any content of this newsletter. PROMPTLY CONSULT YOUR PHYSICIAN OR CALL 911 IF YOU BELIEVE YOU HAVE A MEDICAL EMERGENCY.