Stress is an emotional or psychological state that is usually caused by environmental factors—a hectic, demanding, or chaotic lifestyle void of quiet and leisure may all lead to manifestations of stress. Those who suffer from stress may experience a feeling of pressure or tension building up within. Although stress is thought of as a psychological state, it causes physical, behavioral, and emotional symptoms, and can have incredible implications on the gastrointestinal tract, acting as a primary contributor to general digestive upset, as well as more serious digestive diseases and conditions. Researchers frequently refer to the “second brain” in the gut—the millions of nerve cells in the digestive tract that allow us to “feel” the inner world of our gut. This gut-brain interaction is essential for good digestive health and therefore, reducing stress is an important component in treating digestive diseases.
If you think stress may be contributing to your GI symptoms but you’re not sure, here are some useful signs and symptoms to look for:
Stress can contribute to and worsen nearly every digestive condition. Some of the most common digestive conditions that are strongly linked to stress include:
You may wonder how an emotional or mental state such as stress can cause physical symptoms that potentially lead to disease. There is a very clear physiological explanation linking stress (a psychological condition) to physical manifestations. When presented with a stressful event (for instance, let’s say you stumble upon a large black bear in the woods), the body responds in very physical ways; the adrenal glands send hormones coursing through the body, including adrenaline and cortisol, mediators of the “fight or flight” response that provide us with quick bursts of energy. As a result, your heart rate increases, you start to breathe fast, you get sweaty, the hair on your body stands on end, your blood pressure goes up, and your pupils dilate. This adrenal response strongly affects the digestive system as well: it increases stomach acid production, causing heartburn and nausea; shunts blood away from the intestines, interfering with digestion and absorption of nutrients; decreases enzyme secretion; slows down stomach emptying; and speeds up colonic contractions. In times of stress or threat, the adrenal system diverts resources from the digestive tract, so that all energy and attention can be focused on the stressor at hand, protecting our survival. Once the danger passes, the relaxation response kicks in, allowing everything to get back to a normal, mellow state. But modern life tends to keep many of us constantly revved up. Our body experiences this as an onslaught of one stressor after another. This chronic fight-or-flight, stressed-out state can have the following devastating effects on the body:
These physical manifestations of chronic stress lead to chronic digestive upset and gut bacterial shifts that can result in serious disease.
Stress is typically a clinical diagnosis based on how a person feels. Assessing one’s lifestyle, environment, and daily demands and schedule, as well as personal, medical, and emotional history, can help in diagnosing stress. Being familiar with the physical, emotional, and behavioral manifestations of stress is also a helpful tool in diagnosing or self-diagnosing stress.
When diagnosing the cause of your digestive problems, stress is an important factor to consider, as stress is often a major contributor to digestive upset, and stress reduction proves an incredibly effective treatment for many digestive disorders. Although stress can be an incredible contributor to your digestive distress, keep in mind that it may not be the whole story. Most digestive disorders have more than one cause and often, stress is a contributing factor, and not the main cause. Be wary of conditions like bacterial overgrowth, leaky gut, and irritable bowel syndrome –all conditions that a decade ago we thought were “all in people’s heads” but we now know they are caused by very real gastrointestinal disturbances. Thinking outside the box and realizing that stress may not be the only cause can help you find both the source behind and the remedy for your digestive distress. This means taking an honest and well-informed look at your diet, the medications you are taking, your health history and symptoms, your exercise routine, as well as your stress levels.
Stress can also influence how you are diagnosed and treated. When people appear anxious and stressed during medical appointments, it can be distracting for the physician, who may then surmise, incorrectly, that stress and anxiety are the only problems at hand. This error happens far more frequently with female patients. Women suffer needlessly and doubt their own intuition about their bodies when their complaints are attributed purely to stress. In these cases, a more thoughtful and comprehensive diagnosis and treatment plan is usually needed—which of course, might include stress reduction. If you are told that stress is what’s causing your digestive distress and you are unsatisfied with the diagnosis or are convinced there is more to the story, be persistent. Our body has its own innate sense of when something is wrong, and it usually encourages us to seek answers and solutions even when mainstream medicine is telling us we’re fine or failing us in other ways. Ultimately, our bodies have a wisdom that should not be ignored.
If you think stress may be to blame for some of your digestive problems, seeking out methods to reduce your stress is important and may even save your life. Recommended integrative treatment methods for reducing stress include:
If you think you may be depressed, anxious, or overly stressed, it may be important to have your mental health assessed by a professional, especially if you’ve been diagnosed with a digestive condition (like IBS) and told that stress is partly to blame. Seeing a therapist and undergoing talk therapy may be helpful in reducing your stress and treating your digestive symptoms.
Gut-directed hypnotherapy (GHT), hypnosis focusing on gut-related issues, to relieve stress has been found to be an effective therapy for IBS in several studies, and superior to medical treatment alone. Quality of life outcomes are improved, and it has a long-term positive effect, even in difficult to treat cases of IBS.
Exercise, or simply moving your body, is a longtime solution for stress, as it increases endorphins and promotes better sleep, both mechanisms that can drastically reduce stress.
By relaxing the mind and moving the body, yoga proves effective in managing stress. Studies show that yoga can raise levels of the feel-good hormone serotonin as well as endorphins, and decrease stress-related hormones like cortisol, improving mood and reducing stress.
Breathing is a type of meditative practice that can relieve stress and anxiety and may help in treating your digestive distress. Follow this breathing model to help manage your stress:
(Courtesy of Emily Perlman, MS, BCB. Adapted from Richard Gevirtz and Paul Lehrer.)
Other types of meditation have proven effective in relieving stress, including Transcendental Meditation (TM). TM alone leads to startling changes in heart rate, metabolic rate, and breathing rate and studies show that people who practiced TM have much lower blood pressure.
Studies have found massage beneficial for stress relief, anxiety, depression, boosting immunity, treating pain, improving stiffness, and even cancer therapy. Massage also has a hugely beneficial effect on the GI tract, particularly in people with IBS and chronic abdominal pain.
Recent studies show that gut bacteria may be associated with stress, anxiety, and depression. Therefore, promoting a healthy microbiome is important in reducing and managing stress, as well as in practicing resilience in stressful situations.
