The Stress-Digestion Connection

Maybe you’ve lost your appetite before a big presentation or event. Or perhaps you’ve been so anxious that you found yourself in need of a restroom…IMMEDIATELY. Others may find that stress and constipation go hand in hand. Think about phrases like a ‘gut-wrenching’ situation,’ ‘butterflies in my stomach,’ a bit of news that makes you ‘sick to your stomach,’ he’s got a ‘cast iron stomach,’ she’s got a ‘gut feeling,’ and so on. These idioms all refer to the connection between our gastrointestinal (GI) system and brain. Our emotional brains and our physical bodies communicate constantly and what happens to one certainly affects the other.

It's called the gut-brain connection, and it’s very real. Let’s learn more. 

Because the gut and brain are so deeply connected, a person’s intestinal duress can be either the result of stress and anxiety, or the cause. 

Gastrointestinal disorders like bloating, pain, loose stools, constipation or other maladies which occur unrelated to a physical cause like an infection, food poisoning or illness, are called functional gastrointestinal disorders and they affect between 35 and 70 percent of people at one point or another. Women are affected in greater numbers and with more frequency than men. 

While multiple types of factors can cause or contribute to a functional gastrointestinal disorder (think social, biological and psychological), studies indicate that stress is to blame. When you’re dealing with psychological or environmental stress, those stressors can exacerbate (or trigger) gastrointestinal pain. In fact, psychological therapy can be used alongside, or in lieu of, other treatments for functional gastrointestinal disorders.

Your GI tract, AKA the enteric nervous system, is sometimes called the ‘second brain,’ and with good reason: it functions independently from the central nervous system. It operates using the same sorts of neurotransmitters and neurons as does the brain and spinal cord (central nervous system). When the neurons lining the digestive tract sense that food’s on the scene, they send a message to muscle cells, telling them to start a series of contractions to move the food through, breaking it down, separating the nutrients we need from the waste we do not. 

Stress can worsen an existing GI issue, or it can trigger GI issues. Here’s how it affects different parts of your gastrointestinal system:

There are millions of neurons in the gut, which communicate with the brain constantly. That connection is what allows us to feel things like butterflies in our stomach. When stress stops by for a visit, it disrupts that communication, potentially triggering bloating, constipation, pain and general feelings of discomfort in the gut. Stress can also affect the millions of bacteria that live in the gut. Those bacteria influence both gut health and brain health. 

Stress changes gut bacteria, which changes your mood – not for the better. In fact, stress experienced in early life can permanently change how the nervous system develops, which in turn can set a person up for gut dysfunction and disease later in life.

Stomach pain, bloating, discomfort and nausea are more easily triggered when the body is experiencing stress. Extreme swings in appetite – either eating way too much or way too little – are also hallmark effects of stress on the stomach. Eating too much or too little also affects mood, so a vicious cycle can occur. Ulcers may feel more painful under stress, but it’s a myth that stress causes them – they’re actually caused by bacteria. 

The esophagus can also suffer during times of stress. When we self-medicate with tobacco or alcohol, for example, acid reflux can occur. Heartburn pain is increased by stress. Intense stress can even cause esophageal spasms so severe they mimic a heart attack. Less frightening but annoying stress symptoms are burping and gassiness, caused by swallowing too much air when eating. Swallowing in general can also feel more difficult.

The intestinal barrier, which protects our bodies from most food-related bacteria can be weakened by stress. This can allow harmful bacteria to enter the body. Most of these are mitigated by the immune system, but it weakens when stressed as well, meaning the odds of becoming ill (or just feeling a constant low-grade malaise) are increased.  

Bowel pain, discomfort and bloating can be a byproduct of stress. The rate at which food moves through the bowels is also affected by stress. It can dramatically speed up, which can mean diarrhea. It can also slow way down, and that sets us up for constipation. Our ability to absorb nutrients can be lessened by stress, but our ability to produce uncomfortable gasses can ramp way up. People with bowel disorders like irritable bowel syndrome or inflammatory bowel disease will likely see these conditions worsen under stress, because the nerves in their gut are already made more sensitive.

Managing stress is an important tool in maintaining a healthy and well-functioning GI tract/digestive system. Ways to lower stress include maintaining a healthy social network, getting regular exercise and making sure you get enough sleep. Morning routines can be important, too. Check out our tips for creating stress-lowering morning routines.

Because stress levels and digestive issues can build on one another, creating a vicious cycle, making lifestyle adjustments to benefit your GI tract and digestive function can also reduce stress. You can break the negative cycle, and even get it moving in a positive direction. Here are some things to try:

Stop smoking. This helps reduce or prevent reflux because smoking weakens the muscles of the GI tract. Weakened muscles don’t properly seal off the stomach, which is full of strong acid, from entering the upper GI tract like the esophagus and throat. Reflux causes pain and heartburn and can eventually lead to permanent damage.

Lose weight. Did you know that belly fat itself can cause heartburn? It’s true. Extra tummy fat puts pressure on the stomach and literally squeezes acid up into the esophagus, causing heartburn, reflux and pain. Maintaining a healthy BMI can lessen or even entirely relieve symptoms like heartburn or reflux.

Don’t binge alcohol. Binge drinking means drinking eight or more units of alcohol in one sitting for men, and six or more units in one sitting for women. The National Institute on Alcohol Abuse and Alcoholism defines a unit, AKA ‘standard drink,’ this way: one "standard" drink (or one alcoholic drink equivalent) contains roughly 14 grams of pure alcohol, which is found in: 12 ounces of regular beer, which is usually about 5% alcohol. 5 ounces of wine, which is typically about 12% alcohol. 1.5 ounces of distilled spirits, which is about 40% alcohol.

If you are experiencing GI issues and need relief, talk to an INTEGRIS Health primary care provider. For more health and wellness content, visit the INTEGRIS Health For You blog.