Stress and the Digestive System

Handout:
Digestion.pdf

The Science

• Have you ever felt nervous and experienced “butterflies” in your stomach? Or felt stressed and then felt nauseous? This is because the brain directly affects the stomach. The gut is the highest area of nerves outside of the brain and is sometimes called the "second brain."
• The stress response inhibits the digestive system while the relaxation response activates it. That is why the relaxation response is often called “rest and digest.”
• When the stress response is activated, digestion is suppressed so the body can reroute its resources to trigger fight or flight. The central nervous system shuts down digestion by slowing contractions of digestive muscles and decreasing secretions for digestion.
• If the stress response happens occasionally, the body recovers and continues with normal functioning. If the stress response is triggered too often, the body has a harder time recovering. This impedes the flow of digestion and can cause stomach upset. It can also contribute to the development of irritable bowel syndrome and/or ulcers.
• The digestive system cannot function properly with too much stress or stimulation. Thus, we need to practice activating the relaxation response as often as we can.

Stress can cause:

• Acid reflux
• Bloating
• Butterflies
• Constipation
• Cramps
• Diarrhea
• Excess stomach acid
• Gas
• Heartburn
• Increase/decrease in appetite
• Indigestion
• Inflammation
• Nausea
• Stomach pain/discomfort

Stress plays a role in:

• Crohn’s Disease
• Gastritis
• Gastroesophageal Reflux Disease (GERD)
• Infections
• Irritable Bowel Syndrome (IBS)
• Ulcers

The Techniques

Here are some tips for learning how to manage stress and decrease symptoms affecting the digestive system:

• Exercise: Exercise is one of the best things you can do to manage stress and maintain healthy digestion. It improves hormonal balance and stimulates the release of endorphins that improve mood and decrease stress.
• Breathing: Hyperventilation and over breathing can cause excess air, leading to bloating, gas, pain and stomach discomfort. Relaxed breathing can stop this. Slow breathing also engages the body’s relaxation response and lowers the stress response.
• Relaxation Therapy: Relaxation techniques can be used to retrain your body’s response to stress. You can do things such as yoga, tai chi, meditation, breathing exercises, gut-directed hypnosis, progressive muscle relaxation, or biofeedback.
• Diet: Eat regular meals and snacks throughout the day, and avoiding skipping any meals. This helps to alleviate symptoms of irritable bowel syndrome, acid reflux, constipation, bloating, diarrhea, and stomach cramping. Waiting too long to eat, not eating enough, or having an unbalanced food intake (i.e. not eating enough then eating large amounts in one sitting) can cause more digestive problems. Eating regularly also helps to prevent ravenous hunger that often leads to eating quickly and eating past comfortable fullness. It may help to find a quiet place to relax and to eat at a normal pace. Drinking an adequate amount of water or adjusting fiber intake (decrease or increase fiber from whole grains, fruits, vegetables, and other food sources) may also be beneficial to improve digestion. Not eating enough reduces the healthy diversity of gut bacteria. So if you are working on increasing your food intake, it is common to expect worsening digestive problems before you notice improvements. That doesn’t mean that you need to cut any types of food out of your diet completely. Before eliminating any foods from your diet, it is important to speak with a dietitian who can help you to identify when certain foods might actually be triggering symptoms. A dietitian can also help you to identify when emotions cause an increased or decreased appetite, and the dietitian can help you to become more attuned to physical cues for hunger and fullness. Consider taking probiotics (healthy bacteria for your gut) to help regulate digestion. Also consider incorporating prebiotic foods (foods that aid in production of healthy gut bacteria) into your diet. This includes any of the following: artichokes, asparagus, bananas, barley, beans, beets, berries, carrots, chickpeas, fennel, flax, garlic, ginger, honey, leeks, legumes, lentils, maple syrup, nuts, oatmeal, onion, potatoes, radishes, rye, seeds, sweet potatoes, turmeric, turnips, wheat bran, wheat flour.
• Keep a Daily Journal: Keep track of what you eat and what your symptoms are to look for patterns. This may help you identify foods that irritate your stomach.
• Cognitive Behavioral Therapy: This is often done as one-on-one training with a therapist for stress management skills and emotional regulation. It could also help you pinpoint psychological conditions contributing to GI stress.
• Perspective: In many studies, subject’s GI problems worsened when they had negative perceptions of stressful events. Before emotionally reacting to a situation, take a step back, breathe, and ask yourself how you can see the situation as an opportunity instead of a threat.
• Medical: In some cases, you also may want to see a doctor to rule out other causes of intestinal discomfort, such as a virus, bacteria, lactose intolerance, allergies, acid reflux, or a more serious condition. A doctor or nutritionist may also have more information on fiber supplements or probiotics that can help regulate digestive health.