If you think that stress is affecting your digestion, you could be right. The old narrative in medicine was that the cause of IBS is not clear. A modern perspective acknowledges the impacts of gut microbes and stress on digestion. I will share what we know now and provide some easy and accessible ways to feel better.
Stress and Digestion Woes
Stress is a normal part of life, as are digesting and eliminating. Yet, if you are reading this, your experience of them may frequently feel uncomfortable. Functional bowel problems and being overwhelmed by stress are extremely common. The American Institute of Stress says that 77 percent of people experience stress that affects their health. What you may not know is that if you have experienced food poisoning or too much stress or adversity, especially during your early development, there is an even greater chance that severe digestive symptoms will bother you now.
Double Digestion Trouble
Two big factors that can disrupt the gut are infections and stress. Whether recent or long ago, acute or chronic, stress and infection promote inflammation and intensify digestive woes. Luckily, we understand the relationship between stress and microbes and irritable bowel syndrome much better these days, making it easier to treat the symptoms effectively and move towards resolution.
The Brain in Your Head and the Brain in Your Gut
One physical connection we can make between stress, microbes and IBS is via the nervous system. The main brain in our head interacts with all organs via the central nervous system (CNS), which connects to the ENS, or enteric nervous system in your gut, and the microbiome there, via the vagus nerve. The ENS is made of 100 million nerve cells embedded in the walls of your GI tract from your esophagus to your rectum. It is like a brain in the gut that controls blood flow and movement in the gut, directing processes like swallowing, releasing enzymes, absorbing nutrients, and relieving yourself.
The Gut-Brain Connection
Your ENS, gut microbes and main brain communicate via molecules and chemical messages. In this way, your gut may strongly influence your brain and vice versa. Through this gut-brain circuitry, stress affects digestive functions. Brain imaging shows that folks with IBS are wired differently than those without. When their gut tissues (viscera) are stimulated, a region of the brain involved in physical and social vigilance and discomfort (the anterior cingulate cortex) lights up in a way that doesn’t happen for those without digestive woes.
Effects of Stress on Digestion
If you’ve ever had to run to the bathroom due to nerves, or wondered why you can’t “go” when you travel, you know that stress directly affects gut motility and fluid secretion and can make food pass through your gut too quickly or too slowly. Stress chemicals intensify pain, leading to stomach cramps or discomfort in the bowels. As discussed, folks with IBS react to stimuli that would not bother someone else. This more intense response usually affects the large intestine with some combination of chronic diarrhea, bloating and constipation. Hormones released as part of our stress response also encourage bad bacteria to grow.
The Microbe Connection
In those with chronic bowel disorders, even mild psychologic stress affects the digestive system. One reason for this may be a difference in gut bacteria leading to different neurotransmitters and digestive secretions. 95% of the serotonin we have is made by gut bacteria and stored in the gut, and it appears to stimulate the production and release of acid in the stomach and mucus in the colon. If good gut bacteria are too few (in number or type), the bad ones easily take over, and that can contribute to the stress response.
Big Stress has a Big Impact
Another component to this cascade is stressful life events. Stress at any point in life that is especially intense or long-lasting is associated with changes in gut bacteria, impacting neurotransmitters and thus mood. When the stress is chronic, the changes to the gut can become the stable state, and the microbiome can become deeply affected and hard to change. But stress does not only change our digestion or microbes, of course, it affects our emotions. Interestingly, despite IBS being an intestinal disorder, most health care costs associated with IBS are for non-gut complaints, such as mood disorder symptoms.
A Heightened Stress Response Primes the Brain and Gut for IBS Feeling
People with IBS tend to feel bad. Digestive complaints affect how we feel and how we feel affects the gut. Additionally, folks exposed to too much adversity during a pivotal time in their development may be primed to have an up-regulated stress response. The resulting exaggerated reaction to future stress affects their emotions and their guts. Intense stress in childhood, as measured by Adverse Childhood Events, or ACEs, is a contributor to IBS or IBD in adulthood and is correlated with increased IBS severity. Managing stress can interrupt this pattern.
Calming Stress can Prevent a Cascade into Serious Illness
One way out of the cycle is to address our stress and our gut simultaneously. Stress management may also strengthen the gut barrier. The intestines have a tight barrier to protect the body from pathogenic bacteria in our food. Stress can weaken the intestinal barrier, damaging the gut and making it overly permeable (AKA leaky). This allows bacterial pathogens into the body, worsening inflammation. The more stress in our lives, the more likely we are to have a pathogenic bacteria imbalance, chronic inflammation and potentially even an autoimmune illness such as Ulcerative Colitis or Crohn’s Disease.
The Long-Term Goal
For a more joyful life without constant mood and digestive challenges, I suggest mindfully creating a relaxed lifestyle. It is also a good idea to using proven mind-body modalities to reduce stress, and if necessary, address old traumas. Adopting a plant-based, non-inflammatory diet is also a good way to support digestive and intestinal health. But of course, these deep changes take time. That is okay! Changes are more likely to last if undertaken a step at a time. Meanwhile, it is okay to use supplements to kick-start your quality of life.
Feel Better Faster
Using supplements is an easy way to start to turn stress related IBS around. While food-based approaches seem like a no-brainer, they can often be hard from a mental health perspective. I do think well researched diets like the low FODMAP diet can work wonderfully, but the risk is that being on restrictive diets may trigger disordered eating, reduce microbial diversity and be unsustainable.
I suggest always pairing food-based approaches with gut-directed CBT or Hypnosis (both have a great evidence record) under the guidance of a therapist, and always having an exit strategy or plan to widen the diet and reintroduce foods. One strategy you can incorporate for quick relief is ashwagandha. This is a medicinal botanical with a long track record of efficacy for stress.
My favorite product is Flora’s Stressveda, which uses a clinically-proven ashwagandha extract. It can make it easier to make the best food choices. In one study folks reduced emotional eating and cortisol related belly fat, losing 3% of their body weight after 8 weeks. Starting this supplement while incorporating diaphragmatic breathing would be a wonderful way to get a jump on stress and feel better faster. Taking Stressveda provides 600 mg of KSM-66 ashwagandha, which was shown in clinical studies to reduce perceived stress by 44%.
Psychological and physical stress can trigger inflammation. Ashwagandha’s many benefits seem to mostly stem from an ability to address an imbalanced stress response. Managing stress and cortisol seems like a reasonable way to prevent development of inflammatory disease and a range of other issues.
Inflammation occurs when tissues are injured by bacteria, trauma, toxins, heat, or any other cause, like stress that causes cortisol release. After repeated exposure to high cortisol, the immune system breaks down, and autoimmunity affecting gut tissue can be a result. This can worsen autoimmune symptoms contributing to the development of Ulcerative Colitis or Crohn’s.
Gut muscles contract to move food in your intestines. This is connected to stress because the adrenals regulate electrolytes which signal the muscles to contract. Under stress, the adrenals can be too overwhelmed by their other job making the stress hormone cortisol, thus impacting absorption of water and nutrients, and our gut contractions. Those with IBS have stronger, longer contractions that cause gas, bloating and diarrhea, or weak or reduced contractions that slow food passage and lead to hard, dry stools.
The other important factor is to modulate and rebalance the gut bacteria. Moving toward a diet filled with leafy greens, colourful vegetables and fiber filled beans and grains can come from foods, or specific fiber-friendly supplements. This helps feed the good bacteria with prebiotics and fiber to encourage the good bacteria to grow more plentiful without promoting less helpful microbes.
Healing the gut, supporting the nervous system and rebalancing the microbiome is a way that we can work towards reintroducing foods. Reducing stress can also prevent a slide into more serious conditions, and it can prevent stress eating, reduce inflammatory cortisol, and speed up and improve our healing.
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