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!

First published in the Inside Tract® newsletter issue 162 – July/August 2007
Photo: pixabay.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.