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Dr. Brynna Connor, MD
Dr. Brynna Connor
Healthcare Ambassador at NorthWestPharmacy.com

Gastrointestinal Health

How Stress Affects the Gut and What You Can Do About It

April 1, 2021

Your gut, also known as your digestive system, includes all of the organs that help your body digest and absorb food. When your gut isn’t working properly, you may not be able to absorb the nutrients you need in order to properly fuel your body. You also may end up dealing digestive symptoms that cause discomfort or pain.

Different areas of the body, including the digestive system, can be affected when you’re feeling stressed. Too much stress can cause health problems and make you feel worse both physically and mentally. Learning how to better deal with stress may lead to better digestive health and fewer gut symptoms.

Understanding Stress

Stress happens when an outside event, situation, or life change makes you feel physically or emotionally tense. Stress is not always a bad thing -- it can help protect you from danger. For example, if you’re driving and a car cuts you off, a feeling of stress allows you to respond quickly by slamming on the brakes. Additionally, stress can motivate you. Feelings of nervousness during a big test or work event can help you perform better.

Everyone experiences feelings of short-term stress from time to time. These feelings go away on their own once the outside factor causing the stress is gone. However, some people also deal with longer-term feelings of stress, called chronic stress. Examples of chronic stress include ongoing problems with money, work, or relationships. This type of stress can be harmful over time.

What Happens in the Body When You’re Stressed?

A few basic changes happen within your body in response to stress:

  • Your muscles tense up
  • Your heart beats faster
  • You breathe more quickly
  • Your brain becomes more alert

Once danger has passed, your body will calm back down, and heart and breathing rates will return to normal. However, during times of chronic stress, your body feels like it needs to hold on to these responses. You don’t feel like you can relax and go back to normal.

What are the long-term effects of feeling constantly stressed?

When you feel constantly stressed, you don’t sleep as well, your immune system can’t fight off infections as easily, and different organs in your body don’t work as well. You may also develop anxiety or depression. Over time, chronic stress can make you more likely to develop different diseases. Chronic stress can also lead to weight gain, insulin resistance, the development of several chronic health conditions (diabetes, metabolic syndrome and psychological conditions) that may be very difficult to treat once they begin.

Managing stress in a healthy way helps your body and mind function at their best.

How Does Stress Impact the Gut?

Chronic stress can lead to changes in every part of the digestive system. These changes can show up as different gut symptoms.

Esophagus

Chronic stress may lead to problems with the esophagus -- the tube that leads from your mouth into your stomach. Some common problems with the esophagus include:

  • Acid reflux: In this condition, acid and food from the stomach may come back up into the esophagus.
  • Gastroesophageal reflux disease (GERD): GERD is a more severe form of acid reflux that can eventually lead to additional health problems.
  • Heartburn: This is a feeling of pain or burning in your throat or chest. Heartburn can be a symptom of acid reflux or of GERD.

Some studies have found that people who are frequently stressed out are more likely to have GERD and experience heartburn. Additionally, among people who already have GERD, chronic stress can make symptoms worse. Stress can lead to GERD (through the physiological changes mentioned above as well as lifestyle changes related to stress, such as "stress-eating" and the food choices made therein. Likewise, GERD can also then lead to more stress about one’s health, especially, as the conditions mentioned above worsen because the pain can be quite severe.

Stomach

One common physical symptom of stress is feeling sick to your stomach. For example, you may get stomach pains or even throw up while before or during a big, stressful event.

Stress is also frequently connected to stomach ulcers, or sores that develop in the tissue lining your stomach. Ulcers can cause pain or a burning feeling in your stomach, often at night or in between meals. Some studies have found that people with high stress levels are more likely to have severe stomach ulcers. However, many experts believe that stress doesn’t directly create stomach ulcers -- it just makes existing ones worse.

Intestines

Your intestines are long tubes in your abdomen that help digest nutrients from food. When you are stressed, your intestines may not be able to do their job as well, leading to symptoms like constipation and diarrhea.

There are a few reasons why this may happen:

  • Inflammation: Stress makes your body produce substances that cause inflammation in your gut.
  • Gut bacteria: You have helpful bacteria growing in your intestines that help digest food. Stress can kill off some of these good bacteria and allow the growth of more harmful bacteria that release toxins, make you feel sick, and lower your mood.
  • Leaky gut: Stress can lead to a phenomenon called "leaky gut." While normally the intestines carefully control what is allowed in or out, stress makes them more leaky, allowing bacteria to leave the intestines and enter the bloodstream.

Stress can also make symptoms worse for people with irritable bowel syndrome (IBS). IBS is a health condition in which people frequently experience abdominal pain, constipation, and/or diarrhea. Much research has found that stress can make your intestines more sensitive to problems and can make you more likely to experience IBS symptoms.

In my medical practice, we utilize very comprehensive testing tools to better understand an individual’s very specific issues. This can involve breath testing, saliva testing and stool testing, in addition to serum (blood) testing.

Learning to Relax

You may not realize that relaxation is a skill that you can learn, practice, and get better at. Trying new strategies that help your body learn to relax can help reduce your stress levels.

Deep Breathing

When you feel stressed, you typically breathe faster and shallower and may not take in enough oxygen. Deep breathing exercises can help counteract the body’s response to stress, making you relax and feel calmer.

To practice deep breathing, put one hand on your chest and the other on your stomach. Take in a slow breath through your nose. If you’re breathing deeply, you should be able to feel your stomach move, but the hand on your chest should stay still. Once you’ve taken a deep breath in, release the air slowly out of your mouth. Repeat this process several times, until you start to feel your body slowing down. Practicing deep breathing on a regular basis can lead to improved health and better digestion.

Meditation

Meditation is another stress-fighting tool. There are many types of meditation, but most of them involve spending a period of time focusing on something specific, such as your breath, an object, a phrase, or the present moment.

Meditation can help you feel calmer. While stress increases inflammation and hurts the immune system, meditation has the opposite effect. Meditation has been found to improve digestion and reduce symptoms of IBS.

You can practice meditation on your own by finding a quiet area, sitting in a comfortable position, and focusing on your breath. If your thoughts wander, bring them back to your breathing. Try this for five or ten minutes. If you’d like a little more guidance, there are many different websites, smartphone apps, and online videos that can walk you through a guided meditation.

Practicing Mindfulness

Mindfulness is a specific type of meditation. It includes the idea of living in the moment and being aware of what’s going on around you. An important part of mindfulness is learning to not judge events, moments, or thoughts as "good" or "bad," but rather to accept them as they come. Some ways you can practice mindfulness include:

  • Take a walk. Don’t look at your phone or listen to music as you stroll, but rather pay attention to the things happening around you.
  • Find little moments throughout the day. As you’re working, waiting at a traffic light, or doing chores around the house, take a brief moment to pause and notice your environment. What do you see, hear, and smell?
  • Do one thing at a time. If you have a lot of tasks that need to get done, try to avoid the temptation to multitask. Instead, choose one specific thing to do and focus all your attention on that until it’s done.

For people with digestive issues, mindful eating can be a big help. Mindful eating means paying close attention to the food you’re eating and the way the food makes your body feel. Mindful eating can help you digest your food more easily and have fewer gut symptoms after your meals. Ways to practice mindful eating include:

  • Stopping and assessing how hungry you feel before you begin to eat
  • Practicing deep breathing exercises before a meal
  • Chewing your food more slowly
  • Paying more attention to how your food looks, smells, feels, and tastes
  • Turning off the TV or other electronic devices while eating

You can find books, websites, and classes that can help you better understand mindfulness. Some studies have shown that mindfulness programs can reduce symptoms of different digestive disorders, including IBS.

Yoga

Another relaxation technique that may help the gut is yoga. Yoga is a practice that combines physical exercises, breathing exercises, and meditation. People who practice yoga can reduce stress levels and often experience many health benefits, including better digestion. Taking a yoga class or following along with a yoga video may help relieve symptoms of IBS.

Other Ways to Reduce Stress

There are also many other ways to prevent and treat chronic stress. It may take some trial-and-error, and using a combination of different stress-reducing techniques, before you find something that works for you.

Physical Activity

Exercise can improve your mental and physical health and lessen stress. However, you don’t have to join a gym or start an intense workout program to see the benefits. Light activity such as walking is completely sufficient to relieve stress. If you try yoga, that also counts as physical activity! Aim for about half an hour of activity per day to raise your spirits.

Physical activity is also connected to gut health. It encourages the muscles to release substances called myokines that control metabolism, decrease inflammation in the digestive system, and reduce your chances of getting different digestive diseases. Exercise can also help lower your risk of getting cancer in your digestive system.

Change Your Diet

If you’re someone who suffers from a digestive disorder like GERD or IBS, stress can make your symptoms worse. Try to figure out which foods are more likely to trigger your symptoms, and avoid those during times when you know you’re going to be under more pressure.

If you have GERD or frequently experience heartburn, it may help to stop eating foods that are acidic, spicy, or high in fat. You can also try avoiding coffee, tea, chocolate, and mint. Additionally, try to finish up meals and snacks three hours before you go to bed. This can help you avoid nighttime heartburn.

If you have IBS, it may be helpful to avoid dairy, caffeine, soda pop, and alcohol during times when your stress levels rise. Getting more fiber, eating smaller meals, and drinking more water can also reduce IBS symptoms.

Get More Social Time

When you’re feeling overwhelmed, try talking to friends and family. Having someone to vent to, help you work out problems, or share in fun times can help you feel less stressed. What’s more, social isolation can itself be a cause of stress.

To connect with others while also promoting gut health, try sharing meals with a friend or family member. If you’re trying to follow a specific eating plan to help with digestive symptoms, try finding an accountability partner. This person can check in with you to see how well you’re sticking to your plan and offer encouragement when you need it. Having an accountability partner can help you more easily reach your goals.

When to Get Outside Help

Sometimes, stress can pile up and start to feel impossible to manage on your own. If you are feeling like you can’t keep up at work or at home or like your worries are growing out of control, it may be time to seek help from a professional.

One way to get help is by talking to your doctor. Your primary care provider can give you a referral to a mental health specialist, such as a psychiatrist, psychologist, therapist, or counselor. These professionals can help you work through the causes of your stress and find effective treatments that help you better manage it.

Conclusion

Stress is a factor that can bring on new gut problems or make existing ones worse. It can make multiple different parts of your digestive system, including your esophagus, stomach, and intestines, not work as well as they should. If you experience ongoing stress for long periods of time, you are more at risk for developing a variety of different health conditions.

Treatments are available. Learning how to relax can help you avoid carrying around the effects of stress within your body. Dealing with stress can be challenging, but your doctor and other health professionals can help you figure out how to prevent stress from being an ongoing problem.

Articles authored by Dr. Connor are intended to facilitate awareness about health and wellness matters generally and are not a substitute for professional medical attention or advice from your own healthcare practitioner, which is dependent on your detailed personal medical condition and history. You should always speak with your own qualified healthcare practitioner about any information in any articles you may read here before choosing to act or not act upon such information.