How to tell when stress is causing gut problems

Here, we'll take a closer look at what stress can do to your gut, and what you can do to try to alleviate the symptoms.

What stress does to your gut

If you've ever felt nauseous or anxious while stressed, this may well have been a result of your gut. Our guts are intricately linked to other systems within our bodies, including the brain, and so when you're feeling stressed, your gut is told, and it responds in a variety of ways.¹ One way, according to a number of studies, is through decreasing gastric motility, or the rate of your stomach emptying, which can, in turn, leave you feeling sick and anxious.² But at the same time, stress can increase the contractions lower down in the gut, whilst also increasing fluid secretion, which can result in diarrhoea and/or the feeling of needing to urinate more often.³

What's worse, stress can also increase intestinal sensitivity, which lowers the threshold at which we feel discomfort.⁴ For instance, analysis of the pH (acidity level) in the oesophagus, or food pipe, indicates that the amount of acid reflux doesn't increase during stress, but the probability of experiencing the feeling of reflux as heartburn does increase.

Many of the effects of stress on the gut are thought to be brought about by a hormone called corticotropin-releasing factor (CRF), which is released from nerve cells in the hypothalamus of the brain. CRF stimulates the gut directly via two types of receptors in the gut wall. CRF-1 receptors stimulate colonic contractions, while CRF-2 receptors reduce upper gut activity. One theory is that this dual effect preps the body to eliminate toxins through vomiting and diarrhoea should it be necessary.⁵

Alongside the above side-effects, stress can also help to contribute to several gut conditions, including:

• Inflammatory bowel disease: a study concluded that chronic stress, adverse life events, and depression could increase the risk of relapse in patients with Crohn's and ulcerative colitis.⁶
• Irritable bowel syndrome: in a study looking at almost 600 people with gastroenteritis caused by the bacterium Campylobacter, researchers found that the patients' ability to handle stress before the infection was a pivotal factor in whether they went on to develop IBS.⁷ It's also commonly agreed upon that in people who have IBS, stress can make it worse.
• Peptic ulcer disease: most ulcers result from infection with bacteria called Helicobacter pylori (H. pylori) that weakens the protective mucous coating of the stomach, allowing acid to get through to the sensitive lining beneath. However, some evidence suggests that ongoing stress inflames the mucosal lining, allowing gastric juices easier access to the area they damage.⁸

Reducing stress

While keeping stress under control is by no means an easy task, there are a number of steps you can take to help keep it at bay, including:

• Breathe deep: stress can cause shallow breathing, which means that your body won't get enough oxygen to fully relax. Taking some time to focus on your breathing, and to breathe deeply, can help you to relax and reduce your stress. Imagine you've got a beach ball behind your belly button and try to slowly inflate and deflate it.
• Get physical: exercise is a well-known tension reducer and can help to relieve the symptoms of stress, too. Aim to add more exercise into your life, carefully increasing the amount slowly, whilst assessing your body's tolerance as you do so. Remember to also make sure you get a good night's sleep to recover properly and avoid injury.
• Learn to say no: thinking you can 'do it all' and taking too much on can create unnecessary pressure. Learn how to set boundaries for yourself and consider carefully whether you're able to take on additional responsibilities, like projects at work or family commitments that you might not have the extra time or energy for.
• Take time out for yourself: take at least one day off each week to do something you really enjoy: whether this is listening to music, playing with a pet, or spending time with friends. If it gives you a good chuckle, so much the better, as laughter is a natural stress reliever that can help to lower blood pressure and relax your muscles.⁹
• Consider therapy: CBT, or cognitive behavioural therapy, is a type of psychotherapy that helps you to change counterproductive thoughts and behaviour and learn coping skills, to better manage stress and anxiety.

Nutrition and stress

There's anecdotal evidence that a diet high in sugar and fat, and lower in vitamins and minerals, can make you feel more stressed, whilst eating a higher nutrient, more wholesome diet could help to ease the impact of stress. It's important therefore to make sure your diet is well-rounded and healthy, not just to help your stress, but also for your overall health. The ideal diet is high in fruits, vegetables, wholegrains, nuts, pulses and legumes and low in refined sugar, saturated fat and processed foods.

The bottom line

Stress can have a big effect on your gut: from IBS to feeling nauseated, it can bring a lot of discomfort. It's important therefore to try to reduce stress, whether this is by upping your exercise, eliminating things that might induce stress, and adopting a healthy and varied diet. Ultimately, though, make sure to contact your local GP if you're feeling negative side effects of stress.

If you'd like to read more about the benefits of keeping a healthy gut, as well as find more information on how you can promote good gut health, select Digestion from the Your health menu above.