Stress and functional GI disorders

You may feel nauseated before giving a presentation or feel intestinal pain during times of stress. You're not imagining it. The gut and the brain influence each other.

For example, stress (or depression or other psychological factors) can affect movement and contractions of the gastrointestinal tract, as well as sensations perceived to come from the gut.

There is also emerging evidence that psychosocial factors may alter the types of bacteria that live in your gut, which can contribute to chronic inflammation.

In addition, research suggests that some people with functional GI disorders perceive pain more intensely than other people do because their brains do not properly regulate pain signals from the digestive tract.

In other words, stress can make the existing pain from functional GI disorders seem even worse. These observations suggest that at least some people with functional GI conditions might find relief with therapy to reduce stress or treat anxiety or depression. And sure enough, one review of 32 studies showed that people treated with psychologically based approaches had greater improvement in their symptoms compared with people who received conventional medical treatment.

Integrative therapy for functional GI disorders shifts the focus away from pinpointing a specific cause for symptoms to engaging patients in activities and therapies that can help in managing symptoms and increasing quality of life. This may include the use of medications, dietary changes, and stress-reduction techniques.

When assessing whether your gastrointestinal symptoms— such as heartburn, abdominal cramps, or loose stools—are related to stress, watch for these other common symptoms of stress and report them to your clinician as well.

Physical symptoms

• Stiff or tense muscles, especially in the neck and shoulders
• Headaches
• Sleep problems
• Shakiness or tremors
• Recent loss of interest in sex
• Weight loss or gain
• Restlessness

Behavioral symptoms

• Procrastination
• Difficulty completing work assignments
• Changes in the amount of alcohol or food you consume
• Taking up smoking, or smoking more than usual
• Grinding teeth
• Rumination (frequent talking or brooding about stressful situations)

Emotional symptoms

• Crying
• Overwhelming sense of tension or pressure
• Trouble relaxing
• Increased desire to be with or withdraw from others
• Nervousness
• Quick temper
• Depression
• Poor concentration
• Trouble remembering things
• Loss of sense of humor
• Indecisiveness

For more on the connection between brain health and gut health, read The Sensitive Gut, a Special Health Report from Harvard Medical School.

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