How Stress Makes Your Digestive Symptoms Worse

I want you to think on this: over a 24 week study on people with IBS, yoga alone was shown to be as effective at calming digestive symptoms and improving quality of life, as was a restrictive low FODMAP diet. The simple task of this mind body practice – of breathing and stretching (without any dietary interventions) had the ability to reduce and improve digestive symptoms.

Could stress be what’s causing your digestive issues, or, making your digestive issues worse? The answer is yes. In my practice, I’ve yet to meet a new patient where stress, to some degree, wasn’t playing a pivotal role with digestion. It is likely that acute and long term stress preceded the onset of your diagnosis. It is also true that stress will exacerbate digestive symptoms, and, sometimes these effects are strong enough to get in the way of healing.

Another way of looking at this – how can you not be stressed out by having to deal with daily digestive symptoms? You may have already identified that your symptoms worsen with stress, but, the depth of change that stress incurs is rarely taken seriously enough. For women especially, we are used to taking on so much in our lives, that when we get sick, it is one more thing to deal with and sometimes it can feel like it is enough to break us.

Perhaps you might take stress and the effects of stress on your body, more seriously, if you knew this: when you’re in a stress state, your body diverts resources away from the digestive tract. Blood flow to your digestive organs dwindles to 5% while in a stress state. When in rest and digest, your body directs 50% of blood flow to your digestive organs.

Unfortunately, your body doesn’t have a neutral position – you’re either in fight or flight (sympathetic dominance), or you’re in rest and digest (parasympathetic dominance), or you’re in a freeze state (paralyzed by the event, or stress load). Your body evolved with fight or flight as a survival mechanism, so you could have a better chance of escaping a predator. Unfortunately, today, even non-life-threatening stressors like chronic worry, anxiety, social media, lack of social support, lack of community and a go-go lifestyle of daily life stressors drive this response.

When you’re worried about how you’re going to feel today, which foods will trigger your system, if you’ll make it to a bathroom, or, if your bloating will get worse and your pants will stop fitting by the end of the day – this will keep you in sympathetic dominance. To add to this, our past year with COVID has dumped a huge load of stress on the world. Between washing your hands multiple times a day, worrying about job or home security, stressing over the state of your community and country and still trying to get a full night of sleep, this will all keep you in sympathetic dominance.

The Effects Of Stress on Digestion

Let’s look at what happens within your body when it feels like it’s being backed into a corner, and the only correct response is to fight or run.

But, I want to correct something first – digestion is not a direct result of gut function. Digestion is driven by the enteric nervous system, and this can be thrown out of whack by acute and chronic stress, inflammation, malnutrition and hormone imbalance.  The enteric nervous system is a component of the autonomic nervous system that is embedded in the lining of the GI tract – this regulates digestion through feedback loops between the gut and the brain (also called the gut-brain axis).

When you’re in sympathetic dominance, your body releases a group of stress hormones which trigger a cascade of events in the body that prepare you to fight or run. These same stress hormones also engage the enteric nervous system and trigger it do down-regulate digestion.

• Blood flow to the digestive organs is redirected to the limbs, which reduces blood flow to the digestive organs to a measly 5%.
• If you’re stressed out, your body will divert resources away from producing chemicals to help you digest your food – saliva, stomach acid, digestive enzymes, bicarbonate production, are all inhibited and this can really stall digestion.
• Smooth muscle movement is inhibited, which can alter GI sphincter muscle function. This can slows motility in the small intestine, but, this can also speed transit in the large intestine.

The Effects of Chronic Stress on Digestion

Your body can handle some stress. It can handle acute stress, that passes, and when this passes, the body adapts and brings your stress response back to neutral. Simply put, your body can handle stress that is short lived. What it does not do well with is chronic stress. This interferes with your body’s ability to adapt and reset. Instead, chronic stress will continue to overstimulate your body, driving inflammation, and driving digestive dysfunction.

If chronic, this can really take a toll on your body. For example, we know that stress affects the ability of the stomach to produce stomach acid. While digesting, a proper low pH activates trypsin and pepsin, which helps you digest protein. A low pH also helps to signal proper gastric emptying. If the pH is too basic (you aren’t producing enough stomach acid), you can experience delayed gastric emptying BUT, you can also experience antral dumping (the antrum is the bottom section of your stomach organ). Antral dumping will place undigested food into the intestinal tract and this will increases digestive distress, and place you at risk for food sensitivities, fermentation symptoms (from SIBO), and malabsorption (you can’t absorb what you can’t break down).

If stress is chronic, this can lead to gut dysbiosis and increased intestinal permeability (leaky gut). When undigested food particles are able to essentially “leak” out of your intestines and into the bloodstream, this can trigger intestinal dumping (diarrhea), and this places you at risk for developing food sensitivities. This can also place you at risk for systemic inflammation.

If you are thinking, “Well – I don’t have low stomach acid; I have heartburn and I produce too much stomach acid,” then let’s look again at the mechanisms that I discussed above. Sympathetic dominance can inhibit the function of the esophageal sphincter (so it doesn’t properly close), and it can inhibit the production of stomach acid which can stall gastric emptying (food sits there too long) and it can inhibit your ability to break your food down and digest and absorb nutrients. All of which can lead to heartburn. Heartburn is rarely caused by too much stomach acid.

How Can Constipation and Diarrhea Both be Caused by Stress?

Stress can cause diarrhea or constipation, or both. This is highly individualized. Stress can cause dumping and it can also cause motility to stall. Which you experience depend a lot on your past history, hormone status, microbiota status (history of antibiotic use), inflammation and things like liver/ bile flow.

Your past health history plays a role – for example, if you are hypothyroid, this can slow the metabolic rate of every cell and process in your body. When in a chronic stress state, this will affect your ability to digest nutrients properly; possibly leading to anemia, and poor vitamin B12, iodine, zinc, selenium and copper status, which are all cofactors for proper thyroid function. Which can interfere with thyroid hormone production and this will keep this vicious cycle going.

Hypothyroid + chronic stress à depleted nutrients à worsening hypothyroid condition = slower motility and suppressed digestion. This is a vicious cycle and no amount of medication and thyroid support will correct this. The target is stress, supporting digestion and replenishing thyroid co-factors.

Stress hormones can speed transit and dumping, especially when they affect blood sugar balance and insulin balance.

Lifestyle Steps to Soothe Stress-Related Digestive Issues

To combat the effects of stress on your body, you will need to make a conscious effort on slowing down.

• 10 minutes before each main meal – shift gears. Remember that you don’t digest well when you are in sympathetic dominance. Turn off electronics and go for a walk, or meditate, or practice some gentle yoga moves, or work on belly breathing/ diaphragmatic breathing.
• Create a tradition around your meals – eat at the table, play soft music, put a placement down, and maybe light a candle.
• Set the tone for each meal. When you sit down at your meal, take a deep cleansing breath. Then, look at your food and smell your food. Imagine how it will taste. Take the first bite of food and set your fork down. Close your eyes and really chew and taste your food. Chew your food enough that it is completely broken down before you swallow it. Then, continue to eat. You don’t have to work through this process with each bite. By doing this once at the beginning of your meal, you will set the tone for the meal and this will slow down your eating.
• Chew your food. No really, I mean CHEW your food. The food in your mouth should be unrecognizable when you swallow it. Chew, chew and then chew some more.
• Connect with your food. If you look at your meal and sneer, worrying that this will affect you negatively, your prophecy will likely come true. The same can be said when you look at food in a positive light – think and say, this meal will heal me. This food is energy and light and it will taste so good.
• Choose foods that are easier to digest. Cook your vegetables (remove raw vegetables for the time being), and choose nut butters vs. whole nuts, and wet foods over dry foods (it is easier to chew chicken with a sauce present than when chicken breast is eaten dry). Ground meats are easier to chew than whole meats.

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