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Influence of stress on gastrointestinal diseases

From the butterflies we feel in our stomach when we fall in love, to the stomach pain we feel when we are nervous about something, emotions are intimately related to our digestive system.



It is for this reason that gastrointestinal ailments are often related to our lifestyle; the way we eat, our physical activity and even our mood and stress can influence the development of some of these diseases.




Stress is generally defined as a physiological reaction aimed at acting in defense against threatening factors. This stress can be both physical and emotional, in such a way that situations such as the loss of a loved one, bereavement, divorce, work or economic worries, can trigger this reaction and affect our health.

From the biological point of view, the digestive system is controlled both by the nervous system and by some brain hormones, which implies that many of the signs and symptoms of gastrointestinal diseases are mediated by alterations in these systems. On the other hand, the immune system can also be affected by stress, which in turn compromises the digestive system through infection and inflammation.

Among the diseases that are closely related to stress are: gastritis, ulcers, colitis, irritable bowel syndrome, gastro-esophageal reflux and constipation.





Gastritis is the inflammation of the stomach lining, which is commonly caused by the presence of a bacterium called Helicobacter pylori. However, there are other causes of gastritis, such as alcohol consumption, the use of non-steroidal anti-inflammatory drugs (aspirin, ibuprofen or naproxen) and the consumption of highly irritating foods. On the other hand, an ulcer is a lesion in this same gastric lining and is caused by the same factors as gastritis. Ulcers can occur in the esophagus, stomach and intestine, and when these lesions are not treated, they can go all the way through the stomach tissue, which represents a medical emergency.

The relationship between gastritis, ulcers and stress lies in the increased production of acid that is observed in these situations. The same acid secretion can favor inflammation of the gastric lining, while the growth of the H. pylori population increases because acid represents a favorable environment for its survival. Studies have shown that chronic stress has an important association with ulcer risk in combination with irregular eating habits.




This syndrome affects approximately 10% of the population and is characterized by symptoms of abdominal pain, stomach discomfort, inflammation, flatulence and alterations in the intestinal rhythm, which causes from diarrhea to constipation. Psychological factors are believed to be among the causes that alter intestinal motility. Some researchers have pointed out that an important substance in this stress response is corticotropin-releasing hormone, which is a molecule found in both the brain and the intestine. In the brain, the receptors to which this substance binds are found in areas related to the control of digestion and emotions. In the intestine, this same molecule increases the secretion of mucus and water, affecting the motility of the intestine.




Reflux, or also called “heartburn”, is a condition in which the sphincter located at the end of the esophagus, just where the stomach begins, does not close after the passage of food through the esophagus, causing food, liquids or gastric contents to return to the esophagus. Among the causes of reflux are alcohol consumption, obesity, pregnancy and smoking. Many studies have tried to relate reflux to the amount of acid secreted by the stomach, but the results have not been conclusive. However, it has been observed that people in a state of stress seem to be in a state of “hypervigilance” i.e. they are more sensitive to the perception of these symptoms, which translates into a greater record of reflux episodes.





People often suffer from constipation due to lack of fiber in their diet, insufficient fluid intake or loss of intestinal muscle tone. Stress can create a vicious cycle between mood and poor digestion. Lifestyle changes due to stressful pressures at work, school or travel may be responsible for aggravating constipation. Bad habits such as not eating breakfast, irregular meal times, ingesting irritating foods and not responding to the defecation reflex, cause alterations in digestive regularity leading to constipation and discomfort.

More and more is known about the relationship between chronic stress and the way in which the interactions between the digestive system and the brain are modulated. Thus, in the understanding of these conditions, it is no longer only necessary to find the “organic” cause of the disease, but also to evaluate the psychological profile of the patient. The treatment of this type of diseases should have a more holistic approach, so that the use of medications, as well as the change in diet and learning to assimilate emotional experiences, are part of the solution.



Dr. Mansi Shah

Functional Wellness Network

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