How stress can affect your digestion

Prolonged stress can be toxic to your digestive health, which is true for many of my clients that come to my functional medicine practice.

Meet Helen

Helen 40 is suffering from digestive issues that started six months previously. Her symptoms include abdominal cramps, alternating constipation and diarrhea, bloating, gas and heartburn. She has a full-time job working for the federal government and is a mother of two young children. She describes her diet as poor because she has to rely on many processed products and to eat out. Lack of time also means she infrequently exercises, socialises rarely and has not played her piano in a year. Her husband is often away on business leaving Helen to manage the home. She usually thrives on stress but since her last child was born she feels less able to cope with her busy home and work life. She suspects that the increased stress may have triggered her symptoms but is not sure how.

Scientists have identified some ways in which stress affects digestion.

Stress has been shown to cause:

• Increased Intestinal Permeability or Leaky Gut, which would predispose her to develop food sensitivities.
• Reduced gut immunity and reduced stomach acid production, predisposing her to the possibility of infections.
• Reduced gut motility, predisposing her to bacterial overgrowth in the small intestines.

Food sensitivities, gut infections and bacterial excess are potential causes of Helen's symptoms, but the root cause of these is her chronic stress. Without addressing the root, treating the other issues may prove a futile exercise.

Establishing that stress is the root of Helens digestive issues is easy, trying to untangle her from its grasp is the tricky part. Many people feel trapped in their lives and making any changes can seem monumental.

Change must happen however to begin the process of healing which means slowly unpicking stress making behaviours and replacing them with stress reducing or managing behaviors. For Helen, initial changes could be walking, catching up with her friends and sitting down at her piano.

Finally

I hope you found these ideas useful. More importantly, I hope you do something with them.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment.

Why is my stomach so bloated and painful?

Bridgette, 35 an architect was a single mom and had a busy an active professional and personal life. 

Some two years ago she had caught MONO and had to receive a large dose of antibiotics that had thankfully put her symptoms into remission. Two months later she noticed some unusual digestive symptoms. She experienced abdominal pain and cramping, which was relieved by going to the bathroom. Her tummy was often bloated and swollen. Her bowel habits changed and would alternate between diarrhea and constipation (several days without having a bowel motion). She occasionally had an urgent need to go to the bathroom, and she sometimes had a feeling that she could not fully empty her bowels after going to the toilet.
Being health conscious, she quickly decided to visit her family physician who immediately diagnosed her with irritable bowel syndrome (IBS). 

The usual standard of care for IBS are four types of medication, which only control symptoms, including: 

• An antispasmodic (which helps reduce abdominal (stomach) pain and cramping).
• A laxative (to help relieve constipation).
• An antimotility medicine (to can help relieve diarrhoea).
• A low-dose Antidepressant (to help reduce stomach pain and cramping).

Like most people, Bridgitte was exceptionally wary of taking any medication because of the potential side effects, and they do not address the underlying cause.

Not happy with this approach Bridgette wisely stood her ground and asked to see a Gastroenterologist, a doctor who specializes in digestive issues. Her doctor agreed and arranged an appointment for a week later.

At the meeting, the consultant went over her symptoms and agreed with her doctor's diagnosis of IBS. He also listened to her concerns about taking medication and her need to find a more natural solution to which he said he was more inclined to with patients under his care.

He suggested that Bridgette follows a Low FodMap Diet.

FodMap (Fermentable Oligo-Di-Monosaccharides and Polyols) are carbohydrates that found in certain foods. A low Fodmap diet has been shown to reduce symptoms in 75% of people with IBS. (1) 

FODMAPs in the diet are:

• Fructose (fruits, honey, high fructose corn syrup (HFCS), etc)
• Lactose (dairy)
• Fructans (wheat, garlic, onion, inulin etc)
• Galactans (legumes such as beans, lentils, soybeans, etc)
• Polyols (sweeteners containing isomalt, mannitol, sorbitol, xylitol, stone fruits such as avocado, apricots, cherries, nectarines, peaches, plums, etc)

Bridgette began the low Fodmap diet the next day and within 2-3 days felt 80% improvement in her symptoms.

Following a low Fodmap diet will help relieve many of the symptoms of IBS but like the medication it does not address the cause.

So why do people become intolerant to Fodmaps?

Recent scientific research has identified a link between IBS and Small Intestinal Bacterial Overgrowth (SIBO). (2) Your friendly bacteria should predominantly be living in your large intestines, with SIBO, these bacteria migrate up into the small intestines. These bacteria feed on Fodmaps and when they do they produce different gases causing the bloating, constipation, diarrhea, gas and abdominal pain. You can test for SIBO using a simple breath test and then treatment can be a combination of antimicrobials and diet.
Emotional factors have also been shown to contribute to the development of IBS, and could induce a Fodmap intolerance for reasons not yet understood.
When dealing with any condition, including IBS, it is always important to look at diet but also lifestyle factors including stress management, exercise, and sleep. If you correct one factor without addressing the others, this often results in a poor outcome.

Finally

I hope you found these ideas useful. More importantly, I hope you do something with them.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment.