Stress, anxiety and gut health

Stress is a normal reaction to mental or emotional pressure and can play a significant role in triggering and exacerbating symptoms of IBS. Stress activates the body's "fight or flight" response, causing physical changes such as increased muscle tension and alterations in the digestive system. This can result in increased symptoms such as abdominal pain, bloating, diarrhea or constipation in people with IBS. Stress isn’t always a terrible thing (learning to cope with challenges can increase our resilience), but when we are constantly dealing with stress and the physical responses our bodies and mind can suffer.

Why do we feel stress in our stomachs? We naturally think of our brains as the main control system for our body, but our intestines have their own nervous system, sometimes known as a “second brain.” This system is called the enteric nervous system, it has the largest collection of nerve cells in the body outside of the brain and allows our gut and brain to communicate. It controls gastrointestinal functions and produces and responds to the same stress hormones and neurotransmitters that our brains do. Psychological stress can affect this gut-brain communication, disrupting the normal balance of digestive functions and so, if our brains feel stress and anxiety, they communicate this with the gut which can trigger IBS symptoms. Simply put: If our brain is in knots its likely our stomach is too! Additionally, stress can directly influence gut motility and fluid secretion and thus affect bowel movements i.e., stress can both delay emptying stomach contents and/or speed up the passage of material through the intestines. This is why you might experience diarrhoea when feeling nervous or stressed e.g., before an exam, competition, work event etc. Furthermore, if you suffer with IBS you are thought to have “visceral hypersensitivity”, which is an increased sensation of pain experienced; and thus explains why people with IBS have increased sensitivity to distension and movement of food, gas or faecal matter through their digestive tract. Stress can be multifactorial and thus is not an easy thing to resolve at once but below are some strategies to help ease feelings of anxiety and calm your nerves and gut:
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Mindfulness/meditation/breathing exercises have all been shown to elicit the relaxation response by reducing anxiety, reducing heart rate and improving concentration, the opposite of your “fight-or-flight” impulse, which is your stress response. Focus on relaxation techniques to quiet down your stress response.

 

Breathing can activate the relaxation response (direct opposite of the stress response), help muscles relax and ease tension and increase mindfulness and be more present in the moment. When feeling stressed, we might take shallow breaths, which means that your body won’t get enough oxygen to fully relax. Learn to breathe more slowly and deeply from your abdomen to slow down your mind.

 

Mindfulness is a practice that involves being present and fully engaged in the current moment and has been shown to have a positive impact on stress and improve overall mental wellbeing. Mindfulness can help reduce overthinking which can contribute to stress.

 

There are some great apps you can use to help you start including Headspace: https://www.headspace.com/  or this breathing app: https://breatheapp.uk/

Cognitive Behavioural Therapy

 

Cognitive Behavioural Therapy is based on the idea that thoughts, feelings, and behaviors are interconnected and that negative thoughts can lead to negative emotions and behaviors. These therapies work to identify unhelpful thoughts or behaviour patterns that cause anxiety and negative emotions and help reframe these. Much of our anxiety is self-induced, meaning we can get ourselves wound up worrying about worst-case scenarios or blowing small incidents out of proportion. Catch your ‘self-talk’, challenge your self talk and then work to change this talk.

Self-Care

Self care is an important aspect of stress management and refers to the actions that individuals take to maintain their own physical, mental, and emotional health. Self care can encompasses a wide range of activities and habits, that brings pleasure and examples include getting enough sleep, exercising, having a leisurely bath, having a pamper session, listening to music, playing with a pet or enjoying a night with friends. When we are feeling our best both physically and emotionally we are much more resilient and more able to handle life’s stress. Life will pull us in all different ways but try to incorporate one thing you really enjoy doing.

 

Saying “no” is an important aspect of self care because it allows you to set boundaries and prioritize your own needs and well-being. If we find ourself taking on too much, whether it be work responsibilities, social obligations, or personal commitments, it can lead to burnout, stress, and decreased overall health.  Saying “no” is not selfish, but rather a necessary step towards taking care of yourself.

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Exercise

 

Exercise is a well-known tension reducer and studies have consistently shown how exercise can reduce fatigue, improve alertness and concentration, boost mood and reduce stress and anxiety. Exercise stimulates both the production of serotonin, a feel good hormone which can boost mood and wellbeing; and endorphins which act as natural painkillers and can help improve sleep (which can then indirectly help with stress).

 

Evidence has demonstrated the benefit of exercising in the outdoors. For most of us it is a cheap and accessible form of therapy and when combined with friends or family it can increase social interaction, which itself can help alleviate stress! Another form of exercise that has been shown to reduce stress levels is yoga. Yoga is a mind-body practice that combines controlled breathing with physical poses and meditation; and through a combination of these can help enhance a person’s mood and wellbeing. Seeing me trying to master the “downward dog” pose is enough to give anyone a chuckle!

The caveat to the above is strenuous, high-impact exercises might induce symptoms of reflux so aim to increase your exercise slowly.

The take home point here is almost any form of exercise or physical activity can act as a stress reliever and it doesn’t have to cost a penny!

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The above are just some simple ways to address stress management and you do not need to focus on them all. Pick one that feels achievable to you and start small.

If you feel how you talk to yourself has a greater impact on your mood and stress levels this is a great read on how to challenge our thoughts: https://www.nhs.uk/every-mind-matters/mental-wellbeing-tips/self-help-cbt-techniques/

 

Stress management forms part of my discussions in consultations when supporting behaviour change through intuitive eating or to improve gut symptoms.

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