GI issues, Stress and You

irritable-bowel-syndromeWe have already clearly established the fact that stress wreaks havoc on every bodily system.  By controlling the stress, we can control these symptoms. But in reality, we don’t even know the half of what our body is going through and the catastrophic changes that are taking place every second we are stressed.

Since April is Irritable Bowel Syndrome month, let’s focus on what stress does to our GI tract. Household names you have likely heard, IBS, Lactose intolerance, Bacterial overgrowth, Celiac, Colitis are mere labels for a deeper inflammatory response occurring that extends beyond the bowel walls.

In a series of experiments presented in The American Journal of Pathology, Yang and colleagues demonstrate that stress contributes to the development of food allergies by increasing transepithelial permeability in a corticotropin-releasing hormone (CRH)-dependent fashion. Their report offers convincing data to support their earlier groundbreaking observations that stress may alter epithelial function.

An ever-increasing number of reports suggest that gastrointestinal pathogens may cause disease, at least in part, by increasing transepithelial permeability. For example, Helicobacter pylori has the ability to increase the passage of food antigens across the gastric epithelium, and infection with this gastric pathogen may be associated with the development of food allergies.

This mechanism may be implicated in the stress-induced worsening of arthritis or psoriasis. Together with these observations, the findings of Yang and colleagues now question whether this pathway may also be involved in stress-induced worsening of chronic inflammatory disorders of the gut, including food allergy.

Not only does stress affect the physiological function of the gut, but it has also been shown to actually cause changes in the composition of the microbiota, possibly due to the changes in neurotransmitter and inflammatory cytokine levels. Research in mice has found that exposure to stress led to an overgrowth of certain types of bacteria while simultaneously reducing microbial diversity in the large intestine of the stressed mice. Furthermore, this disruption of the microbiota increased susceptibility to enteric pathogens

Experimental studies have shown that psychological stress slows normal small intestinal transit time, encourages overgrowth of bacteria, and even compromises the intestinal barrier. Chronic stress may therefore play an important role in the development of small intestinal bacterial overgrowth (SIBO) and leaky gut syndrome.

Stress-induced alterations to microbial flora could increase the likelihood of intestinal permeability, which in turn sets the stage for systemic and local skin inflammation.  When gut integrity is compromised, an increase in circulating endotoxins derived from gut microbes can manifest as skin eruptions such as rosacea and acne.

Treatment

Consuming probiotic foods and/or supplements might influence both mood and acne, by reducing systemic inflammatory cytokines and oxidative stress, increasing peripheral tryptophan levels, normalizing brain levels of stress hormones, modulating tissue lipid levels, and possibly even regulating glycemic control.

Recently, research has demonstrated significant improvements in depression, anger, anxiety, as well as lower levels of cortisol among otherwise healthy adults taking a daily probiotic supplement as compared to a placebo. This data suggests that not only can chronic stress change the diversity of microflora in the gut, but that the quality and health of friendly gut bacteria may also conversely have an effect on mental health and wellbeing.

One interesting method of treatment that researchers used in the 1930s to treat acne and mood disorders was the combination of “an acidophilus milk preparation and cod liver oil”, which we now know provided patients high levels of probiotics, omega-3 fatty acids, and fat soluble vitamins A and D.  Healing the gut, reducing inflammation, and providing a diverse array of friendly bacteria can make a big difference in your gut’s susceptibility to the negative effects of stress

Psychotherapy options

Reviews suggest that several types of psychotherapies may help ease persistent gastrointestinal distress — or at least help people learn to cope with such symptoms.

Cognitive behavioral therapy (CBT). This standby of psychotherapy helps patients to change counterproductive thoughts and behavior and learn coping skills to better manage stress and anxiety. One three-month study involving 431 adults with functional gastrointestinal disorders found that CBT was significantly better than patient education at improving overall symptoms and well-being, but had little or no effect on pain. This and other research suggests that CBT may be most useful in helping patients to cope with persistent gastrointestinal distress, rather than reducing pain. Preliminary research suggests that CBT can be modified for children with such disorders.

Relaxation therapy. This encompasses a number of techniques designed to help people relax and reduce reactivity to stress. Techniques include progressive muscle relaxation, visualization, and restful music. Relaxation therapy has seldom been studied alone, but the research suggests that it is effective for gastrointestinal disorders when it is combined with CBT.

Hypnosis. Gut-directed hypnotherapy — which combines deep relaxation with positive suggestions focused on gastrointestinal function — may be helpful for people whose symptoms occur even without obvious stress. In one small randomized controlled study, patients with severe irritable bowel syndrome underwent three months of hypnotherapy that involved placing their hands on their abdomens while being asked to feel warmth and imagining they had control over gastrointestinal function. By the end of the study, symptoms had significantly improved in the hypnotherapy group when compared with a control group who underwent supportive psychotherapy. Another study suggests that benefits of gut-directed hypnosis may persist for years.

As researchers continue investigating the exact chemical reaction that takes place in the intestinal lining , there is enough compelling evidence to support stress response has a direct effect on the GI tract. Our GI tract serves to absorb nutrients needed and eradicate toxins that are not. Due to the cellular inflammatory reactions that occur under stress, the GI lining absorbs toxins and excretes nutrients.

What can you do to get control of your gut?

  1. Watch what goes in your mouth! Everything you eat contributes to how you feel. Choose wisely. 
  2. Start Probiotic. There is gaining momentum and clinical evidence to support the benefits of probiotics. Some of my favorites are Align and Floragen (by Pure Encapsulations). 
  3. Limit or restrict sugar. Simple glucose molecules that breakdown in the gut offer an open invitation to harbor bad gut flora. Not worth it! 
  4. Get evaluated by a physician for other medical conditions that can cause stomach issues. Don’t treat thy self. Rule out the bad stuff first. No symptom is insignificant. 
  5. Sleep. I don’t care if you can get by on 5 hours of sleep…because you can’t. No body can function on that little sleep and be ok. Your body will trigger an inflammatory response that will eventually lead to bigger problems.  NEGLECT YOUR Z’s….and YOU WILL HAVE LIFE LONG WORRIES! 

Until next month, wishing you health and well-being! Contact me if you have any questions!