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Stress-related eating and gastrointestinal disorders

    When you experience a dangerous situation that scares you, your body releases a cocktail of hormones that speed up your heart rate and cause many other somatic (physical) symptoms.

While these natural responses can be helpful in a truly dangerous real-life situation, when dangers are imaginary, the feelings of fear you experience - such as stress and anxiety - can negatively impact your well-being and health. When stress and anxiety become very intense or chronic, they may have a negative impact on health and well-being, particularly on eating patterns, weight management, and gastrointestinal issues.

Constipation, diarrhea, nausea, vomiting, irritable bowel syndrome (IBS), stomach upset, gas, belching, bloating or burning mouth and tongue, constant cravings for sweets, feeling a lump in the throat, constricted throat, swollen tongue or dry mouth are the most common manifestations of stress, anxiety and other negative emotions on the gastrointestinal system.

When stress and anxiety become very intense or chronic, they can impact not only the ability to choose healthy food but the somatic (physical) health of the gastrointestinal system as well. Even with a healthy diet, people exposed to prolonged or repetitive stress are exposed to weight gain and gastrointestinal issues.

However, it is good to know that stress and anxiety are not normative concepts, nor are they diseases in themselves. Although your stress and anxiety are not imaginary, there is no laboratory test available to confirm or measure them. Yet you feel them, and therefore you are best positioned to assess whether or not you feel stressed or anxious.

As the nervous system modulates the physiological functions including the complex functions of the gastrointestinal system, and as the brain takes into account the emotional state in all that it does, the strong emotions always end up having an impact not only on the behavior and the food choices but also on the health of the gastrointestinal tract and the etiopathogenesis of all kinds of gastrointestinal system health issues.

Emotions are not just mental states and emotional feelings. Today's view of emotions is that emotions are experienced at four different, but closely interrelated levels: the mental or psychological level (the brain), the physiological level (the chemistry of your body), the somatic level (bodily emotional feelings), and the behavioral level. These complementary aspects are present in all human emotions, even in the most basic ones like stress, fear, and anxiety.

The scientific study of emotion and of the bodily changes that accompany the diverse emotional experiences, known as psychosomatic medicine, marks a relatively new era in medicine. The central concept of psychosomatic medicine is the scientific fact that the mind and body are integral aspects of all human functions. The term ‘psychosomatic disorder’ is used for a physical disease that is thought to be triggered, made worse, or caused by emotional factors. To an extent, most diseases are considered psychosomatic, as there is an emotional aspect to every physical disease.

Although healthy eating and self-control are important, stress plays a significant part in weight gain. Chronic stress and anxiety disrupt sleep and blood sugar levels. This leads to increased hunger and comfort eating. All these lead to further disrupted sleep, even higher levels of stress, and even more disrupted blood sugar. In time, this vicious cycle can lead not only to unhealthy levels of body fat and obesity, but also to type-2 diabetes.

Therefore stressed people tend to overeat and “comfort eat” foods that are high in sugar, fat, and calories. Eating comfort foods appears to reduce negative feelings associated with stress, which might be perceived as lessening the impact of stress. The brain and intestines are closely related. Some research suggests that the gut itself has features of a primitive brain. It’s not surprising that prolonged stress can disrupt the digestive system, irritating the large intestine and causing diarrhea, constipation, cramping, and bloating.

Chronic stress and anxiety leads to chronic activation of the neuroendocrine system. Cortisol favors central fat deposition, a decrease in the adipostatic signal leptin and an increase in the orexigenic signal ghrelin, inducing increased appetite and food intake. This endocrine response is the hormonal mechanism connecting stress and anxiety to the current epidemic of obesity.

Irritable bowel syndrome (or spastic colon) is strongly related to stress. With this condition, the large intestine becomes irritated, and its muscular contractions are spastic rather than smooth and wave-like. The abdomen is bloated, and the patient experiences cramping and alternating periods of constipation and diarrhea. Sleep disturbances due to stress can make irritable bowel syndrome even worse.

As you already know, rather than passively observing what happens to you, your subconscious mind is actually in charge of the proper functioning of your conscious mind and your body through the regulatory mechanisms of your autonomous nervous system. When you feel relaxed and safe, the sympathetic branch of the autonomous nervous system kicks in and your body is nourished, and healed and energy is restored. Whenever you are facing a threat, the parasympathetic branch of the autonomous nervous system kicks in and the stress response will mobilize all your resources for your survival inbuilt fight or flight response.

While you are in the middle of a stress response, the stress response will mobilize all your resources for your survival, and your body's nourishing, restorative, maintenance and self-repair functions come to a screeching halt. Unfortunately, when the threat is imaginary, the subconscious mind doesn't realize that there is no real threat. Over time, when this stress response is repetitively triggered by imaginary threats, nature's biological response ends up doing more harm than good.

Long term, if your body is not properly nourished, restored, maintained, and repaired, the effects of chronic wear and tear on your body take its toll and you will end up mentally and physically sick. Therefore, by releasing stress and anxiety, your body creates a loop of positive feedback through the autonomic nervous system, feedback that can rebalance your sympathetic and parasympathetic branches and lead so to significant improvement in symptoms of your stress and anxiety-related autoimmune conditions. The degree of improvement you can reasonably expect by relieving your persistent stress and anxiety depends on how much you feel that your emotional state affects your health issues.

When dealing with a fractured bone, the standard medical approach is to align and join the broken parts of the bone and let it heal, as this ancestral approach works for everyone and every time. However, when dealing with stress and anxiety, there is no such thing as a one-size-fits-all approach. Therefore psychiatry, psychotherapy, hypnotherapy, neuro-linguistic-programming, E.F.T. (emotional freedom tapping), pet therapy, art therapy, mindfulness, yoga, craniosacral therapy, gravity blanket, mini-horses therapy, and many other approaches based on very contradictory and yet scientific concepts, are all available to solve emotional issues.

Chronic, intense, or repetitive stress and anxiety can lead to various emotional troubles and even psychiatric or physical medical conditions. According to the American Psychosomatic Society “… there is no such thing as psychosomatic disease. All disease can be looked at from this point of view”.

Here are a few of the many eating and gastrointestinal disorders that are aggravated, triggered, or even caused by stress, trauma, and anxiety, and for which you can reasonably expect improvements when you improve your emotional health.

Stress, Anxiety, Stomach Pain, Diarrhea, Constipation, Ulcers & More : "Stress and anxiety are common causes of stomach pain and other GI symptoms. The enteric nervous system communicates with the central nervous system and is known as the “brain-gut axis.” This connection explains why stress may cause digestive problems.
According to the American Psychological Association, stress may increase the risk for or exacerbate symptoms of the following gut diseases or dysfunction: Bloating, burping, gas; Heartburn, acid reflux or gastroesophageal reflux disease (GERD); Nausea and vomiting; Diarrhea; Constipation; Ulcers; Inflammatory bowel disease or irritable bowel syndrome, etc "

Anorexia "Many people who develop anorexia share certain personality and behavioural traits that may make them more likely to develop the condition. These include: a tendency towards depression and anxiety, finding it hard to handle stress, excessive worrying and feeling scared or doubtful about the future, pressures and stress at school, such as exams or bullying, particularly teasing about body weight or shape, a stressful life event, such as losing a job, the breakdown of a relationship or bereavement "

Binge eating disorder: "Binge eating disorder is a common eating disorder where you frequently eat large amounts of food while feeling powerless to stop and extremely distressed during or after eating. You may eat to the point of discomfort, then be plagued by feelings of guilt, shame, or depression afterwards, beat yourself up for your lack of self-control, or worry about what compulsive eating will do to your body.
Binge eating disorder typically begins in late adolescence or early adulthood, often after a major diet. During a binge, you may eat even when you’re not hungry and continue eating long after you’re full. You may also binge so fast you barely register what you’re eating or tasting. "

Stress Could Make You Crave Fatty, Sweet Foods “There may be something to that cliché about stress eating. Researchers at “University College London” found that feeling stressed changes what we eat. Those under pressure didn't necessarily eat more, but they did reach for sweeter, fatty foods than usual.”

Bulimia Nervosa "The essential features are binge eating and inappropriate compensatory behavior such as fasting, vomiting, using laxatives, or exercising to prevent weight gain. Binge eating is typically triggered by dysphoric mood states, interpersonal stressors, intense hunger following dietary restraints, or negative feelings related to body weight, shape, and food. Patients are typically ashamed of their eating problems, and binge eating usually occurs in secrecy. Unlike anorexia nervosa, bulimia nervosa patients are typically within normal weight range and restrict their total caloric consumption between binges."

Stressed Brains Amplify Comfort Food Cravings: "When you’re stressed, a high-calorie snack may seem like a comforting go-to. But this combination has an unhealthy downside. According to Sydney scientists, stress combined with calorie-dense comfort food creates changes in the brain that drive more eating, boost cravings for sweet, highly palatable food and lead to excess weight gain."

Stress can give you heartburn: “Stress can increase the production of stomach acid, leading to that annoying reflux, as acid irritates the esophagus. And if you already suffer from chronic heartburn, stress can make it worse. A study of nearly 13,000 sufferers published in Internal Medicine discovered that nearly half reported stress as the biggest factor that worsened symptoms.”

Can anxiety cause nausea and how? “When a person is anxious, their brain releases chemicals called neurotransmitters, which put the body into a high state of alert. This process prepares the body for "fight or flight" in response to a perceived threat. Some of the neurotransmitters enter the digestive tract where they can upset the gut micro biome - the delicate balance of microorganisms that live inside the gut. Imbalances in the gut micro biome can result in nausea.”

How stress causes belly fat. "Stress can have a negative effect on where fat is being stored. Stress is known to be bad for blood pressure, our heart, our skin and our memory. Due to new research, belly fat can be added to that list. Stress can have a negative effect on where fat is being stored. Once chronic stress kicks in, it causes hormone changes and redirects fat to the belly."

How Stress Can Mess With Your Gut: "The connection between stress and the gut is a deeply embedded one. It can create a vicious cycle in which stress or anxiety trigger the immune system to send out signals that break down the lining of the gut. Imbalance or damage to the gut can also cause a chronic stress response within the body. In short, stress stimulates a fight-or-flight response in the body, thus perpetuating more damage to the gut – not good!  This cycle can further be compounded if you’re already experiencing leaky gut issues. These issues occur when the gut’s barrier is compromised, allowing large compounds into the bloodstream - hence, the term leaky. Ultimately, it creates an overactive inflammatory response. "

How relationship stress can affect your gut health: According to a new study published in the journal Psychoneuroendocrinology, stress in your marriage can actually take a negative toll on your gut health. And as poor gut health has been linked to everything from poor digestion to memory problems to skin issues, you may want to keep the findings in mind.

Stress Diarrhoea and Constipation : “There are several forms of IBS, including IBS-D (IBS that causes diarrhea) and IBS-C (which causes constipation), and stress is often a trigger that can bring on symptoms. The same thing can happen in people with an inflammatory bowel disease, like Crohn's disease or ulcerative colitis. In these cases, a person's digestive tract, colon, or rectum is already prone to inflammation, and stress can add to that inflammation and bring on symptoms”

Anxiety often leads to eating disorders: "People with untreated anxiety disorders are prone to developing eating problems like anorexia and bulimia. When people develop eating disorders, it isn't really about food. Anorexia or bulimia can usually be traced to an underlying emotional issue, where control over food or food as comfort is a way to self-treat. Often, the condition that leads to restricting food or binging and purging is really anxiety."

Stressed? Listen to your gut. "Stress can trigger health problems like acidity and heartburn. According to a 2011 article titled “Stress And The Gut: Pathophysiology, Clinical Consequences, Diagnostic Approach And Treatment Options” in the journal Physiology And Pharmacology, stress has both short- and long-term effects on the gastrointestinal tract. Exposure to stress results in alterations of the brain-gut interactions, ultimately leading to the development of a broad array of gastrointestinal disorders, including inflammatory bowel disease, irritable bowel syndrome and other functional gastrointestinal diseases, food antigen-related adverse responses, peptic ulcer and gastroesophageal reflux disease."

Stress link to IBS and other functional gastrointestinal disorders: "University of Newcastle honours student Jessica Bruce has discovered the way stress might be triggering the symptoms of gut diseases, particularly functional dyspepsia. Through her research at the University of Newcastle, Ms Bruce has made a link between stress and immune changes that can lead to symptoms such as constipation, bloating, nausea, abdominal pain and diarrhea."

Stress Can Give You a Stomach Ache “Your gut has the most nerves in your body, this side of your brain, and stress can adversely affect your entire digestive system. The hormones released when you're stressed can interfere with digestion and harm the microorganisms living in your digestive tract. Cue indigestion, cramps, nausea and a whole host of other gastrointestinal issues.”

Studies show a strong connection between ulcerative colitis and stress. "For people with ulcerative colitis, stress may bring on a painful and unpleasant flare. Being exposed to extreme stress causes a fivefold increase in the risk of a relapse of ulcerative colitis the next day, according to a recent study involving 60 people with inflammatory bowel disease (IBD) published in the journal Gastroenterology Research. Stress, bad mood, and major life events are also associated with flares of IBDs, according to another study in the American Journal of Gastroenterology".

Your stress can add inches to your spouse’s waist: "Stress isn’t good for you, but it’s not good for your spouse, either. For older married couples, one spouse’s long-term stress can cause the other’s weight gain. Researchers looked at how the negative quality of marriage can be detrimental for weight gain—possibly leading to obesity—when couples 50 and older are stressed. The results varied by gender. The study specifically focused on chronic stress, which is an ongoing circumstance occurring for more than a year and threatens to overwhelm an individual’s resources, such as financial problems, difficulties at work, or long-term caregiving."

Chronic stress may raise obesity risk "These results provide consistent evidence that chronic stress is associated with higher levels of obesity. People who had higher hair cortisol levels also tended to have larger waist measurements, which is important because carrying excess fat around the abdomen is a risk factor for heart disease, diabetes, and premature death." - Dr. Sarah Jackson

Obesity "The causes of obesity are rarely limited to genetic factors, prolonged overeating or a sedentary lifestyle. What we do and don't do often results from how we think and feel. For example, feelings of sadness, stress or anxiety, often lead people to eat more than usual. Unless you act to address these emotions, however, these short-term coping strategies can lead to long-term problems."

Stress may undermine your diet: Stress could undo some of your healthy food choices, a new study suggests. Stressful events from the day before appear to eradicate any health benefits a person might have gained from choosing a breakfast rich in “good” monounsaturated fats, as opposed to a breakfast loaded with “bad” saturated fats, Ohio State University researchers found

Indigestion (Dyspepsia, Upset Stomach) "Have you noticed cramping, tightness and fluttering in your stomach during  stressful situations ? Nervous stomach is usually reported by people when they are in situations of stress or anxiety. The digestive system is susceptible to emotional changes, stress, anxiety and depression."

Heartburn (Acid Reflux) "This study provides evidence of a strong dose-response association between stress, anxiety and depression and an increased risk of reflux symptoms, while no consistent association was observed between covert coping and reflux symptoms. Our finding of positive associations between anxiety and depression and increased risks of reflux symptoms is consistent with some previous cross-sectional population-based studies of smaller sample sizes and with hospital-based studies"

Research suggests marital stress can inflame lining of gut, allow bacteria into bloodstream: New research suggests stress can inflame the lining of your gut, allowing harmful bacteria to leak into your bloodstream. How does that happen? In the so-called "leaky gut," the lining of the intestines is weakened, allowing bacteria to slip into the bloodstream, affecting everything from mental health to the immune system. Ultimately, it's anything that's in the gut that's going to influence our health is going to end up in the blood first and circulate through the blood and make its way to individual organs If you let stress build up on you and you let it really, really get to you, it can cause a lot of problems. Other research has linked marital stress to a higher rate of heart disease and a greater risk for diabetes.

Stomach aches from anxiety, stress "Stress can affect kids as young as two or three years old and cause a wide range of stomach issues from tummy aches to diarrhea, vomiting, or constipation. As many as 10 percent of school-age kids have stomach pain with no identified cause or diagnosis. What’s important is distinguishing whether your child is actually sick with a virus or if it is a recurring issue due to stress."

Phantom stomachaches due to anxiety.Anxiety can mess with your belly’s regularly scheduled programming. “Normally when you start eating, the proximal stomach is going to relax so the stomach can act as a reservoir to accommodate all the incoming food.” But when you have anxiety, the stomach doesn’t relax, which can cause aches and pains. Additionally, anxiety and pain are pretty circuitous: If you’re anxious, that anxiety can make your stomach hurt—and then you can also experience anxiety about your stomach hurting in general. It’s basically a stressful, never-ending cycle.”

Stress and the Microbiome: Prolonged stress triggers unfavorable shifts in bacterial composition and diversity. Men are particularly vulnerable to the health effects of long-term stress. It's well known that stress can tip the scales in favor of conditions such as heart disease, heart attack, high blood pressure, depression, anxiety, headaches and obesity. What you may not know is the gut microbiome can also become seriously injured, having a ripple effect throughout the body and a huge impact on overall well-being. The gut microbiome is the collection of trillions of bacteria living in the intestine. These tiny beings are responsible for many of the health benefits we have come to rely upon for optimal function. In a healthy environment, the intestine is teeming with a variety of different strains of organisms contributing to the overall balance of the ecology. This balance is particularly important because bacteria are directly involved in key processes such as immune function, mood regulation, intestinal health, digestion, caloric extraction, bowel function, protection from pathogens and even vitamin and nutrient production.  While a positive balance of such bacteria can ensure these functions are performed at the highest level, imbalances can wreak havoc on just about every system of the body.

Stress, anxiety, and Irritable Bowel Syndrome (IBS): "It's not clear how stress, anxiety, and irritable bowel syndrome (IBS) are related or which one comes first. But studies show they can happen together. When a doctor talks to people with this digestive disorder, "what you find is that about 60% of IBS patients will meet the criteria for one or more psychiatric disorders," says Edward Blanchard, PhD, professor of psychology at the State University of New York at Albany." 

What to know about stress ulcers: « A stress ulcer causes sores in the upper gastrointestinal tract. These sores damage the gastrointestinal lining and cause pain and a feeling of burning, as well as an increased risk of infection. The damage ranges from minor irritation to severe bleeding. Ulcers are common among people under immense physical stress, such as those in intensive care units. Doctors sometimes call stress ulcers stress-related mucosal damage.”

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Disclaimer: The above article may contain statements that reflect the opinion of the author. It is intended for general informational purposes and does not constitute psychological or medical professional advice. I don't diagnose medical conditions, nor do I interfere with any treatments given by your medical professional.

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