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Stress-related eating and gastrointestinal disorders

    Stress and anxiety do not only affect daily life, they can also have a profound impact on health, particularly on eating, 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.

Since 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 on 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 diverse emotional experience, known as psychosomatic medicine, marks a relatively new era in medicine. The central concept of psychosomatic medicine is the scientific fact that mind and body are integral aspects of all human function. 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 only to unhealthy levels of body fat and obesity, but also to type-2 diabetes.

Therefore stressed people tend to overeat and to “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, 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 takes 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 immobilize the bone and let it heal, because this ancestral approach works on all bones. However, when dealing with stress and anxiety, there is no such thing as a one-size-fits-all approach. Therefore the psychiatry, psychotherapy, hypnotherapy, neuro-linguistic-programming, 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”.

The following eating and gastrointestinal disorders may be aggravated, triggered or caused by anxiety and stress, or may be conditions for which you may be at increased risk if you are exposed to prolonged or intense stress and anxiety.

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 "

Stress and Emotional Eating : “Emotional eating is a way many people cope with negative feelings such as depression, anxiety, loneliness, stress, and boredom. We consume unhealthy foods or unhealthy amounts of food to hide negative thoughts and feelings.”

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."

Binge Eating Disorder "You use food to cope with stress and other negative emotions, even though afterwards you feel even worse. You may feel like you're stuck in a vicious cycle, but binge eating disorder is treatable. With the right help and support, you can learn to control your eating and develop a healthy relationship with food."

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 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”

Eating Disorder "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."

Irritable bowel is associated with stress and anxiety.When you’re stressed you might experience abdominal pains, bloating, constipation or diarrhoea. If you suffer from Irritable Bowel Syndrome already, being stressed can worsen the symptoms. This is because the digestive system is controlled by the nervous system – the mediator of stress. As already noted, the body’s response to stress involves the release of a range of hormones. These hormones can alter digestion in complex ways and can alter water intake to the digestive system in some way that either slows food (constipation) or pushes food too quickly through the digestive tract (diarrhoea).”

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".

Overweight, Obesity  "Depression, anxiety, and other mood disorders are associated with both eating disorders and obesity. A person may binge or overeat for emotional reasons, including stress, depression, and anxiety. Adolescents who are depressed may be at an increased risk of becoming obese. One recent study found that depressed adolescents were two times more likely to become obese at the one year follow up than teens who did not suffer from depression. In addition, many people with eating disorders suffer from clinical depression, anxiety, personality or substance abuse disorders, or in some cases obsessive compulsive disorder."

How stress can make you overweight: "Stress causes a fat generating cell known as Adamts1 to produce more fat cells around internal organs, a study has found. Weight gain from stress isn't just due to comfort eating, as feeling under pressure causes our bodies to build up more fat, new research has discovered. After a hectic day it's not unusual to treat yourself to a bar of chocolate or a cheeky takeaway to relieve strain. However, even without these luxuries we're at risk of putting on the pounds as it's been found that stress triggers a fat generating cell called Adamts1"

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, anxiety or stress 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 anxiety, stress 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.

Irritable Bowel Syndrome (IBS) "Stress may play a sygnificant role in triggering a person's irritable bowel syndrome, or IBS, symptoms. This doesn’t mean that IBS is purely 'in the mind. Psychological factors, such as stress and anxiety can cause chemical changes in the body that can affect processes like those that occur in the digestive system.
The discomfort, inconvenience and pain from IBS can also affect a person's mental health, with around three out of four people with IBS experiencing depression at some stage, and half having the unease and worry of generalised anxiety disorder."

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