You have likely experienced stress and digestive issues at some point during your life. These two common conditions are often closely related to each other as is evident in the case of irritable bowel syndrome (IBS), a common gastrointestinal disorder that is often influenced by stress.
Stress: A Pervasive Lifestyle Factor with Profound Influences on Health
When you experience a situation or event that you perceive as a threat, your body triggers your fight-or-flight, or stress response, which creates many physiological changes in the body, especially in the digestive tract. This ancient response evolved to prepare the body either to fight a potential danger, such as a large predator or to flee to safety. Its purpose is to put you in a heightened state of energy and alertness to help you maintain balance and ensure your survival.
This interconnection between mental states and physical processes is orchestrated by the central nervous system, which communicates with the autonomic nervous system and hypothalamic-pituitary-adrenal (HPA) axis to allow the body to cope with, and respond to, stress.
While stress itself is not a disease, living in a state of chronic stress is a major underlying factor in the development of many chronic illnesses, including irritable bowel syndrome.
Stress, Digestion, and the Autonomic Nervous System
The brain has a direct impact on the digestive system via what is known as the brain-gut axis. This direct relationship involves neurological and hormonal signaling, which allows the brain and nervous system to communicate with the digestive tract and vice versa. Under stress, hormones are released and nerves are activated, which leads to changes in the digestive tract, including a decrease in blood and oxygen flow to the stomach, cramping, an imbalance in gut bacteria, and inflammation. This connection makes the digestive system especially susceptible to the impacts of stress.
The brain-gut connection is facilitated by a network of nerve fibers that line the walls of your digestive tract. This active system of nerves is a branch of the autonomic nervous system called the enteric nervous system. The enteric nervous system is sometimes called the “second brain” because it communicates extensively with the brain. Due to this intimate connection, it is not surprising that conditions related to psychological stress, including anxiety and depression, are associated with gastrointestinal symptoms in conditions like IBS.
Irritable Bowel Syndrome
IBS is a common and usually chronic functional disorder of the digestive tract. The growing knowledge of the gut-brain axis is helping to shape an evolving explanation of irritable bowel syndrome as a stress-sensitive disorder.
Symptoms of IBS include the following:
- Abdominal pain
- Altered bowel habits such as diarrhea, constipation, or both
These symptoms of IBS seem to result from altered brain-gut interactions, imbalances in the gut microbiome, and a damaged intestinal barrier. Chronic stress, and its accompanying hormonal changes, contribute to the dysregulation of these systems.
Not only does the brain influence the gut, but the gut also sends signals back up to influence the brain. This two-way communication contributes to many of the symptoms experienced by people with IBS. For example, research suggests that irritation in the gastrointestinal system may send signals to the central nervous system, which can trigger mood changes and contribute to the development of disorders such as anxiety and depression.
Research also demonstrates that autonomic nervous system activity both at baseline and under stress impacts bowel function and the composition of the gut microbiome. The gut microbiome is made up of microbes that colonize the digestive tract and play essential roles in maintaining human physiology. Evidence suggests that imbalances in these gut bacterial communities (gut dysbiosis) can lead to activation of the immune system in the intestines, which contributes to symptoms of IBS, such as changes in stool form and frequency.
Altered intestinal barrier function (leaky gut) may also play a role in the development of IBS symptoms. This lining of the intestines can be altered by infections, dietary choices, chemotherapy, and the overall composition of the gut microbiota.
A Lifestyle-Based Approach to Managing IBS and Improving Digestive Health
Given these findings, there are many ways to balance the stress response, reduce chronic stress, and improve digestive health. These approaches are based on mindfulness, functional nutrition, and lifestyle medicine approaches.
Be sure to consider these strategies in conjunction with your health care provider to find an approach that is appropriate for your unique needs.
Balance Vagal Tone with Relaxation and Breathing Exercises
The vagus nerve (cranial nerve X) is an important component of the parasympathetic (rest and digest) division of the autonomic nervous system. It facilitates communication between the brain, cardiovascular system, immune system, and digestive tract. Relaxation and focused-breathing exercises turn on the vagus nerve in a beneficial way so that it acts as a brake on the stress response. This leads to greater autonomic balance and reduced symptoms of IBS.
Deep breathing triggers the parasympathetic nervous system, which activates processes involved in rest, repair, and digestion. When the body is in parasympathetic mode, blood flow and oxygenation to the digestive tract is increased, making digestion more efficient.
Here are a few other effective techniques for shifting into a parasympathetic mode that favors relaxation and healthy digestion:
Nourish the Microbiome with Prebiotics and Probiotics
A balanced microbiome is more resistant to the negative impacts of inevitable stress. When your gut has a healthy balance of microbes, you have less intestinal permeability, improved resistance to illness, and better psychological and gastrointestinal health.
Prebiotics are functional foods that promote the growth and/or activity of beneficial gut bacteria. Specific types of dietary fibers, including inulin, fructo-oligosaccharides (FOS), galactooligosaccharides (GOS), and oligosaccharides, are prebiotic foods that nourish healthy gut bacteria. These non-digestible carbohydrates are found in foods like bananas, asparagus, onions, oats, garlic, and Jerusalem artichokes.
Probiotics are live or attenuated healthy bacteria or yeasts that help to populate your gut microbiome when taken in appropriate amounts. Including naturally fermented foods in your diet, such as raw sauerkraut or other cultured vegetables and kombucha, can contribute to microbial diversity.
The term psychobiotics has been coined to encompass a subtype of probiotics that may influence the brain-gut-microbiota axis to have a beneficial effect on mood, anxiety, and cognition. Several studies suggest that psychobiotics can exert an anti-inflammatory effect and improve overall symptoms in IBS patients. Research has demonstrated beneficial effects of probiotics on psychological symptoms in healthy individuals as well as those with IBS.
Restore and Maintain a Healthy Intestinal Barrier
The integrity of the intestinal lining is highly influenced by diet and the balance of the gut microbiota. A whole food-focused diet rich in anti-inflammatory vegetables, fruit, and fiber can help maintain a healthy intestinal barrier. Conversely, a diet high in added sugars and artificial ingredients contributes to inflammation, which can lead to increased gut permeability.
In particular, certain dietary components can help heal the intestinal lining. These include the following:
- Omega-3 fatty acids such as those in wild salmon and walnuts
- Fat-soluble vitamins A and D
- Quercetin (found in apples and red onions)
- EGCG in green tea
- Curcumin (one of the primary components in turmeric)
While anti-inflammatory fruits, vegetables, and fiber can benefit some patients with IBS, others may benefit from a low-FODMAP diet. FODMAP stands for” fermentable oligosaccharides, disaccharides, and monosaccharides and polyols,” which are categories of carbohydrates that can be hard for the body to absorb, resulting in bloating and abdominal pain. Reducing the intake of FODMAP foods can reduce GI symptoms and improve disease-specific quality of life in these patients with IBS. Caution remains in this area as long-term studies are needed to assess the overall impact of a low-FODMAP diet on the gut microbiome since it excludes many foods that may be beneficial to microbial balance.
Stress is pervasive in life but the way you cope with and react to it is what determines its impact on your mind and body, including your digestive tract. This emerging understanding of the links between stress, compromised intestinal barrier function, systemic inflammation, and the gut microbiome provide hope and empowering insights for taking control of your health and managing your symptoms. These healthy habits support balanced mind-body health to counteract the negative consequences of chronic stress on the digestive tract.
*Editor’s Note: The information in this article is intended for your educational use only; it does not necessarily reflect the opinions of the Chopra Center's Mind-Body Medical Group; and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health providers with any questions you may have regarding a medical condition and before undertaking any diet, supplement, fitness, or other health programs.
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