The holidays can be the most wonderful time of the year because it’s a festive time that means vacations, traditions, good food, and spending time with family and friends. However, it can also be an extremely stressful time of the year because of all that cooking, the crowds, the money spent on gifts, traveling, sleeping on the couch, floor, air mattress, or old twin bed from your teenage years, and spending time with those you may not be as excited to see. A stressful holiday is difficult for anyone but for those with health issues, managing that stress is even more important. This includes those who have digestive disorders. The holidays can be very hard because you have more temptations to eat foods that can make you sick and if you are eating at family or friends, you have less control over the food being served. And because our stomachs and brains are connected, stress can also increase your digestive symptoms.
How are the brain and gut connected?:
The body contains two main nervous systems; the central nervous system, which is the brain and spinal cord and the peripheral nervous system, which is all the nerves outside of the brain and spinal cord. The peripheral nervous system communicates information between the brain and every other part of our body. The autonomic nervous system is part of the peripheral nervous system and its role is to control our involuntary activities, such as breathing, heartbeat, respiratory rate, and digestive functions. The autonomic nervous system is broken down into three divisions. 1. The sympathetic nervous system, also known as the fight or flight response helps us react in scary situations; 2. The parasympathetic nervous system eases our body back to calm afterwards; and 3. The less well-known enteric nervous system has a role in digestion, including digesting food, absorbing nutrients, contracting the intestinal walls, and removing waste. The enteric nervous system is known as the “second brain” or “little brain” because it is made up of neurons and neurotransmitters (molecules that communicate information from one neuron to another) that are analogous to those found in the brain. The gut wall beginning from the esophagus and ending at the anus has about 100 million neurons. This is the brain gut axis, which allows for communication from the brain to the gut and vice versa. Because of this, stressful situations can affect our digestive systems resulting in indigestion, diarrhea, and abdominal pain. Long-term stress can cause the development of irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), food allergies, peptic ulcers, gastroesophageal reflux disease (GERD), and more.
How does stress affect the digestive system?:
- Change in gastrointestinal motility: In situations that call on the fight or fight response, the body focuses all of its energy to what is going on and will slow down or stop other functions, including the digestive system. This may cause abdominal pain and related symptoms but since these are transient moments, you may not notice any change. However, in long-term stressful situations or if one has chronic anxiety, these symptoms become noticeable.
- Change in intestinal permeability: Stress can increase the possibility of intestinal permeability, which can lead to leaky gut syndrome, which allows for foreign substances, such as bacteria, undigested food, and toxins to enter the bloodstream. This causes an immune response leading to diseases such as celiac and Crohn’s.
- Change in bacterial composition: Two of the roles that bacteria play in the gut are to break down nutrients and in developing the immune system. Stress can change the composition of the bacteria and can affect our ability to digest and absorb nutrients and lead to a compromised immune system, inflammation, and bacterial overgrowth.
- Increase of sensitivity to pain: One example of this is with GERD. Stress can trigger the relaxation of the lower esophageal sphincter, resulting in stomach acid entering the esophagus. Additionally, stress can increase our perception of the pain. It has been shown that in times of stress, the amount of acid in the esophagus might not change but our sensitivity to the pain increases.
- Hormones and neurotransmitters:
Hormones: Cortisol, a stress hormone is released via the sympathetic nervous system due to the flight or flight response. During chronic stress, the sympathetic nervous system does not turn off, preventing the parasympathetic nervous system from being activated when needed, such as during digestion. This prevents proper digestion and absorption of nutrients and indigestion and ulcers may develop. Long exposure to cortisol can also affect the immune system leading to food allergies and autoimmune diseases.
Neurotransmitters: The enteric nervous system uses many of the same neurotransmitters as the brain, including serotonin. Selective serotonin reuptake inhibitors (SSRI), one type of antidepressants increase the serotonin in the brain, which helps with depression. However, this same increase may cause IBS in the gut.
Tips to help manage stress:
- Eat well. If you are travelling, bring food with you. If you are having a meal at family or friends, offer to bring a couple of dishes.
- Make sure you get enough rest.
- Take time for yourself.
- I find walks an easy way to workout when I travel. It also allows me to decompress.
- Make sure you do not overextend yourself. It is okay to say no, it can actually be a good thing.
- Talk to family and friends who can help you manage your stress. If you see a therapist, work with them before the holidays to prepare you to deal with your triggers.
How do you manage stress during the holidays?
1. Foster, JA and McVey, KA (2013) Gut-brain axis: how the microbiome influences anxiety and depression. Trends in Neuroscience, 36(5): 305-312
2. Andre G. Buret (2006) How stress induces intestinal hypersensitivity. The American Journal of Pathology, 168(1): 3-5
3. Konturek, PC., Brzozowski, SJ., Konturek, SJ (2011) Stress and the gut pathophysiology, clinical consequences, diagnostic approach and treatment options. Journal of Physiology and Pharmacology, 62(6): 591-599.
Photo found on PEXELS