The gut-brain connection The gut-brain connection is no joke; it can link anxiety to stomach problems and vice versa. Have you ever had a "gut-wrenching" experience? Do certain situations make you "feel nauseous"? Have you ever felt "butterflies" in your stomach? We use these expressions for a reason. The gastrointestinal tract is sensitive to emotion. Anger, anxiety, sadness, elation — all of these feelings (and others) can trigger symptoms in the gut. Get your copy of The Sensitive Gut   When your digestive system is running smoothly, you tend not to think about it. Once trouble begins, your gut — like a squeaky wheel — suddenly demands your attention. This Special Health Report, The Sensitive Gut, covers the major sources of gastrointestinal distress: irritable bowel syndrome, gastric reflux, upset stomach, constipation, diarrhea, and excess gas. It also includes a special Bonus Section describing how emotional stress and anxiety can cause gastrointestinal distress. The brain has a direct effect on the stomach and intestines. For example, the very thought of eating can release the stomach's juices before food gets there. This connection goes both ways. A troubled intestine can send signals to the brain, just as a troubled brain can send signals to the gut. Therefore, a person's stomach or intestinal distress can be the cause orthe product of anxiety, stress, or depression. That's because the brain and the gastrointestinal (GI) system are intimately connected. This is especially true in cases where a person experiences gastrointestinal upset with no obvious physical cause. For such functional GI disorders, it is difficult to try to heal a distressed gut without considering the role of stress and emotion. Gut health and anxiety Given how closely the gut and brain interact, it becomes easier to understand why you might feel nauseated before giving a presentation, or feel intestinal pain during times of stress. That doesn't mean, however, that functional gastrointestinal conditions are imagined or "all in your head." Psychology combines with physical factors to cause pain and other bowel symptoms. Psychosocial factors influence the actual physiology of the gut, as well as symptoms. In other words, stress (or depression or other psychological factors) can affect movement and contractions of the GI tract, make inflammation worse, or perhaps make you more susceptible to infection. In addition, research suggests that some people with functional GI disorders perceive pain more acutely than other people do because their brains are more responsive to pain signals from the GI tract. Stress can make the existing pain seem even worse. Based on these observations, you might expect that at least some patients with functional GI conditions might improve with therapy to reduce stress or treat anxiety or depression. And sure enough, a review of 13 studies showed that patients who tried psychologically based approaches had greater improvement in their digestive symptoms compared with patients who received only conventional medical treatment. Gut-brain connection, anxiety and digestion   Are your stomach or intestinal problems — such as heartburn, abdominal cramps, or loose stools — related to stress? Watch for these other common symptoms of stress and discuss them with your doctor. Together you can come up with strategies to help you deal with the stressors in your life, and also ease your digestive discomforts. Physical symptoms Stiff or tense muscles, especially in the neck and shoulders Headaches Sleep problems Shakiness or tremors Recent loss of interest in sex Weight loss or gain Restlessness Behavioral symptoms Procrastination Grinding teeth Difficulty completing work assignments Changes in the amount of alcohol or food you consume Taking up smoking, or smoking more than usual Increased desire to be with or withdraw from others Rumination (frequent talking or brooding about stressful situations) Emotional symptoms Crying Overwhelming sense of tension or pressure Trouble relaxing Nervousness Quick temper Depression Poor concentration Trouble remembering things Loss of sense of humor Indecisiveness For more on the connection between brain health and gut health, read The Sensitive Gut, a Special Health Report from Harvard Medical School. Image: © ChrisChrisW | GettyImages Share this story:

The impact of stress on your gut Given how closely the gut and brain interact, it might seem obvious that the pair often influence each other. Some people feel nauseated before giving a presentation; others feel intestinal pain during times of stress. In any case, emotional and psychosocial factors play a role in functional gastrointestinal disorders. Treating the whole body Stress-related symptoms felt in the gastrointestinal tract vary greatly from one person to the next, and treatment can vary as well. For example, one person with gastroesophageal reflux disease might have an occasional, mild burning sensation in the chest, while another experiences excruciating discomfort night after night. As the severity of symptoms varies, so should the therapies, medications, self-help strategies, or even surgeries used to relieve them. Many people have mild symptoms that respond quickly to changes in diet or medications. If your symptoms do not improve, your clinician may ask you more questions about your medical history and perform some diagnostic tests to rule out an underlying cause. For some people, symptoms improve as soon as a serious diagnosis, like cancer, has been ruled out. Your doctor may also recommend symptom-specific medications. But sometimes these treatments are not enough. As symptoms become more severe, so does the likelihood that you are experiencing some sort of psychological distress. Often, people with moderate to severe symptoms, particularly those whose symptoms arise from stressful circumstances, can benefit from mind directed therapies, such as cognitive behavioral therapy and relaxation techniques. Some people are reluctant to accept the role of psychosocial factors in their illness. But it's important to know that emotions cause genuine chemical and physical responses in the body that can result in pain and discomfort. Behavioral therapy and stress reduction treatments help manage pain and improve other symptoms in ways that are different from how drugs act. The goal of all therapies is to reduce anxiety, encourage healthy behaviors, and help people cope with the pain and discomfort of their condition. For more on managing gastrointestinal disorders, read The Sensitive Gut, a Special Health Report from Harvard Medical School. Share this story:

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The Sensitive Gut Featured content: • Inside the gut • Special section: The Stress Connection • Gastroesophageal reflux disease • Antireflux drug therapy • Functional dyspepsia • Irritable bowel syndrome • Constipation Click here to read more »