A few years ago, I was working full time at a doctor’s office as a medical assistant. This job was not inherently terrible, however, I worked in a very toxic work environment. Not to mention that at the time, I was also in school to get my Master’s degree. This meant that I was working 40+ hours a week and trying to fit in school work whenever possible, even if that meant staying up until 3 am to finish an assignment and waking up at 7 am for work the following morning. I was a pre-med student in college, so needless to say I was familiar with “all-nighters” and sacrificing free time to study.
So I thought to myself: how is this any different?
I’ve been stressed out many times throughout college and have come out on the other end, so I figured that there’s nothing I couldn’t handle.
On top of working and going to school, I also experienced a traumatic life event. Again, I told myself to compartmentalize and keep moving forward as I had always done during stressful periods. Next thing I knew, COVID-19 took over and we all found ourselves trying to navigate a new way of life. Because I worked in healthcare, my work did not halt. I still woke up every day and went into work regardless of what was happening in the world and in my personal life.
After a month or two of this routine, I started to notice new GI symptoms that I had never experienced before. I was so bloated I felt like my clothes were not fitting right.
Was I gaining weight?
Could it be because my workout routine has changed since gyms were now closed? The number on the scale had not changed. My diet was clean and full of nutritious foods, I engaged in physical activity almost every day and I typically stayed away from substances such as alcohol. Regardless of all these things, I would still wake up feeling bloated every single morning. Nothing about my diet or everyday routine had changed so I was beyond confused. I was so incredibly uncomfortable and was feeling lost in my own body.
One day in the middle of the night I woke up with intense chest pain. My father rushed me to the hospital, scared that something was wrong with my heart. My hospital visit revealed that I was experiencing esophagitis, which is painful inflammation of the esophagus that can feel similar to a heart attack. After an endoscopy, I was then diagnosed with chronic gastritis. This was new to me, as I was someone who had really never suffered from symptoms of heartburn before. My GI doctor advised me to take Omeprazole, a proton pump inhibitor, to treat the gastritis and reduce my heartburn. I took the medication for a little while and while things somewhat improved, I was still left with unwanted bloating and discomfort.
Why was this all of a sudden happening to me?
To find some answers I decided to take a SIBO test. SIBO, small intestinal bacterial overgrowth, is something that is known to cause excess bloating, but surprisingly, that test came back negative for me. I was a bit perplexed as to what the underlying cause of my GI symptoms were.
Fast forward a few months and I had quit my medical assisting job to finish my master’s degree. I successfully got my degree and was taking a break to figure out what the next step in my career would be. During this time, I noticed that my GI symptoms slowly started to reduce. I no longer was bloated and had not suffered another gastritis episode. Although I never really figured out the cause, I couldn’t help but notice that my health significantly improved when I left my toxic work environment and sought out help from a therapist to address my traumatic life event.
This begs the question, could your unresolved GI symptoms be related to underlying stress and/or trauma? Do you feel like you’re doing everything right but nothing seems to be working?
There is a large connection between stress and the GI system. Periods of prolonged stress can cause GI symptoms such as bloating, increased gas, constipation, acid reflux, etc. through various mechanisms including:
- Altered digestive function
- Changes in motility
- Changes in the gut microbiome
- Gut-brain axis dysfunction (more on this below)
- Damage to the intestinal lining
Changes in motility and altered digestive function– Our parasympathetic nervous system is responsible for our digestion. When our parasympathetic nervous system is balanced, we are in a state of “rest and digest.” When we are stressed or in a heightened state, our sympathetic nervous system becomes activated, which puts us in a state of “fight or flight.” This can divert blood flow away from our digestive system which means that our digestion will slow down, which can cause constipation. When we are constantly in a state of fight or flight, our body may also secrete less stomach acid and digestive enzymes, which are crucial for breaking down and absorbing our food. Because our body becomes less efficient in breaking down food, we may start to experience symptoms such as acid reflux.
Changes in the gut microbiome– We’ve all heard how important it is to have good gut health, but how is this related to stress? The gut microbiome is made up of many bacteria, both “good” and “bad.” When we have an imbalance of the bacteria in our microbiome (i.e. more good than bad), also known as dysbiosis, this may cause unwanted symptoms such as bloating, gas, diarrhea, constipation, etc. Chronic stress is known to shift our microbial environment, leading to reduced diversity of the good bacteria.
Gut-brain axis dysfunction- Have you ever heard that there is a connection between the gut and the brain? We have this communication system that links our gastrointestinal tract and our brain. This involves various pathways such as our nervous system, our immune system and our endocrine system. The vagus nerve is a crucial component of the gut-brain axis. The vagus nerve is associated with our “rest and digest” functions, therefore when we are stressed, the vagus nerve is dampened due to the increase in our “fight or flight” response. A reduction in vagus nerve activity slows digestion which can impact gut motility, thus causing constipation. Not to mention, an important aspect of the gut-brain axis includes the production of neurotransmitters. Our gut microbiome produces neurotransmitters such as dopamine and serotonin, otherwise known as our happy hormones! Therefore, when our gut microbiome is impacted by chronic stress, it may reduce our ability to produce these neurotransmitters effectively, which in turn can impact our mood. This can become a vicious cycle.
Damage to the intestinal lining– Our small intestine has a lining, or a barrier, that plays an essential role in our digestion and overall health. This lining prevents harmful substances such as toxins, pathogens and undigested food particles from entering our blood stream. When the integrity of the intestinal lining becomes damaged, these substances can leak into the bloodstream and cause symptoms such as bloating, gas, diarrhea, constipation, etc. This intestinal permeability, or “leaky gut” can often occur as a result of chronic stress. Our body’s natural response to stress is the release of the hormone cortisol, also known as our stress hormone. This response is normal, and in fact very necessary for our body to function properly. This becomes an issue when the body is constantly stressed, which results in the continuous release of cortisol. Chronically elevated cortisol levels have been known to cause damage to the intestinal lining, making it more permeable. Additionally, excess cortisol can contribute to systemic inflammation, which can also damage the intestinal barrier. Yikes!
So where do we go from here?
If you’ve been struggling for a while with mystery GI symptoms, it may be time to look at your environment and think about the potential stressors that are impacting your well-being. Stressors are something we often discuss with our clients because we know that the body can’t function properly under copious amounts of stress or trauma. Whether it’s stress management techniques, lifestyle changes or therapy, we are always encouraging stress reduction as much as possible.
However, as I mentioned earlier, if you’ve been chronically stressed for quite some time now, the physiological damage may already be done. This is the part that I didn’t quite understand until I was fully educated on the matter. Although some of my symptoms improved with the absence of my external stressors, I still felt as though my digestive function was not fully up to par. I realized that I needed to
- Assess the damage that had been done (typically through functional GI testing that we offer to our clients) and…
- Incorporate functional nutrition interventions that can resolve this damage.
If stress has already impacted the function of your GI system, there are certain interventions that need to be put into play, aside from stress reduction, that can help restore your digestive health. This is where we come in! If you’re feeling frustrated and confused like I was, it’s time to set up a call and chat with us about how we can help!
