Why Managing Stress is More Important Than Anything Else for Gut Issues
The inextricable link between stress, the gut, the adrenals, and more.
I’ve always known my chronic gut issues (IBD) were undoubtedly linked to stress. I developed them when I was around 13, a time that I now realize I started putting enormous pressure on myself to succeed academically, not to mention fit in socially and — be good at everything, basically (except sports since apparently my lack of team athletic ability was just a given).
However, it hasn’t been until the last few years that I’ve truly realized just how big of a driver stress is in my illness and mental health. It’s possibly the biggest factor — more than genetics, more than food, more than toxins —chronic stress is more vicious to the body than just about anything else.
I think the modern conception of chronic disease doesn’t take stress into account nearly enough. But we are starting to get a better idea (hey, COVID) of just how much stress plays into generating and perpetuating all illness.
- This article from the Institute for Functional Medicine finds that 75 to 90% of all human disease is related to chronic stress and inflammation, including cardiovascular, metabolic, and neurodegenerative disease.
- The link between digestive disease and chronic stress is even more pronounced. You will probably have heard of the gut-brain axis, the direct connection between the brain and the gut via the nervous system. Because of this direct line of communication, chronic stress essentially causes a feedback loop of poor psychological health (anxiety, depression) that leads to poor digestive health (IBS, diarrhea, constipation, bloating, microbial dysbiosis) that leads to worse mental health, and on and on until sometimes, you end up with a serious digestive disorder like Crohn’s disease or Ulcerative Colitis.
- A 2018 survey found that two-thirds of Americans are affected by some kind of digestive symptoms.
Stress sets off a cascade of malfunctions in the body, and for people with IBD or IBS, those malfunctions start in the gut — and quickly spread to other areas of the body.
These are the multitude of ways that stress perpetuates intestinal illness — affecting the brain, the adrenals, the colon, and more — and what you can do about it.
How Stress Directly Affects the Gut
There are (unfortunately) multiple ways that stress impacts gut health. We already briefly discussed the gut-brain axis, and how chronic stress affects the microbial balance in the gut.
The gut microbiome contains trillions of bacteria and fungi both beneficial and antagonistic to the body. A balanced microbiome simply has the optimal ratio of bacteria and fungi, “good guys” and “bad guys,” maintaining homeostasis in the body.
However, when the balance is disrupted — by antibiotic or anti-fungal use, for example — the microbiome may not be able to recover properly, and it becomes imbalanced with more “bad guys” than “good guys.”
This is often seen when a person has to take antibiotics for a bacterial infection and ends up with a yeast infection by the time they’re done with the antibiotics. Both the commensal (beneficial) and pathogenic bacteria were wiped out (because antibiotics don’t discriminate) and the opportunistic yeasts were able to grow and flourish without the bacteria there to keep it in check.
In the worst cases, this leads to a terrible and never-ending cycle of antibiotic and anti-fungal use. I’ve been there, and it’s Not. Fun.
Stress can also easily affect the motility of the gut. Food is moved through the gut via peristaltic waves, which can either be sped up or slowed down due to stress. Perhaps you’ve felt this as rumbling in your stomach before you had to speak before a crowd or a “drop” in your stomach when you experienced shock and dread from a catastrophic event.
Of course, it’s more likely to affect you in smaller ways over time. You might begin to notice that you spend a lot of time sitting on the toilet (slow motility, aka constipation) or conversely, you have to rush to the bathroom after eating certain foods (fast motility, aka diarrhea).
And finally, stress has an undeniable impact on a person’s digestion, the actual processing of food via stomach acid, bile, and digestive enzymes. Stress may change when your body produces and releases these digestive aids as well as change how much it produces, either too much or too little.
I could go on and on about how much stress directly impacts gut health, but you get the idea. Chronic stress is bad news for the entire digestive system.
Branching Out: How Stress Affects the Adrenals
But wait, there’s more! We can think of chronic stress as chronically high levels of the stress hormone, cortisol, which is produced from the adrenal glands, two tiny and often overlooked glands that sit directly on top of your kidneys. Rest your hands on either side of your spine in your mid-back; that’s where the adrenals are.
According to Johns Hopkins Medicine, the adrenals produce several different hormones that help regulate your metabolism, blood pressure, immune system, stress response, and more. IMO, the adrenals are really underappreciated for everything they do for us.
But the main thing we want to focus on for now is that the adrenals produce cortisol, the stress hormone. When we are in a high-stress, life-threatening situation, this activates our fight-or-flight response, which under the right circumstances, allows us to escape danger and preserve our lives. Then when the danger has passed, our bodies should return to a more relaxed (rest and digest) state.
But when you’re under chronic stress, your adrenals are churning out cortisol all the time, and things start to go wonky with the body.
When the adrenals start to overproduce cortisol, it causes a cascade of detrimental hormone changes, which basically results in you being chronically tired and cranky, swimming through brain fog, and many other “nonspecific” symptoms, meaning doctors have a hard time figuring out what’s wrong with you because the symptoms could relate to so many different conditions.
This condition may be referred to as adrenal fatigue. Most MDs won’t take this condition seriously, but functional medicine doctors and naturopathic doctors are more open to it if you think you might be experiencing it.
But where’s the gut connection? Well, when the body comes under stress, it basically shuts down the digestive system, because it thinks you’re going to be dead in 20 seconds and you aren’t going to be needing all that digestion stuff.
As I mentioned earlier, it’s supposed to come back online once the danger has passed. But most of us with gut issues are stressed out all the time, and it just perpetuates the cycle of bad digestion.
As OB/GYN, NP Marcelle Pick says in her article about gut and adrenal health:
“As with many connections between different systems in the body, the relationship between gut health and adrenal health is kind of like a circle. They’ve worked together forever, and we can’t always pinpoint where or when the relationship became dysfunctional. Imbalances in the gut contribute to adrenal fatigue or dysfunction, and adrenal fatigue contributes to issues in the gut.”
But the extreme effect of chronic stress on our bodies doesn’t end there. Not even close.
How Stress Affects the Brain and Nervous System
Digging even deeper into the web of interrelated bodily systems affected by stress, we get to the master control centers, the brain and the nervous system.
Wildly, chronic stress has the ability to change the physical structure of our brains, decrease neuron production, and “harden” connections in the brain that are related to anxiety, depression, PTSD, and other psychological conditions.
Once again, our friend cortisol “is believed to create a domino effect that hardwires pathways between the hippocampus and amygdala in a way that might create a vicious cycle by creating a brain that becomes predisposed to be in a constant state of fight-or-flight,” writes Christopher Bergland in a 2014 Psychology Today article.
A body that is stuck in a constant state of flight-or-flight — or stuck in the sympathetic nervous system response — triggers the nervous system to increase heart rate, produce even more adrenaline and cortisol, release glucose into the bloodstream, and shift energy away from digestion.
Recovery from this sympathetic state should be re-balanced by the parasympathetic state, the rest and digest state. But it is very difficult for a chronically stressed nervous system to regain this state because as I mentioned before, the brain has already been rewired to the patterns of chronic stress (and anxiety, depression, etc.).
When the body is in rest and digest mode, the vagus nerve — aka the superhighway of communication from the brain to the rest of the body, particularly the gut — is turned on. But chronic stress dampens the communication of the vagus until eventually, it completely shuts down, leaving the body scrambled and stuck in hormonal disarray.
As this APA article summarizes, “It’s not so much what chronic stress does to the nervous system, but what continuous activation of the nervous system does to other bodily systems that become problematic.”
In the case of the nervous system and the gut, the vagus is essential to good digestion and motility, so when chronic stress essentially turns the vagus off, we once again experience poor digestion, impaired motility, and eventually disrupted microbial balance, which then can lead to the onset of digestive illness.
Whew! If that was stressful to read, I do apologize. Here’s a picture of a smiling dog to help you get back into that relaxed, parasympathetic state.
Now let’s talk about what you can do to reduce that chronic stress in your life and achieve balanced and regular (ha) gut health.
How to Reduce Stress and Fix Gut Function
To sum up, stress is extremely intertwined with chronic disease, especially in the gut. With so many systems affected and the effects compounding over time, this cycle of disease can be incredibly difficult to turn around once it has begun; however, it’s not impossible. That’s important for you to know.
Here are some steps you can take to reduce stress and repair your gut.
Identify the source(s) of your stress.
Maybe it’s stemming from one thing, like an important test or project, or maybe it has more to do with your environment and the people around you.
Either way, just having an awareness of what your stressors are is incredibly helpful and empowering. Now that you know what the problem is, you can do something about it!
Take small steps to reduce the stressors as well as your own internal stress level.
Knowing your stressors is one thing, but actually doing something about them can feel even more overwhelming — which is literally the exact opposite of what we want!
So let’s say, for example, that your main stressor is your office environment. Your coworkers are distracting, or you don’t like them, or your boss is super demanding. The office itself is windowless and dark, which brings you down.
What could you do in this situation to make yourself feel less stressed? Could you wear noise-canceling headphones so that you can focus on your work? Could you relocate to a different part of the office where there is more light for at least part of the day? Could you even see if you could work at home for 1 or 2 days per week, citing that you could be more productive at home instead of in the office?
Obviously, there are a lot of examples we could go through here, but the point is that you purposely take a look at what your stressors are and start making small steps toward resolving them.
Use food to your advantage.
If you have gut issues, food probably stresses you out to some extent. I think it’s one of the worst things about having a compromised gut.
But it’s absolutely critical that you are conscious of what you are putting into your body. If it’s processed junk — and you know exactly what I’m talking about — that’s not going to help you lower your stress or fix your gut.
The best way I’ve found of looking at it is to not focus on what you can’t have but to focus on what you can have, and how that food benefits you.
For example, I don’t eat gluten or dairy. So I can’t have donuts, let’s say, but I can have blueberries, and I freaking love blueberries. When I first overhauled my diet, it was really hard to not think about the restrictions I had placed on myself, but honestly, now I don’t even think about it. It’s just the way things are.
Some delicious foods that help lower stress include avocado, sweet potatoes, salmon, walnuts, flax seeds, almonds, broccoli, citrus fruits, and dark chocolate (in moderation!).
Focus on the foods you can have, know what foods make you feel good, and you’ll have a lot less stress about eating.
Leverage probiotics to rebuild the commensal (good) bacteria in your gut.
I’m sure I’m not telling you anything new by suggesting probiotics, but I have a few caveats you might not have heard before.
As you probably know, probiotics can help support your microbiome to shift the balance of good to bad bacteria over time. But it’s not as simple as popping one or two capsules each day.
First, most naturopaths or wellness practitioners I’ve talked to at this point recommend taking your probiotics at night before you go to bed, to give them time to repopulate in your gut overnight without interference from food or any other supplements you might be taking.
You especially don’t want to take probiotics at the same time as you are taking any other pathogen-killing supplements or drugs, like antibiotics, since you’ll just be killing the probiotics too.
Second, if possible, test what probiotics work for you using biofeedback or muscle testing. Many NDs are familiar with these kinds of testing, and it just helps make sure that your body accepts certain strains of probiotics since everybody’s microbiome is different.
Third, alternate between two to three different kinds of probiotics to encourage diversity in the gut.
Fourth, try soil-based or spore-based probiotics, which are specifically formulated to reach the colon where they are most needed, as well as rebuild the gut wall and combat pathogens.
And fifth, know that more isn’t always better. In fact, if you have something like SIBO, probiotics may actually make you feel worse. All the more reason to take your probiotics super seriously and incorporate testing to see which kinds are good for your gut!
Find a daily stress-relief practice that works for you.
Taking time out of your day to do something that relaxes you is so beneficial to help you lower those cortisol levels — and you can tailor it to your lifestyle and optimal time commitment.
I swear by these 10–20 minute guided meditations as well as short yoga practices. You might also try simply going for walks in nature or listening to something that makes you laugh.
The key is to do it consistently and mindfully to start seeing those stress levels come down over time.
Conclusion
Stress has a crazy cascade loop of effects that extends not only to gut health but also to brain health, hormone health, and more — which all eventually feeds back into even worse gut health.
Living in modern society, we aren’t nearly as aware of our chronic stress levels as we should be. Running on overdrive all the time has become the norm — but it’s not normal for our bodies at all. We need rest and relaxation to function properly.
Being aware of your stress and the many ways it can affect the body is the first step to reducing it and improving your overall health. Then, you have to make a plan around a healthy diet, managing stressors, and incorporating stress-relieving activities into your daily routine.
What are you going to implement to reduce chronic stress in your life and heal your gut?
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