Most of us wouldn’t think stress is vital to our digestive health, yet it does. The digestive system comprises your mouth, throat, esophagus, stomach, and the large and small intestines (collectively called the gut). Three main organs contribute to this system: the liver, pancreas, and gallbladder. Thus, the digestive system, sometimes called the “gastrointestinal system,” is responsible for the digestion and absorption of nutrients and waste removal (excretion). When this system functions poorly or is not healthy, you will experience a host of uncomfortable symptoms such as abdominal pain, bloating, indigestion, and more. You may also lack proper nutrition from the food you eat, which can negatively impact your overall health and well-being.
How Does Stress Impact the Digestive System?
First and foremost, it is essential to understand that the brain and your digestive system (gut) are in constant communication. Your gut has more neurons (nerves) than the entire spinal cord.[i] When stressed, your body releases the hormone cortisol (often called the stress hormone) and the neurotransmitters norepinephrine, epinephrine, and dopamine.[ii] When released during short periods of stress, these compounds will have a healthy impact on the body. The problem arises when the body is under continued stress, and these hormones have flooded the body for extended periods. The combination of this constant elevation contributes to the breakdown of your digestive system and increases our digestive woes.[iii] Many studies prove that stress is associated with the onset of symptoms or the worsening of symptoms in many digestive conditions, such as inflammatory bowel problems, reflux, and even ulcerations.[iv]
The significant effects of stress on the gut physiologically speaking are[v]:
- Alterations in gastrointestinal motility (the movement of food and waste from the mouth to the anus)
- increase the ways people feel their digestive sensations, i.e., discomfort
- Changes in gastrointestinal secretions, such as saliva, mucus, stomach acid, enzymes, and bile, play an essential role in digestion and protection.
- Increased intestinal permeability (the more “permeable” the digestive lining is) increases the chance of adverse effects and the breakdown of the protective lining. When this occurs, bacteria and other toxins pass through the intestinal wall into the bloodstream.
- Adverse effects on the ability of the body to heal, repair, and create a healthy digestive lining
- Negative impact on the microbiome, i.e., beneficial bacteria in the small and large intestines.
Below, you can see how and what stress may contribute to your digestive problems.
Bowel Health
As mentioned, stress can also cause pain, bloating, or discomfort that can be felt more easily in the bowels. In addition, it can affect how quickly food moves through the body, which can cause either diarrhea or constipation. Due to stress’ impact on bowel health, it also affects the digestion and absorption of nutrients into the body. [vi]
The intestines have a tight barrier to protect the body from (most) food-related bacteria. However, stress can weaken the intestinal barrier and allow gut bacteria to enter the body. In addition, the constant low need for inflammatory action can lead to chronic mild symptoms.[vii]
Digestion
According to an article published by the American Psychological Association, “Stress can affect this brain-gut communication and may trigger pain, bloating, and other gut discomforts to be felt more easily. The gut is also inhabited by millions of bacteria, which can influence its health and the brain’s health, impacting the ability to think and affect emotions. Stress is associated with changes in gut bacteria, which can influence mood. Thus, the gut’s nerves and bacteria strongly influence the brain and vice versa.”
Stomach
Stress can result in heartburn or acid reflux. Stress or exhaustion can also increase the severity of regularly occurring heartburn pain. Up to 64% of patients with stress and gastroesophageal reflux reported aggravation of their symptoms by stress, and stress reduction often resulted in an improvement.[viii] [ix] In another condition, dyspepsia (pain or uncomfortable feeling in the upper middle part of the stomach), researchers found that psychological stress, particularly recent life events, was a major risk factor for this condition.[x] Stress is also linked to an increased risk of developing an erosion of the digestive lining.[xi][xii] Stress also may make swallowing difficult or increase the amount of air swallowed, which increases burping, gassiness, and bloating.[xiii]
Suffice it to say that stress (especially long-term) harms the digestive system in many ways. Therefore, formulating products for digestive health should consider adding ingredients designed to address stress and the biochemistry/physiology of what occurs in the body during stressful times. Ingredients such as:
Ashwagandha (Sensoril® from Kerry, KSM-66® from KSM-66®)- Research shows that ashwagandha decreases daily stress and significantly decreases serum cortisol levels.
GABA- GABA not only induces relaxation but also reduces anxiety[xiv] and alleviates the stress induced by mental tasks.[xv]
Holy Basil (Holixer® from Natural Remedies)- A 100-member study with Holixer showed a significant reduction in perceived stress (perceived stress scale) (38%) and hair cortisol levels (66%) when compared to the placebo group. Hair cortisol levels are an indicator of stress over an extended period. Holixer also showed its effects (within 10 minutes) during acute stress.[xvi
L-theanine- Studies show it reduces tension-anxiety[xviii] and decreases stress scores.[xix] Improves self-reported relaxation, tension, and calmness, starting at 200 mg.[xx] Theanine has been shown to increase the production of GABA, too.[xxi] Studies show it reduces tension-anxiety[xxii] and decreases stress scores[xxiii]
Magnesium- Magnesium is key in regulating the body’s stress-response system. Magnesium deficiency is associated with heightened stress.[xxiv] Magnesium status is highly associated with stress levels, both stress and hypomagnesemia potentiating each other’s negative effects.[xxv] Supplementation alleviated stress in healthy adults with low magnesemia, and for those with severe/extremely severe stress, a greater benefit was realized when magnesium was combined with vitamin B6.[xxvi]
Saffron (Affron® from Pharmactive Biotech)- Affron® is a patented and clinically substantiated ingredient of saffron (Crocus sativus). Studies show:
- Alleviating occasional stress, frustration, and tension in adults[xxvii]
- Helped children (12-16 years of age) maintain a positive mood and alleviate occasional stress, frustration, and tension.[xxviii]
- Improve psychological symptoms (low mood and occasional stress) in perimenopausal women (32-33% reduction)[xxix]
When considering gastrointestinal health, a more holistic approach would be to combine ingredients for stress with those that target specific digestive needs, such as clinically proven probiotics, postbiotics, or prebiotics. This is a novel approach to health compared to the products currently found in the marketplace.
References:
[i] Purves D, Augustine GJ, Fitzpatrick D, et al., editors. Neuroscience. 2nd edition. Sunderland (MA): Sinauer Associates; 2001. The Enteric Nervous System. Available from: https://www.ncbi.nlm.nih.gov/books/NBK11097/
[ii] Ranabir S, Reetu K. Stress and hormones. Indian J Endocrinol Metab. 2011;15(1):18-22. doi:10.4103/2230-8210.77573
[iii] Konturek PC, Brzozowski T, Konturek SJ. Stress and the gut: pathophysiology, clinical consequences, diagnostic approach and treatment options. J Physiol Pharmacol. 2011 Dec;62(6):591-9. PMID: 22314561.
[iv] GI Society Canadian Society of intestinal Research website, https://badgut.org/information-centre/a-z-digestive-topics/stress-and-your-gut/ , Stress and Your Gut, accessed November 9 2021
[v] Konturek PC, Brzozowski T, Konturek SJ. Stress and the gut: pathophysiology, clinical consequences, diagnostic approach and treatment options. J Physiol Pharmacol. 2011 Dec;62(6):591-9. PMID: 22314561.
[vi] Konturek PC, Brzozowski T, Konturek SJ. Stress and the gut: pathophysiology, clinical consequences, diagnostic approach and treatment options. J Physiol Pharmacol. 2011 Dec;62(6):591-9. PMID: 22314561.
[vii] GI Society Canadian Society of intestinal Research website, https://badgut.org/information-centre/a-z-digestive-topics/stress-and-your-gut/ , Stress and Your Gut, accessed November 9 2021
[viii] Fass R, Fennerty MB, Vakil N. Non erosive reflux disease—current concepts and dilemmas. Am. J. Gastroenterol. 2001; 96: 303–14.
[ix] Bradley LA, Richter JE, Pulliam TJet al. The relationship between stress and symptoms of gastroesophageal reflux: The influence of psychological factors. Am. J. Gastroenterol. 1993; 88: 11–19.
[x] Stanghellini V. Relationship between upper gastrointestinal symptoms and lifestyle, psychosocial factors and comorbidity in the general population: results from the Domestic/International Gastroenterology Surveillance Study (DIGEST). Scand. J. Gastroenterol.1999; 231: 29–37.
[xi] Dunn JP, Cobb S. Frequency of peptic ulcer among executives, craftsmen and foreman. J. Occup. Med. 1962; 4: 343–8.
[xii] Cobb S, Rose RM. Hypertension, peptic ulcer and diabetes in air-traffic controllers. J. Am. Med. Assoc 1973; 224: 489–92.
[xiii] Carlson D, Gyawali C, Roman S, et. al., Esophageal Hypervigilance and Visceral Anxiety Are Contributors to Symptom Severity Among Patients Evaluated With High-Resolution Esophageal Manometry, The American Journal of Gastroenterology: March 2020 – Volume 115 – Issue 3 – p 367-37, doi: 10.14309/ajg.0000000000000536
[xiv] Abdou AM, Higashiguchi S, Horie K, et al. Relaxation and immunity enhancement effects of gamma-aminobutyric acid (GABA) administration in humans. Biofactors 2006;26:201-8
[xv] Yoto A, Murao S, Motoki M, Yokoyama Y, Horie N, Takeshima K, Masuda K, Kim M, Yokogoshi H. Oral intake of ?-aminobutyric acid affects mood and activities of the central nervous system during stressed condition induced by mental tasks. Amino Acids. 2012 Sep;43(3):1331-7. doi: 10.1007/s00726-011-1206-6. Epub 2011 Dec 28
[xvi] Lopresti AL, “A randomized, double-blind, placebo-controlled trial investigating the effects of an Ocimum tenuiflorum
(Holy Basil) extract (Holixer™) on stress, mood, and sleep in adults experiencing stress” Frontiers in Nutrition 2022 DOI 10.3389/fnut.2022.965130
[xvii] Terburg D, Syal S, Rosenberger LA, Heany S, Phillips N, Gericke N, Stein DJ, van Honk J. Acute effects of Sceletium tortuosum (Zembrin), a dual 5-HT reuptake and PDE4 inhibitor, in the human amygdala and its connection to the hypothalamus. Neuropsychopharmacology. 2013 Dec;38(13):2708-16. doi: 10.1038/npp.2013.183. Epub 2013 Aug 1.
[xviii] Yoto A, Motoki M, Murao S, Yokogoshi H. Effects of L-theanine or caffeine intake on changes in blood pressure under physical and psychological stresses. J Physiol Anthropol. 2012;31:28
[xix] Unno K, et al. Anti-stress effect of theanine on students during pharmacy practice: positive correlation among salivary a-amylase activity, trait anxiety and subjective stress. Pharmacol Biochem Behav. 2013;111:128-135
[xx] Dietz C, Dekker M, “Effect of Green Tea Phytochemicals on Mood and Cognition,” Current Pharmaceutical Design (2017) 23: 2876. https://doi.org/10.2174/1381612823666170105151800
[xxi] Inoue K., Miyazaki Y., Unno K., Min J.Z., Todoroki K., Toyo’oka T. Stable isotope dilution HILIC-MS/MS method for accurate quantification of glutamic acid, glutamine, pyroglutamic acid, GABA and theanine in mouse brain tissues. Biomed. Chromatogr. 2016;30:55–61. doi: 10.1002/bmc.3502
[xxii] Yoto A, Motoki M, Murao S, Yokogoshi H. Effects of L-theanine or caffeine intake on changes in blood pressure under physical and psychological stresses. J Physiol Anthropol. 2012;31:28
[xxiii] Unno K, et al. Anti-stress effect of theanine on students during pharmacy practice: positive correlation among salivary a-amylase activity, trait anxiety and subjective stress. Pharmacol Biochem Behav. 2013;111:128-135
[xxiv] https://www.psychologytoday.com/us/blog/sleep-newzzz/201805/what-you-need-know-about-magnesium-and-your-sleep
[xxv] Cuciureanu MD, Vink R. Magnesium, and stress. In: Vink R, Nechifor M, editors. Magnesium in the Central Nervous System. Adelaide (AU): University of Adelaide Press; 2011. https://www.ncbi.nlm.nih.gov/books/NBK507250/
[xxvi] Pouteau E, Kabir-Ahmadi M, Noah L, Mazur A, Dye L, et al. (2018) Superiority of magnesium and vitamin B6 over magnesium alone on severe stress in healthy adults with low magnesemia: A randomized, single-blind clinical trial. PLOS ONE 13(12): e0208454. https://doi.org/10.1371/journal.pone.0208454
[xxvii] Kell G, Rao A, Beccaria G, Clayton P, Inarejos-García AM, Prodanov M. affron® a novel saffron extract (Crocus sativus L.) improves mood in healthy adults over four weeks in a double-blind, parallel, randomized, placebo-controlled clinical trial. Complement Ther Med. 2017 Aug;33:58-64. doi: 10.1016/j.ctim.2017.06.001. Epub 2017 Jun 13. PMID: 28735826.
[xxviii] Lopresti AL, Drummond PD, Inarejos-García AM, Prodanov M. affron®, a standardized extract from saffron (Crocus sativus L.) for the treatment of youth anxiety and depressive symptoms: A randomised, double-blind, placebo-controlled study. J Affect Disord. 2018 May;232:349-357. doi: 10.1016/j.jad.2018.02.070. Epub 2018 Feb 26. PMID: 29510352.
[xxix] Lopresti AL, Smith SJ. The Effects of a Saffron Extract (affron®) on Menopausal Symptoms in Women during Perimenopause: A Randomised, Double-Blind, Placebo-Controlled Study. J Menopausal Med. 2021;27:e8. https://doi.org/10.6118/jmm.21002