Your Stomach And Brain Are In Constant
By Dr. Komaroff - Monday, December 9, 2013
DEAR DOCTOR K: Whenever I'm stressed out my stomach clenches
up in knots. Why does it do that?
DEAR READER: A particularly sad experience is described as
"gut-wrenching." Hearing about a gruesome crime makes
you "feel nauseated." An upcoming presentation gives
you "butterflies in your stomach." We use these
expressions because anger, anxiety, sadness, elation and other
emotions can trigger symptoms in our gastrointestinal tract.
The brain has a direct effect on the stomach. Even the
thought of eating can release the stomach's juices before food
gets there. This connection goes both ways. A troubled gut can
send signals to the brain, just as a troubled brain can send
signals to the gut. Therefore, your distressed gut can be as
much the cause as the product of anxiety, stress or depression.
Your brain and the gastrointestinal (GI) tract are intimately
connected. The gut is controlled by the enteric nervous system (ENS),
a complex system of about 100 million nerves that starts in the
brain and ends in the gut. It controls every aspect of
digestion, so it's no surprise that when the brain is disturbed,
the gut can be as well.
The nerve endings of the ENS are embedded in the gut wall.
Those nerves not only send messages from the brain to the gut;
they also send messages from the gut to the brain. There is a
rich dialogue between gut and brain during the entire journey of
food through the 30-foot-long digestive tract.
This two-way communication explains why you stop eating when
you're full. It's because nerve cells in your gut let your brain
know that your stomach has expanded. It also explains why
anxiety over this morning's exam has ruined your appetite for
breakfast. The stress activates your "fight or flight"
response, which inhibits secretion of stomach juices and reduces
blood flow to your gut, as more blood is diverted from the
stomach and into your muscles.
Emotions cause genuine chemical and physical responses in the
body that can result in pain and discomfort. For example, stress
can affect movement and contractions of the GI tract. The gut is
a tube containing circular muscles that move food down your
digestive system. Normally the muscles all work in a coordinated
way, like oarsmen rowing a shell. When, instead, the muscles are
not coordinated and start to fight each other, pain can result.
Stress also makes all parts of the body more vulnerable to
both inflammation and infection. Inflammation and infection in
the gut produce pain, gas, bleeding, nausea, diarrhea and other
If ongoing stress is causing frequent GI problems for you,
treatments such as cognitive behavioral therapy, relaxation
techniques and hypnosis might help. These treatments can help
reduce anxiety and encourage healthy behaviors to help you cope
with pain and discomfort.