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The effect of stress on our gut health and 3 steps to break the stress cycle and live a thriving life.

By Dr. Will Bulsiewicz MD MSCI

Have you experienced any of these in the last year?

* You have a big meeting first thing in the morning, but overslept.

* Your kids missed their nap and are cycling between crying and screaming for hours on end.

* You have a huge deadline at work coming up, and your computer just crashed.

* Or a damn pandemic hits and everything and everyone just goes insane.

Stress can come in so many forms in our 21st century life. Sadly, stress is everywhere. It’s a part of our life these days and pretty much impossible to avoid. If handled properly, we can grow and become stronger by controlling our stress. And if we don’t, the stress seems to linger. You just can’t shake it as quickly as you’d like. Why is that?

The answer may surprise you. Did you know that there’s 500 million nerves in your gut, which is why we often refer to it as our “second brain.” 500 million! That’s five times more than you’ll find in your spinal cord. Those 500 million gut nerves are in a continuous two-way communication between your brain and your gut. This is what we call the gut-brain axis.

Stress involves both sides of this collaboration – the brain AND the gut. Let’s start upstairs, in your brain, where a hormone called corticotropin-releasing factor (or CRF) is released by the hypothalamus in response to stress. CRF sets off a cascade of hormonal release that will change physiology throughout the body. For example, the pituitary gland sits very close to the brain. CRF causes the pituitary gland to release ACTH, which travels to the adrenal glands to stimulate cortisol – the stress hormone – to be released.

Let’s zoom in on the gut for a moment and see what happens. When CRF arrives in the “second brain” it causes inflammation and an increase in gut permeability, known as dysbiosis. This leads to visceral hypersensitivity, which means that the exact same stimulus that didn’t cause any pain, discomfort or nausea before now has a different effect and you feel it much more. You also see an alteration of gut motility, either slower or faster.

I think we can all relate to the idea of stress manifesting in our gut. When I was in medical school I remember the line out the bathroom door on test days. Some people get diarrhea, others get constipation, and still others will get nausea or gas and bloating. There’s a lot of ways that altered motility can translate into symptoms.

But if we take a step back for a moment and consider what I just told you. Stress causes increased intestinal permeability, sensitivity of the 500 million nerves in the gut, and alterations in motility. Folks, the picture I just painted for you is irritable bowel syndrome. This is literally the pathogenesis of the disease, and then the result is a change in bowel habits (diarrhea or constipation) and associated abdominal pain.

There’s one part of the story we haven’t touched on yet that we need to. If you know me, then you know that this is my favorite part – the gut microbiota. Research also shows stress alters the gut microbiota. For example, stress enhances inflammatory microbes E. coli and Campylobacter jejuni. Eek!

What’s interesting is that the balance of our gut microbes also influence our immune system, gut permeability, visceral sensitivity, and motility. The point being, we are coming full circle on the brain-gut connection here and it’s becoming increasingly clear that stress is extremely disruptive to our digestive system, which can cycle back to affect our brain too. It’s a vicious cycle. Remember, anything that affects your gut can affect your brain, and vice versa as a result of this.

So how do we break the cycle? Here are three steps:

STEP ONE: Start with diaphragmatic breathing. Anyone can do this at any time and it’s completely free – so #winning! Basically, if you’re feeling stressed this can be your technique in that moment to break the cycle. It’s used to treat anxiety, insomnia and irritable bowel syndrome.

Here’s how to do it:

1. Sit or lie flat in a comfortable position.

2. Relax your shoulders.

3. Put one hand on your chest and the other hand on your stomach.

4. Breathe in through your nose for about 4 seconds. Your abdomen expands outward but you want to keep your chest relatively still.

5. Hold the breath for 2 seconds.

6. Purse your lips (as if you’re about to drink through a straw), press gently on your stomach, and exhale slowly for about six seconds.

7. Repeat these steps several times for best results.

STEP TWO: We need strategies to control our stress. This means controlling what we can to make it manageable – meditation, self-care, exercise, adequate sleep. All of these things can contribute to better stress management. We need to focus on them during this time.

STEP THREE: We want to optimize our gut. If you know me then you already know the answer – maximum plant-based diversity. This means adding extra plants to your daily routine to make your microbes happy. Look for ways to sneak one or two extra plants into each meal, or head to the supermarket and try something new.

When we combine diet, lifestyle interventions, and having a strategy for what to do during times of stress we can get our mind and our gut into alignment, break free from the suppression and get back to thriving once more.

ABOUT THE AUTHOR

Will Bulsiewicz, MD MSCI, (a.k.a. Dr. B) is a board certified gastroenterologist and gut health expert. Every day, he helps patients and members of his #plantfed community bounce back from restrictive and over-hyped diets, and into a whole new way of living and eating that produces the results they really want… permanently.

At the core of his philosophy is what he calls “lifestyle medicine”, that uses food, exercise, and other lifestyle factors to optimize your gut, get you back in control of your health.

For more from Dr. B, say hi to him on Instagram or Facebook at @theguthealthMD.

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