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5 lifestyle tips for a healthy tummy

Digestive problems and stomach upsets can be prevented, relieved and even banished by simple lifestyle changes.

Beat stress to ease tummy troubles

You may have noticed a feeling of unease in your stomach during times of stress. That’s because anxiety and worry can upset the delicate balance of digestion.

In some people, stress slows down digestion, causing bloating, pain and constipation, while in others it speeds it up, causing diarrhoea and frequent trips to the loo. Some people lose their appetite completely.

Stress can also worsen digestive conditions like stomach ulcers and irritable bowel syndrome.

A solution is to avoid eating when you’re feeling very anxious, stressed or unhappy.

It also helps your digestion if you avoid arguing at the dinner table, as getting angry can put you off your food or make eating harder. Try to keep mealtimes happy and relaxed.

Get tips on managing stress

Stop smoking to prevent reflux

Smoking can weaken the muscle that controls the lower end of the food pipe and allow acid from the stomach to travel in the wrong direction back up, a process known as reflux.

Reflux causes the symptoms of heartburn, and can bring on or aggravate stomach ulcers and inflammatory conditions of the bowel.

Smoking is also an important risk factor for stomach cancer.

Find out how to stop smoking

Eat properly to help your digestion

It’s very easy to spend our working lives eating on the move or at our desks, gulping down food between meetings and then crashing out in front of the TV with a takeaway in the evenings.

But eating this way can play havoc with our digestive system.

Follow some basic rules to prevent problems:

  • Do not rush your food. Take the time to eat slowly. Try putting your fork down between bites and chew each mouthful well.
  • Do not overeat. Reduce the size of your portions at mealtimes, or try eating 4 to 5 small meals instead of 3 large ones.
  • Eat regularly and try not to skip meals.
  • Avoid eating a big meal just before you go to bed. Eat your last meal at least 2 to 3 hours before lying down.
  • Make sure you have plenty of water to drink.

Lose excess weight to beat heartburn

If you’re overweight, your tummy fat puts pressure on your stomach and can cause heartburn.

Shedding some pounds may relieve digestive symptoms like heartburn and other acid-related stomach complaints.

Check you’re a healthy weight with the BMI calculator

Get tips on losing weight

Binge drinking causes acid-related digestive disorders

Moderate drinking will not hurt your digestive system, but binge drinking increases acid production in your stomach, and can cause heartburn and aggravate other digestive disorders.

Binge drinking is defined as drinking 8 or more units of alcohol in 1 session for men, and drinking more than 6 units in 1 session for women.

Find out how to cut down on alcohol

Find out how to get rid of bloating

Page last reviewed: 28 August 2019
Next review due: 28 August 2022

How Stress Affects Your Digestive System

Our brain and gut are more in sync than you may realize.  For instance, the very thought of food can cause the stomach to produce digestive juices or the thought of giving a big presentation may cause constipation or uncontrollable bowels.The brain and gut are in constant communication. This direct relationship causes our gastrointestinal system to be sensitive to emotions and reactions such as stress.

When we are stressed, our brain sends signals for chemicals such as adrenaline, serotonin (a hormone that affects mood and is found in the digestive system) as well as the stress hormone cortisol to be released.  These hormones can cause adverse reactions.

Stress negatively affects our digestive system in many ways. It can cause a decrease in blood and oxygen flow to the stomach, cramping, an imbalance in gut bacteria and inflammation.  These symptoms can further develop into gastro intestinal (GI) disorders such as irritable bowel syndrome (IBS), irritable bowel disease (IBD), peptic ulcers or gastroesophageal reflux disease (GERD).

There are several things you can do to reduce stress and improve gut health. Practicing stress-management techniques such as exercising regularly, avoiding stressors, socializing, getting sufficient sleep or relaxing can greatly minimize your levels of stress.

In addition to practicing stress reduction techniques, you can support your digestive health by drinking less alcoholic beverages or consuming less sugar- as too much sugar can cause an imbalance in the ratio of good and bad bacteria in the stomach. Increasing your intake of foods that promote digestive health such as those rich in probiotics or foods that aid the body in producing digestive enzymes is also helpful.

The gut is often referred to as “the second brain” of the body. If you are experiencing consistent complications of the digestive system, your body is probably trying to tell you that there may be a bigger problem. Make an appointment with a gastroenterologist who specializes in the treatment of gastrointestinal, liver, and pancreatic disorders to examine your symptoms.

Jamaica Hospital’s Division of Gastroenterology consists of board-certified gastroenterologists who provide high quality and expert care to patients who suffer from such conditions in both inpatient and outpatient settings. To schedule an appointment, please call 718 206 6742 or 718 206 7001.

Stress and the gut: pathophysiology, clinical consequences, diagnostic approach and treatment options

Stress, which is defined as an acute threat to homeostasis, shows both short- and long-term effects on the functions of the gastrointestinal tract. Exposure to stress results in alterations of the brain-gut interactions (“brain-gut axis”) ultimately leading to the development of a broad array of gastrointestinal disorders including inflammatory bowel disease (IBD), irritable bowel syndrome (IBS) and other functional gastrointestinal diseases, food antigen-related adverse responses, peptic ulcer and gastroesophageal reflux disease (GERD). The major effects of stress on gut physiology include: 1) alterations in gastrointestinal motility; 2) increase in visceral perception; 3) changes in gastrointestinal secretion; 4) increase in intestinal permeability; 5) negative effects on regenerative capacity of gastrointestinal mucosa and mucosal blood flow; and 6) negative effects on intestinal microbiota. Mast cells (MC) are important effectors of brain-gut axis that translate the stress signals into the release of a wide range of neurotransmitters and proinflammatory cytokines, which may profoundly affect the gastrointestinal physiology. IBS represents the most important gastrointestinal disorder in humans, and is characterized by chronic or recurrent pain associated with altered bowel motility. The diagnostic testing for IBS patients include routine blood tests, stool tests, celiac disease serology, abdominal sonography, breath testing to rule out carbohydrate (lactose, fructose, etc.) intolerance and small intestinal bacterial overgrowth. Colonoscopy is recommended if alarming symptoms are present or to obtain colonic biopsies especially in patients with diarrhoea predominant IBS. The management of IBS is based on a multifactorial approach and includes pharmacotherapy targeted against the predominant symptom, behavioural and psychological treatment, dietary alterations, education, reassurance and effective patient-physician relationship. When evaluating for the stress-induced condition in the upper GI tract, the diagnostic testing includes mainly blood tests and gastroscopy to rule out GERD and peptic ulcer disease. The therapy for these conditions is mainly based on the inhibition of gastric acid by proton pump inhibitors and eradication of Helicobacter pylori-infection. Additionally, melatonin an important mediator of brain gut axis has been shown to exhibit important protective effects against stress-induced lesions in the gastrointestinal tract. Finally, probiotics may profoundly affect the brain-gut interactions (“microbiome-gut-brain axis”) and attenuate the development of stress-induced disorders in both the upper and lower gastrointestinal tract. Further studies on the brain-gut axis are needed to open new therapeutic avenues in the future.

Stress and the Digestive System – Consumer Health News

You don’t need a PhD in physiology to know that stress can be hard on the stomach. We’ve all done our own experiments on the subject, intentionally or not. Remember how you felt the last time you spoke in public? Those butterflies weren’t in your head.

The impact of stress on the stomach goes far beyond indigestion, however. In recent years, doctors have uncovered a remarkably complex connection between the brain and the digestive system. The entire system is extremely sensitive to our moods. In fact, experts now see stress as a major player in a wide range of digestive problems, including irritable bowel syndrome, indigestion, and heartburn.

People with digestive problems often scoff at the idea that stress could be at the root of their problems. To them, it sounds like “blaming the victim. ” Robert Sapolsky, a Stanford University stress expert and author of the best-selling book Why Zebras Don’t Get Ulcers (Henry Holt and Co., 2004), says his discussion of stress and irritable bowel syndrome prompted “semi-irate” letters from readers.

But experts who study the link between stress and digestion aren’t searching for people to blame. Instead, they’re looking for scientific explanations for some of life’s most common maladies. By understanding how stress affects our bodies, they’re opening new avenues for prevention and treatment of many conditions.

A two-way street

We all talk about “gut feelings,” but few of us really appreciate the amazingly strong connections between the brain and the digestive system. The stomach and intestines actually have more nerve cells than the entire spinal cord, leading some experts to call the digestive system a “mini brain.” A highway of nerves runs directly from the real brain to the digestive system, and messages flow in two directions. Consider this: 95 percent of the body’s serotonin — a hormone that helps control mood — is found in the digestive system, not the brain.

As Sapolsky writes in Zebras, there are sound reasons why our digestive system should pay such close attention to our brains. In times of stress, our bodies are designed to focus on the things that can help us stay alive. When our ancestors had to fight off hyenas or run away from cave bears, they didn’t want to waste any energy on less important things like proper digestion.

When the brain feels severely stressed, it unleashes a cascade of hormones that can put the whole digestive system in an uproar. The hormones have different and sometimes contradictory jobs. For example, the hormone CRH (short for corticotropin-releasing hormone) is one of the body’s main alarm bells. In stressful situations, the brain pumps out CRH to tell the adrenal gland to start making steroids and adrenaline, chemicals that can give you the strength and energy to run or fight your way out of trouble.

CRH also turns off appetite, which explains why some people can’t eat anything when they’re stressed. At the same time, the steroids triggered by CRH can make a person hungry, which is why some people fight stress with ice cream, chocolate, or potato chips.

Clearly, different people have different responses to stress, and there’s no way to say for sure how specific situations will affect digestion. But there are some general rules of thumb. Over the short term, stress can cause stomach aches, nausea, and diarrhea. In the long term, prolonged stress can aggravate chronic diseases such as irritable bowel syndrome and heartburn.

From irritable bowel syndrome to ulcers

Stress is especially troubling for people who have digestive problems without any clear physical cause — “functional gastrointestinal disorders” in medical speak. In these cases, every part of the system looks healthy and normal, but they still don’t work as they should. These disorders are extremely sensitive to stress. They’re also extremely common. According to a report from the University of North Carolina, roughly 25 million Americans have a functional gastrointestinal (GI) disorder.

The classic example of a functional GI disorder is irritable bowel syndrome (IBS), a very common and perplexing malady often characterized by painful cramps, bloating, and constipation alternating with diarrhea. The National Institutes of Health estimates that as many as one in five Americans has some signs of IBS.

Nobody knows how IBS gets its start, but there’s no doubt that stress can worsen symptoms. For one thing, stress can make the colon contract, leading to stomach pain. It’s not completely clear why people with IBS sometimes become constipated. One possibility is that stress can occasionally make the contractions uncoordinated and unproductive. Stress can also make the mind more aware of sensations in the colon, and since people with IBS may feel more discomfort due to extra-sensitive pain receptors in the gastrointestinal tract, even normal contractions can feel really unpleasant.

IBS can flare up over everyday annoyances, especially those that make a person feel tense, angry, or overwhelmed. But as reported in a 2004 issue of Psychosomatic Medicine, IBS — like other chronic conditions — is even more sensitive to the stress that comes from major life changes, such as a death in the family or a loss of a job.

Here’s a quick look at other digestive conditions that can be aggravated by stress:

  • Indigestion. Your stomach growls, aches, or burns. Sometimes you feel bloated or nauseated, and you vomit or belch. These could all be signs of an ulcer, but millions of people without ulcers have these symptoms, too. Doctors call this “functional dyspepsia,” but it’s better known as indigestion. Indigestion is the second most common functional GI disorder, after IBS. As reported by the Cleveland Clinic, all of the symptoms of indigestion tend to worsen in times of stress. On the bright side, they usually fade when a person has a chance to relax.
  • Heartburn. There are many possible causes for heartburn, from overproduction of stomach acid to overindulgence in pizza. Whatever its cause, stress can definitely make heartburn worse. A study published in a 2004 issue of Psychosomatic Medicine found that heartburn sufferers who had recently gone through a major life-changing event were especially likely to develop severe symptoms within four months. Researchers speculated that stress could pump up the stomach’s production of acid or make the esophagus extra sensitive to pain.
  • Ulcers. Past generations thought ulcers were a sign of stress, and they weren’t far from wrong. It’s now known that most ulcers are caused by a bacterial infection. Some researchers theorize that stress may help the infection take hold, perhaps by disturbing the stomach’s delicate balance of hydrochloric acid and protective secretions, making it more vulnerable to ulcers. Sapolsky believes that stress is a factor in 30 to 65 percent of all ulcers, but some medical experts think the connection remains hypothetical.
  • Ulcerative colitis and Crohn’s disease. These conditions — known together as inflammatory bowel disease (IBD) — are most definitely not caused by stress. But once the diseases take hold, a bout of stress can worsen symptoms.

Setting your mind on relief

If your digestive system isn’t running smoothly, don’t suffer in silence. According to a report from the University of North Carolina, as many as 80 percent of people with IBS or another functional gastrointestinal problems never discuss their symptoms with a doctor. That’s unfortunate, because doctors can often prescribe medications to get the digestive system back on track. A doctor can also check for underlying diseases that might explain the symptoms.

If your doctor can’t find a physical explanation for your digestive troubles, you may need to calm your mind before you can calm your stomach. Ask your doctor if you would be a good candidate for cognitive behavioral therapy, interpersonal therapy, relaxation therapy, or another form of counseling. You can do your part to battle stress by eating well, exercising regularly, and getting plenty of sleep. For more tips on stress relief, click here.

Digestive problems might be a message. Roughly translated, that message is “Live well and learn to relax.” This is one time when you definitely want to listen to your gut.


Sapolsky, Robert M. Why Zebras Don’t Get Ulcers.Third Edition. Henry Holt and Co. 2004.

Naliboff, B.D. et al. The effect of life stress on symptoms of heartburn. Psychosomatic Medicine. 2004. 66: 426-434.

Cleveland Clinic. Indigestion. December 22, 2009.

University of North Carolina Center for Functional GI and Motility Disorders. What are FGIDs? 2007.

National Digestive Diseases Information Clearinghouse. National Institutes of Health. Irritable bowel syndrome. September 2007.

National Digestive Diseases Information Clearinghouse. National Institutes of Health. Indigestion. November 2008.

Neuroscience, 2nd edition. Purves, Dale et al. Sinauer Associates, 2001.

Milla, P. et al. Motility disorders in childhood: Working group report of the First World Congress of Pediatric Gastroenterology, Hepatology, and Nutrition. 35:S187-S195. August 2002. Journal of Pediatric Gastroenterology and Nutrition.

American College of Physicians. New drugs — and some respect — for IBS. 2003.

National Women’s Health Information Center. Inflammatory bowel disease. August 17, 2009.

Toner, B.B. et al. Cognitive-behavioral group therapy for patients with irritable bowel syndrome. 1998 Apr;48(2):215-43. International Journal of Group Psychotherapy.

A Dietitian Explains How Stress Affects Your Digestion

Bloated, gassy, or running to the bathroom more than usual? It’s time to check in on your stress levels. Jessica Bippen, MS, RD, uncovers how stress affects your digestion and how to manage both.

Have you ever had butterflies in your stomach when making a tough decision? Or maybe you’ve had to give a speech but suddenly found yourself running off to the bathroom only moments before you present. Both of these are perfect examples of how stress impacts digestive health.

That’s right! There’s a profound link between stress and gut health. Your digestion gets thrown off when stress goes unmanaged, making for uncomfortable and sometimes even embarrassing moments. But it doesn’t have to be this way! Read on to learn more about the link between stress and digestion. Plus: effective ways to proactively optimize gut health and manage stress.

Your Body’s Response to Stress

Stress is a natural mental and physical reaction to many situations that arise in life. In turn, your body is designed to handle stress. For instance, in short-term instances, stress can be beneficial to your health. Your body responds to stress by releasing hormones that increase heartbeat and send blood rushing to the areas that need it most in an emergency, such as your muscles, heart, and lungs. You may be familiar with the term “flight or fight,” during which stress puts your body in survival mode.

When the stress goes away, your body returns back to its normal state. That being said, for many people, stress is constant, meaning their body stays in a constant survival mode. Your body works in overdrive in order to “protect” you, yet this prolonged state of stress can take its toll on your health.

In both cases, stress affects your body on a cellular level. Even a small amount of stress can trigger mental and physical symptoms. In the short-term, this change could go unnoticed, but long periods of stress can cause a number of undesirable symptoms.

Symptoms of chronic stress include:

  • Irritability
  • Anxiety
  • Depression
  • Headaches
  • Insomnia
  • Breakouts
  • Digestive issues


You can’t feel your best when you’re stressed to the max and feeling backed up and bloated. It’s important to consider the link between stress and digestion.

Believe it or not, stress can impact every part of your digestive system, including your esophagus, stomach, and intestinal tracts. Its effects on your digestive system can vary depending on the length of time in which you experience stress.

Short-Term Stress

This sudden onset of short-lived stress can cause you to lose your appetite and your digestion to slow down. So if you feel stressed and eat much more than usual, it may be a coping mechanism you’ve adopted. This change in appetite and food intake can result in heartburn or acid reflux.

You may start to notice gastrointestinal (GI) issues like bloating, constipation, diarrhea, indigestion, or an upset stomach. This occurs because stress can affect how quickly food moves through the body. Additionally, some individuals may even experience nausea or vomiting.

Chronic Stress

Unmanaged stress over extended periods of time may lead to more serious issues. While it can vary among individuals, research shows a link between stress and irritable bowel syndrome (IBS) and other GI conditions. For those who already suffer from digestive issues, stress can exacerbate symptoms. It’s thought this happens due to the nerves in the gut becoming more sensitive during times of stress. Other possibilities include changes in gut microbiota, changes in how quickly food moves through the gut, and/or changes in gut immune responses.

The Gut + Microbe connection

We can’t talk about digestion without mentioning the importance of a healthy gut microbiome. Research shows an intricate link between stress, digestion, and gut bacteria. For instance, we know times of prolonged stress can negatively impact your microbiome. But interestingly enough, it works both ways.

Certain strains of bacteria in your gut can also impact the way neurotransmitters in the body. The gut-brain axis describes this dual relationship and ongoing communication between the activity in both the gut and the brain. Stress can affect this brain-gut communication and may be the trigger of how easily you feel pain, bloating, and another gut discomfort.

In addition, a team at Ohio State University found that stress can actually change the composition, diversity, and number of intestinal bacteria along with greater numbers of potentially harmful bacteria. So having a diverse microbiome can actually help your body manage stress more effectively!

How to Achieve Optimal Gut Health

In order to help manage stress, it’s important to optimize your gut health on multiple fronts. Doing so includes focusing on proper nutrition and probiotics. Be sure to incorporate fiber-rich foods and balance them out with quality protein and healthy fats to support your gut microbiome. Research also shows that eating a wide variety of fresh produce can improve the diversity of your gut bacteria.

Still, eating well isn’t always enough. Because there are so many factors that can throw off the delicate balance of our microbiome, you often need extra support. Here’s where probiotics come in! Using quality probiotics is one of the best ways to help balance your gut bacteria.

Choose a probiotic like Gut Instinct, which is specifically formulated to support the comprehensive health of your body and digestion with 10 strains of probiotics and 25 billion organisms in each capsule. The live-strain probiotics in Gut Instinct are clinically researched to support digestion and improve overall health. For instance, bifidobacterium longum helps stabilize the acidity of the GI tract and inhibit the growth of harmful bacteria. It’s also one of the species researched for its ability to decrease stress levels and improve memory.

How to Manage Stress

In addition to optimizing gut health, incorporate daily stress management practices to keep stress—and accompanying digestive issues—at bay. The best ways to reduce stress can vary from person to person. Still, some standard stress-relieving practices include:

  • Movement and exercise
  • Yoga
  • Meditating
  • Talking with a friend, loved one, or therapist
  • Journaling
  • Petting a furry friend
  • Laughing
  • Incorporating adaptogens
  • Volunteering or performing an act of kindness

The key is finding the stress management practices that work best for you. You may find that movement helps calm nervous energy, or maybe you thrive with stillness and meditation. Figure out which strategies help you feel more at ease, and keep those in your back pocket when you start to feel stress creep in.

Upset Stomach? Your Anxiety Might Be Affecting Your Digestion

Ever relied on your gut to make a decision? Or felt nauseous before a big presentation? Those are physical signs that your gut and brain are connected.

“There’s mounting evidence that stress and anxiety impact gut function,” says Eva Alsheik, M.D., a gastroenterologist at Henry Ford Health System. “Stress impacts our ability to control inflammation and that can increase stress on the gastrointestinal tract.” Interestingly, gastrointestinal distress can also lead to anxiety.

The Gut-Brain Connection

For decades, scientists have known that anxiety contributes to gastrointestinal (GI) problems. Now they’re realizing that the relationship goes both ways.

It turns out that when you’re suffering from GI upset, your body sends signals to the central nervous system that can cause mood changes. Just as an anxious mind can create butterflies in your stomach, a troubled tummy can signal the brain to go on high alert. So your stomach pain could be the cause or the effect of stress, anxiety and worry.

“It’s not uncommon for people — especially children — to internalize their feelings,” Dr. Alsheik explains. That stress affects the movement, function and sensation in the gastrointestinal tract.

The good news: Treating anxiety could have welcome side effects for your gut, and vice versa. In fact, studies show that treating anxiety can lead to improvements in digestion.

Treating An Anxious Gut

Our gastrointestinal tracts are remarkably tuned in to our emotions. So if you’re experiencing ongoing belly pain coupled with increasing stress and anxiety, there are a number of things you can do for both body and mind to quiet troubling symptoms.

1. Clean up your diet: Consider replacing processed, high-sugar foods with whole foods like fruits, vegetables and grains. Foods that are rich in probiotics, prebiotics and fiber are especially good choices since they help replenish the good bacteria in the gut.

  • Probiotic foods include sauerkraut, kefir, kimchi, kombucha and Greek yogurt.
  • Prebiotic foods include jicama, asparagus, onions, garlic and leeks.
  • High-fiber foods include Brussels sprouts, apples, peas and leafy greens.

2. Practice mindfulness: Taking time out each day to focus on yourself and quiet your mind can have powerful stress-busting effects. When you’re relaxed, your body is better equipped to digest.

3. Get moving: Exercise is a powerful prescription for both anxiety and gastrointestinal distress. It keeps blood flowing to all of your vital organs, including your brain and your gut. It also releases feel-good hormones that can help alleviate anxiety.

4. Get help: There are a number of medications doctors can use to treat both anxiety and GI distress. For the anxiety piece, working with a counselor or cognitive behavioral therapist can help you better manage uncomfortable emotions. There are even specialists called functional gastroenterologists who specialize in digestive disorders that may be related to stress and anxiety.

If you’re experiencing anxiety or intestinal problems, such as heartburn, cramping or loose stools, don’t suffer in silence. Your primary care provider can help you come up with strategies to calm your mind and your gut at the same time.

Want more health and wellness advice?
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To find a doctor at Henry Ford, visit henryford.com or call 1-800-HENRYFORD (436-7936).

Dr. Eva Alsheik is a gastroenterologist who sees patients at Henry Ford Hospital in Detroit and at Henry Ford Medical Center – Columbus.

Tags: Eva Alsheik, Gastroenterology

How Your Brain and Emotions Control Your Gut | Blog

Publish Date: 07/06/2017

By Sarah Kinsinger, PhD, Digestive Health Program, Director of Gastrointestinal Behavioral Medicine Program

We all understand what it means to have a “gut feeling,” or to feel a clenching in your gut when you realize you missed an important deadline.

But how is it that emotions can be experienced in your gut?

There have been many scientific advances in the past 10 years that have greatly improved our understanding of how the brain and the gut are connected and how we can improve gut health through mind-body medicine.

What is the brain-gut connection?

The digestive system has its own nervous system, called the enteric nervous system. It has over 100 million nerve endings and in many ways, it can control digestion independently without your conscious awareness.

The enteric nervous system has been nicknamed our “second brain.” This gut-brain is intimately connected to our “big brain” via a network of nerve pathways and the two nervous systems share many of the same neurotransmitters to facilitate communication.

In fact, 95% of serotonin is found in the gut! This bidirectional pathway is referred to as the brain-gut axis and involves moment-to-moment communication to control digestion.

This pathway explains why your stomach may start growling at the sight of a juicy steak, before the food even hits your stomach.

Can stress give me a stomach ache?

The brain-gut axis also explains how you can feel stress and emotions in the gut. Most people have experienced butterflies before a first date or diarrhea before public speaking.

These “gut feelings” are the result of stress being communicated to the gut via these bidirectional nerve pathways. For many patients, living with unpredictable GI symptoms can be highly stressful on its own.

Having to find a bathroom at a moment’s notice or feeling uncomfortably bloated at a party can trigger stress and anxiety, which further aggravates the gut, creating a vicious cycle.

Can stress cause a gastrointestinal illness?

Individuals with a chronic digestive condition, such as irritable bowel syndrome (IBS) or inflammatory bowel disease (like Crohn’s disease, ulcerative colitis) may be particularly sensitive to the effects of stress.

However, these are complex disorders and experts do not believe that stress causes these conditions. We do believe that stress can aggravate symptoms through brain-gut interactions, and patients are keenly aware of this association.

70% of patients with Crohn’s disease and ulcerative colitis believe that flare-ups of their disease are related to stressful events. And researchers have confirmed a connection between stress and the gut. For example, animal studies have shown that stress can instigate inflammation in the colon or reactivate the disease when it has been in remission.

Therefore, stress can play an important role in the course of a digestive disease, even if it is not the initial cause.

What is a sensitive gut?

Some individuals are thought to be particularly sensitive to the effects of stress, and they are referred to as “gut responders.” This gut sensitivity is thought to play an important role in functional gastrointestinal diseases, such as irritable bowel syndrome (IBS).

Experts refer to this as “visceral hypersensitivity,” meaning that the nerves of the gut are overly sensitive and firing in response to normal digestion. This is why for some individuals, a normal sized meal or the movement of gas through the intestines can cause severe pain, whereas for a healthy individual these sensations would be barely noticeable.

The brain also plays an important role and influences how these sensations in the gut are experienced. Brain imaging studies have shown that individuals with IBS have abnormalities in how their brains process signals from the gut, failing to properly tune out painful stimuli.

This breakdown in brain-gut communication is an important component for many digestive conditions and why we need to consider the role psychological factors when we treat patients.

How can I use my mind to heal my gut?

Medicine is moving towards a more holistic approach to treating patients, and there is growing interest in finding non-medication treatment options. GI diseases are a great example of the positive effects of mind-body interventions on health.

Because of the brain-gut axis, we can use psychological treatments to directly influence digestion. For example, hypnotherapy seems to have a quieting effect on the gut and has been shown to directly influence gut motility, gut secretions, and pain sensitivity.

Cognitive-behavioral therapy and gut-directed hypnotherapy are evidence-based treatments for IBS and have been shown to benefit patients’ symptoms. Gut-directed hypnotherapy has even been shown to prolong remission in patients with ulcerative colitis.

Through these treatment approaches, patients can learn to regulate their stress response and reprogram the brain to tune out unwanted pain signals from the gut.

Sarah Kinsinger, PhD, practices behavioral gastroenterology and is the director of the gastrointestinal behavioral medicine program in the digestive health program at Loyola Medicine. Her clinical interests include cognitive behavioral therapy, inflammatory bowel disease (IBD), irritable bowel syndrome and medical hypnosis. She is also a board-certified health psychologist.

Dr. Kinsinger earned her doctorate in clinical psychology from the University of Miami and completed a residency in health psychology at the VA Puget Sound Health Care System and a fellowship in health psychology at the University of Illinois Medical Center at Chicago.

Book an appointment today to see Dr. Kinsinger by self-scheduling an in-person or virtual appointment using myLoyola.

90,000 What is “stress” and can it be useful?

  • Daria Prokopik
  • for the BBC News Ukraine

Photo author, Vladislav Muslakov / Unsplash

We talk about stress as a daily negative experience and are looking for ways to overcome it. What is behind the word “stress”, and are there any scientific recommendations for reducing it?

The body’s response to sudden changes around us that threaten our safety or comfort is called a stress response.The ability to respond quickly to challenges and adapt to difficult times is an evolutionary achievement. That is, it’s good.

Another thing is that stress factors are now completely different, and our reaction is the same. The modern man is no longer attacked by wild animals, from which one must flee. We worry about careers, mortgages, and news on the internet.

Stress can be different

Stress can be acute – we were almost hit by a car. Sometimes it is medium-term – for example, a session at the university.And sometimes it is chronic. This is a war, living in dangerous conditions, or working with great responsibility and low support.

Highlight eustress – our attempt to adapt to difficult, but positive changes in life: new interesting work or life together. We manage to get used to the changes, although at first we are anxious.

Photo by Hailey Kean / Unsplash

There is distress – a reaction to unpleasant, sad and threatening changes in life. For example, domestic violence, breakup, or war.

The greatest harm to our well-being is caused by chronic distress – it is debilitating, and episodic acute stress – it happens unexpectedly every time.

What Happens During Stress?

Classical stress theory distinguishes between three stages: acute stress, habituation and exhaustion. It is addiction that helps us survive war or long-term illness. But exhaustion must be prevented.

Both consciousness and subcortical structures of the brain send danger signals to the hypothalamus.It is a small part of the brain that orchestrates hormonal, biochemical, and some behavioral processes in the body. It triggers the secretion of the hormones cortisol and adrenaline by the adrenal glands. The sympathetic link of the autonomic nervous system is activated. All of this prepares us for a fight-or-flight scenario.

Acute stress is a rapid heartbeat, dilated pupils, increased blood glucose levels, the breakdown of fat in stores, but also stopping digestion. But we cannot live in such a state for a long time.

Photo by Francisco Moreno / Unsplash

How Does Chronic Stress Affect Us?

The stress hormone cortisol is useful when it is released in response to a short stressor, or in the morning, giving us a wake-up call without an alarm. When there is always a lot of it, it hurts us.

Cortisol contributes to the retention of water and ions in the body, that is, edema. It interferes with muscle and skin regeneration. Long-term exposure to cortisol impairs the ability of the intestines to absorb vitamins and minerals.Hair accumulates ultra-high doses of cortisol, and also grows worse and lives shorter. Chronic stress suppresses the immune response, especially the ability to recognize and kill tumor cells. Changes in daytime fluctuations in cortisol lead to sleep disturbances and chronic fatigue.

Stress during pregnancy is especially dangerous, as it impairs the mental capacity of children and teaches them to high doses of cortisol. Such children then live in a state of chronic causeless anxiety, writes the author of the book “The Rules of Brain Development” prof.Medina.

Photo by elizabeth lies / Unsplash

Long-term negative emotions are transmitted to the vagus nerve. It goes to the heart, intestines, lungs, and we feel its excessive excitement as a physical pain in the chest, and it can also provoke irritable bowel syndrome.

Prolonged stress over-activates the sympathetic nervous system and suppresses the parasympathetic nervous system, which is responsible for physiological processes in a state of comfort. This increases the risk of chronic disease.

In addition, stress leads to new bad habits: a lot of coffee, alcohol, smoking for the sake of calmness and communication. It is also an eating disorder. People either stop caring for themselves and eat poorly nutritious foods, or overeat.

Cortisol increases appetite and cravings for sweets and fats. And cakes, in turn, give the brain pleasure. This vicious circle leads to the habit of “seizing stress” and excess weight afterwards. One of the effects of overexposure to cortisol is visceral fat deposition.This greatly disrupts the hormonal balance.

What are the ways to cope with stress?

First of all, it is advised to understand whether this stress leads to good or bad changes. What stressors can be eliminated or considered minor? If the cause of the stress is significant and so far insurmountable, then it is advised to take measures to reduce the harm from stress.

Disturbed lifestyles create new health problems and make it difficult to cope with stress. You should have a clear daily routine.Waking up, going to bed and eating at the same time, just rest and plan the next day in writing. This will allow us to recover well, to establish biorhythms, and our body perceives the predictability of life as a sign of life without stress.

It is worth finding a support group – close people who understand your condition and can help with conversation or in everyday life, help establish a healthy regime, eliminate stressors and a feeling of isolation.

You should consciously approach your diet: do not skip meals, but do not overeat, do not snack, eat wholesome food, not sweets and alcohol.

Scientists recommend consuming fatty fish, nuts, eggs, unrefined grains and lots of fresh vegetables. This advice is universal, but it is especially important to follow it during times of stress. After all, vitamins B12, B6, folic acid, taurine contained in these products are involved in the formation of the neurotransmitter gamma-aminobutyric acid (GABA). It helps calm and reduces cortisol levels.

Egg yolk fats also have this effect. And foods rich in the amino acid tryptophan – dairy products and hummus – contribute to the formation of serotonin.

Regular aerobic exercise, jogging, and cycling helps to cope with stress. First of all, because during the movement, a person is distracted and rests with thoughts. In addition, sports release endorphins, serotonin, dopamine and endocannabinoids – compounds that give us happiness, pleasure and euphoria. That is, they improve the mood. Regular jogging normalizes vagus nerve tone and restores the balance of the autonomic nervous system.

Photo by Daniel Monteiro / Unsplash

Cleaning is one of the most effective ways to reduce stress.It is advised to clean thoughtfully: wash the dishes, being aware of this process, the smell of detergent and the shine of a clean surface. Being in the here and now reduces the anxiety and imaginary stress of thinking about situations that haven’t happened yet.

Singing can help overcome stress. First, obsessive thoughts that cause anxiety are advised to be chanted many times. Someday they will lose their meaning and stop scaring. Second, singing in chorus dramatically lowers cortisol levels, allows a sense of belonging and trust, and synchronizes the hearts of the singers.In conclusion, the music that was listened to before the stressful situation made it easier to cope with it.

The hormone oxytocin helps to reduce cortisol levels. It stands out when we hug, love, sleep naked, pet animals, and feel connected to our surroundings. Experiments have shown that a work environment that promotes tactile contact is less stressful.

It should be remembered that not all events are worth our experiences. You need to not just hide from stress, but try to actively fight it back.

How emotions and the gastrointestinal tract are connected – Knife

Jak Panksepp, a neurologist at the University of Washington, made important contributions to affective neuroscience, a neuroscience discipline that studies emotions from a neuroscience perspective.

In animal studies, he concluded that our brains have at least seven emotional operating programs that govern the body’s responses when we experience fear, anger, sadness, playful mood, lust, feelings of love and maternal concern.

These programs quickly and automatically trigger the appropriate reactions of the body, even in those cases when you are not yet aware that you have a particular emotion. This is why your face turns red when you are embarrassed, goosebumps run through your skin when you watch a horror movie, your heart beats faster when you are scared, and even your gastrointestinal tract becomes more sensitive when you are anxious.

Emotional operating programs are written in our genes.This genetic coding is partly inherited from parents, partly influenced by early experience.

Suppose you inherited genes that tune your fear or anger programs to overreact in stressful situations, and after your childhood emotional trauma, your body added additional chemical tags to the memory of stress-responsive genes.

As a result, as an adult, you are more likely to experience an increased response to stress in your gastrointestinal tract.

When the gastrointestinal tract is under stress

Among our emotional operating programs, there is one that is associated with stressful events and has been studied better than others. When a person feels anxiety or fear, a stress response occurs; it allows you to maintain homeostasis (constancy of the internal environment) in the face of internal and external threats.

When we talk about stress, we usually mean stressful situations that occur in everyday life, or exposure to more intense stressors, such as trauma or natural disaster.

But our brains perceive many influences on the body as stressful, including infections, surgery, accidents, food poisoning, lack of sleep, attempts to quit smoking, and even natural manifestations such as menstruation in women.

<…> If the brain decides that a threat is approaching, it activates its existing stressor program, which selects the most appropriate reaction of the body to a specific situation, including the reaction of the gastrointestinal tract.Each emotional operating program uses a specific signaling molecule and, by further releasing certain substances in the brain, can trigger the entire stress response program – with all the consequences for the gastrointestinal tract and the body as a whole. These specialized signaling molecules in the brain include several hormones, including corticoliberin (CRH), which acts as a master switch in stress. <…>

When a person is in a state of stress, the hypothalamus, the region of the brain that controls all vital functions, is triggered first in the brain.The hypothalamus is the main production site for CRG.

Immediately after the release of CRH, the adrenal glands are activated and begin to release cortisol, increasing its level in the blood and preparing the body for the expected increase in metabolic needs.

Acting as a master switch in stressful situations, the hypothalamus secreted CRH acts on the amygdala, an area of ​​the brain that causes feelings of anxiety or even fear. The activation of the amygdala responds in the body with a rapid heartbeat, sweaty palms and a desire to free the gastrointestinal tract from its contents.These stress-induced changes in the gastrointestinal tract, as you can imagine, create far from ideal conditions for enjoying a delicious meal. <…>

Once an emotional program has been launched, it can run for several hours, and sometimes for many years. Thoughts, memories of past events, and expectations of the future can influence the interactions between the brain and the digestive tract, and the consequences can sometimes be painful.

For example, if you find yourself in a restaurant where you once had a fight with your spouse at lunchtime, the memory of this can activate the operating program of anger even while you are having a friendly conversation with someone.

If that restaurant was Italian, any Italian restaurant, and even just the thought of seafood risotto, can trigger an anger program.

I often explain the possibility of such a scenario to patients who strongly blame certain foods for their problems with the gastrointestinal tract.I ask them to analyze whether the problem is really to blame for the ill-fated product or it is actually related to the memory of some past event. By starting to pay attention to the circumstances that trigger the symptoms, patients often realize how strong the interaction between the brain and the digestive tract is.

Role of serotonin

The most painful sensations in the intestines are those associated with food poisoning. About 40 years ago, I got to know them too closely.I took part in a four-week tour in India, which at that time was already ending.

Along the path that ran through desert valleys and mountain passes leading from northern India to the foothills of the Himalayas, I saw peaceful Buddhist monasteries and oases with many peach trees. My daily diet consisted of lentil soup, rice, and suma tea, a popular tea among Tibetans with milk, yak butter and salt.

I took drinking water from pristine streams.I have rarely been in such high spirits as when I finally arrived at the railway station in Manali. To celebrate, I stepped back from my normal diet and decided to indulge myself in a delicious spicy meal at a local restaurant.

The next day, early in the morning, I got on the bus to get to New Delhi in 24 hours. That day I will remember all my life – it was the day of the worst problems. My attempts to control gastrointestinal activity were like trying to convince an attacking flock of hyenas to lie on the ground and tumble.All of this has left a deep imprint on my emotional memory, and I will always remember how powerful inner sensations (and the memory of them) can be.

Food poisoning occurs when you accidentally eat or drink something that contains pathogenic viruses, bacteria, or the toxins they produce. For example, it can be the toxin of the invasive species Escherichia coli (Escherichia coli).

In the digestive tract, it binds to receptors located on cells containing serotonin.This immediately switches the gastrointestinal tract to “terrible vomiting and violent diarrhea.”

Some anti-cancer chemotherapy drugs, such as cisplatin ( Cisplatin ), cause a similar reaction.

This response is a built-in survival mechanism: when the digestive tract detects a significant amount of a toxin or pathogen, the enteric nervous system issues an order to vigorously remove the entire contents in order to flush the toxin out through both ends of your digestive tract – a beneficial, albeit extremely unpleasant reaction.

Serotonin-containing cells in the upper gastrointestinal tract cause this reaction, which play an important role in the formation of sensations. When secreted under normal conditions, serotonin helps the digestion process to proceed normally. It is released as a result of the action of weak mechanical forces that occur when the digested food moves along the digestive tract and “rubs” against the so-called enterochromaffin cells. Like other hormones contained in the endocrine cells of the gastrointestinal tract, the released serotonin activates the sensitive nerve endings of the vagus nerve and the enteric nervous system (ENS), which, in turn, keeps the ENS aware of its progress through the digestive tract, allowing it to trigger the peristaltic reflex. …But when food poisoning occurs or in response to cisplatin, too much serotonin is released, resulting in vomiting, intense bowel movements, or both.

My research team, in collaboration with a group from the Netherlands, found that in healthy people, a diet deficient in the amino acid tryptophan, which is essential for the production of serotonin, lowers serotonin levels in the brain and increases the activity of nerve circuits in a state of arousal.

Such changes in the functioning of the central nervous system are also associated with increased sensitivity to mechanical stimulation of the colon.A diet that lowers serotonin levels has been shown above to increase the likelihood of depression in people at risk (including those with a family history of depression).

Serotonin is an essential signaling molecule for the brain and gastrointestinal tract. Cells containing serotonin are bizarrely associated with both the small brain in the GI tract and the brain. Gut-based serotonin signaling plays a key role in linking GI events to food, gut microbiota, certain medications and digestive system activity, and our well-being.Small amounts of serotonin, found in the neurons of the digestive tract and brain, are also tasked with very important roles.

Serotonin-containing nerve endings in the GI tract are of prime importance for regulating peristalsis, and the accumulations of nerve cells in the brain send signals to most areas of the brain, affecting a wide range of vital functions, including appetite, pain sensitivity and mood …

<…> Huge stores of serotonin in the gastrointestinal tract are located next to the vagal tract, which leads directly to the centers of emotions in the brain.It is likely that in response to the mechanical effect of the digested food on the cells containing serotonin, or on the metabolites of the intestinal microbiota, a constant stream of weak signals goes from the gastrointestinal tract to the centers of emotions in the brain. Even if we are not aware of these serotonin-encoded signals, the release of serotonin in trace amounts can affect our background emotions and how we feel, creating a positive attitude. Maybe this explains why so many people experience feelings of satisfaction and well-being when they eat delicious food.

I wonder what’s next? This and other interesting books can be bought online with a 10% discount especially for the readers of Knife. Just enter the secret word knife in the promotional code field, it is valid for any orders in 2018.

Revealing stress and its stages

Investigation of daily fluctuations in the steroid hormones contained in saliva – cortisol and dehydroepiandrosterone – involved in the neuroendocrine mechanisms of stress development, as well as reflecting the staging of its course and the adaptive capabilities of the body.

Measured parameters: – Cortisol (morning) – Cortisol (noon) – Cortisol (day) – Cortisol (noon + afternoon) / 2 – Cortisol (evening) – Total cortisol – Dehydroepiandrosterone (DHEA) (morning) – Dehydroepiandrosterone (DHA) ) (noon) – Dehydroepiandrosterone (DHEA) (day) – Dehydroepiandrosterone (DHEA) (noon + day) / 2 – Dehydroepiandrosterone (DHEA) (evening) – DHEA / Cortisol ratio (marker of stress resistance).

Synonyms Russian

Cortisol (morning, afternoon, evening and night portions), dehydroepiandrosterone (DHEA), the ratio of DHEA to cortisol (a marker of stress resistance) in saliva.

Synonyms English

24 hour Salivary Adrenal Stress Profile, Salivary cortisol and dehydroepiandrosterone (DHEA) measurement.

Research method

High performance liquid chromatography-mass spectrometry (HPLC-MS).


Ng / ml (nanogram per milliliter).

Which biomaterial can be used for research?


How to properly prepare for the study?

  • For a day and during the entire period of saliva collection, exclude the use of caffeine, alcohol, physical activity.
  • Taking sedatives, cortisone acetate, estrogens, oral contraceptives, glucocorticoid drugs (including ointments) can cause an increase in cortisol levels. Cancellation of drugs is carried out strictly on the recommendation of the attending physician.
  • Do not smoke for 1 hour before collecting saliva.
  • Rinse mouth with water 10 minutes before collecting saliva.
  • For 30 minutes before collecting saliva, refrain from eating, brushing teeth, using dental floss, mouthwash and chewing gum.

General information about the study

A person in the course of his life is constantly exposed to various adverse factors. Moreover, in the modern world, among them, first of all, technogenic and psychosocial influences come to the fore: physical and mental overload, a sedentary lifestyle, prolonged lack of rest, emotional exhaustion, monotonous work, conflicts, general dissatisfaction, etc.e. The effect of such factors on the human body brings it into a state of stress. Stress is a complex of physiological changes in the work of the nervous and endocrine systems, as well as other internal organs, which occurs in response to the action of an irritant. It is a protective, adaptive reaction that allows the body, having mobilized all possible reserves, to survive an unfavorable period.

One of the physiological mechanisms of the development of a stress reaction is the activation of the hypothalamic-pituitary-adrenal system: the hypothalamus secretes corticoliberin, which stimulates the secretion of adrenocorticotropic hormone (ACTH) by the pituitary gland, and under the influence of ACTH, the production of cortisol hormone is activated in the adrenal cortex.The metabolic changes that occur in the body under the influence of cortisol are critical for successful adaptation to stress. Under stressful conditions, the nervous tissue requires a large amount of energy, which is provided by the synthesis of glucose from non-carbohydrate substances. Part of the proteins of the skeletal muscles under the action of cortisol breaks down to the initial components – amino acids, from which glucose is then formed. This is the catabolic effect of the hormone, which, during the period of adaptation to the stressor, helps to efficiently distribute the body’s energy resources.At the same time, the long-term preservation of such a restructuring of metabolism would have a negative effect on the body, therefore there are physiological mechanisms for inhibition of cortisol synthesis. They include, first of all, a decrease in the production of corticoliberin under the action of cortisol itself (the so-called negative feedback) and the parallel formation of another steroid hormone by the adrenal glands – dehydroepiandrosterone (DHEA), which has the opposite effect of cortisol. The constant content of a certain amount of DHEA in the blood prevents the development of psychological maladjustment and stress-induced diseases.In addition, a number of modern studies on the effect of stress on human health have shown a relationship between the DHEA / cortisol ratio and the development of disorders in the activity of the cardiovascular, nervous and reproductive systems, as well as social adaptation.

A feature of most stress-generating factors of the present time is their long-term impact. At the same time, the neuroendocrine mechanisms of adaptation of the organism, of course, are not designed for such situations – they are necessary to gain time and either cope with unfavorable conditions, or leave the sphere of their influence.Modern people often do not cope with the stressor (or do not take it into account) and continue to be under its influence, which leads to a loss of control over the mechanisms of adaptation, their depletion and the development of pathological conditions. The regularity of the course of stress and related neuroendocrine processes reflect the stages:

  • The first stage – alarm reaction – the stage of mobilization of the body’s adaptive capabilities. This is a normal short-term response to stress.At this stage, the work of the hypothalamic-pituitary-adrenal system is activated, the level of cortisol in the blood increases, catabolic processes begin to prevail for increased energy supply of the nervous system. The pattern of changes in the hormonal profile of saliva at this stage will be as follows: increased cortisol levels, normal DHEA levels.

  • The second stage – stage of resistance – is characterized by long-term adaptation to the continuing action of the stressor.Due to the formation of adaptive mechanisms, energy consumption in this stage becomes less, however, the amount of hormones produced, including cortisol, remains increased – it corresponds to the needs of the body under the influence of a stressor. In this case, the total substrate necessary for the synthesis of cortisol and DHEA is spent exclusively on the production of the former, as a result of which the level of DHEA decreases. This is the first sign of adrenal fatigue. Hormonal pattern in saliva: increased cortisol and low DHEA.

  • The third stage – stage of exhaustion – occurs if the effect of the damaging factor has not ended, but the adaptive capabilities of the organism have already been exhausted. The depletion of the adrenal glands at this stage is manifested by a decrease in both cortisol and DHEA levels. First, the pattern in saliva changes to normal cortisol levels and low DHEA levels, and then low concentrations of both hormones are detected.

  • Subsequently, with successful adaptation to the stressor or termination of its action at the beginning of adrenal gland recovery, the level of DHEA gradually normalizes, while the concentration of cortisol remains low.

In the blood, a certain part of cortisol and DHEA is in a state bound to plasma proteins and has no biological activity. For diagnostic purposes, it is preferable to determine the concentration of free, that is, not associated with plasma proteins, hormones. The molecules in the blood can pass through the membrane that separates the bloodstream from the ducts of the salivary glands. The free fractions of steroid hormones, being lipophilic molecules with a relatively small molecular weight, can freely penetrate the membrane of the salivary glands, and, on the contrary, is impermeable to those associated with plasma proteins.Thus, measuring the concentration of hormones in saliva gives information about the level of their biologically active – “free” fractions.

The production of cortisol by the adrenal glands obeys a circadian rhythm – it is maximum in the morning hours and reaches minimum values ​​by night. Variations in the intensity of cortisol secretion are quite significant; therefore, the study requires at least 4 samples of biological material collected at different times of the day. The use of saliva as a material for research in this situation has great advantages, since its collection is a non-invasive, painless and convenient procedure.

What is the research used for?

  • Investigation of the endocrine response to acute and chronic stress;

  • in sports medicine – for the diagnosis of “overtraining syndrome”;

  • in industrial medicine in order to differentiate easily and poorly adaptable people (for example, during work accompanied by a high probability of developing stress).

When is the study scheduled?

For symptoms and signs of prolonged stress or adrenal dysfunction, which may include:

  • neurological disorders such as chronic fatigue syndrome (especially morning fatigue), mood disorders, depression, anxiety, memory and concentration disorders;

  • metabolic disorders – obesity (often the accumulation of fat in the waist and abdomen), thyroid dysfunction, menstrual irregularities;

  • digestive disorders – constipation, diarrhea, reflux of bile in the stomach and esophagus, peptic ulcer;

  • skin diseases – psoriasis, eczema;

  • decreased sex drive.

What do the results mean?

Reference values ​​

Cortisol (morning), ng / ml




21-31 year

1.12 – 7.43

2.72 – 13.5

31-51 year

1.22 – 15.5

0.94 – 15.1

51 and
older than

1.12 – 8.12

1.49 – 7.39

Cortisol (noon), ng / ml




21-31 year

0.8 – 5.2

2.0 – 7.5

31-51 year

0.65 – 7.0

0.4 – 6.4

51 and
older than

1.2 – 5.4

0.95 – 6.8

Cortisol (day), ng / ml




21-31 year

0.5 – 4.5

1.5 – 5.0


0.32 – 4.5

0.18 – 4.3

51 and
older than

0.6 – 3.8

0.51 – 4.2

Cortisol (noon
+ day) / 2 – A, ng / ml




21-31 year

0.5 – 5.2

1.5 – 7.5

31-51 year

0.32 – 7.0

0.18 – 6.4

51 and

0.6 – 5.4

0.51 – 6.8

Cortisol (evening), ng / ml




21-31 year

31-51 year

51 and
older than

0.22 – 2.54

Total cortisol, ng / ml




21-31 year

2.5 – 20.0

5.0 – 22.0

31-51 year

3.0 – 22.5

2.9 – 18.4

51 and
older than

2.0 – 16.5

1.8 – 18.6

(DHEA) (morning), ng / ml



0.106 – 0.3

0.137 – 0.336

(DHEA) (noon), ng / ml



0.106 – 0.3

0.137 – 0.336

(DHEA) (day), ng / ml



0.106 – 0.3

0.137 – 0.336

(DHEA) (noon + day) / 2
– B, ng / ml



0.106 – 0.3

0.137 – 0.336

(DHEA) (evening), ng / ml



0.106 – 0.3

0.137 – 0.336

DHEA / cortisol ratio

115.0 – 1200.0

Usually, an increase in cortisol levels is regarded as an indicator of the presence of stress – with acute stress, the production of cortisol increases.However, with prolonged exposure to an unfavorable factor, both an increase and a decrease in the activity of the hypothalamic-pituitary-adrenal system are possible, which is manifested, respectively, by an increase or decrease in the concentration of the hormone. According to the summarized data from several studies, an increase in cortisol production is more often observed with depression. And post-traumatic stress disorder, chronic stress syndrome and general psychological exhaustion are associated with a decrease in its level.

For more details on the correlation between the level of hormones determined in this study and the course of stress, see the section “General information about the study”.

The index of stress resistance – the ratio of DHEA to cortisol – is interpreted taking into account its deviations from the reference interval: below the lower limit – reduced ability to adapt, above – increased, within the interval – the ability to adapt is preserved.

Influence of stress on health – GBUZ JSC Regional clinical anti-tuberculosis dispensary

Ministry of Health of the Astrakhan Region
GBUZ JSC “Center for Medical Prevention”

Effects of stress on health

“There is no bodily illness apart from the soul”

The human body is the unity of the soul and body.And any disease is a problem of the entire human personality, consisting not only of the body, but also of the mind, feelings and emotions.

Doctors are well aware that the effectiveness of medical treatment largely depends on the patient’s faith in recovery and on the trust in the attending physicians. An optimistic attitude towards life and a positive inner attitude are sometimes more effective than drugs, contribute to recovery.

Negative emotions, caused by various psychological stresses, contribute to the development of various diseases.Moreover, in recent decades, the role of psychological and social factors in the origin of diseases of Russian citizens has increased dramatically. This is especially true of the so-called psychosomatic (from the Greek words psyche – soul, soma – body) diseases, in the development of which, along with biological factors, the so-called psychological stress is involved.

What is hidden behind the concept of stress?

It is not easy to answer this question unequivocally, although every person has experienced this condition.In everyday life, we often use the term “stress” when we experience work or family problems, financial difficulties, and worry about a serious illness of a loved one. Despite the fact that these are completely different problems, a person reacts to them stereotypically – with certain psychological, hormonal and biochemical changes.

Many scientists define psychological stress as a strong psychological and physiological reaction to the impact of extreme factors perceived by a person as a threat to his well-being .Stress can develop both in the presence of real signs of threatening factors, and in the presentation of a possible threat, or an image of a past adverse event, since the human psyche reacts equally to both a real threat and an idea of ​​a threat. Therefore, people get upset when they remember emotionally distressing events or think about an upcoming difficult operation.

A number of personality traits play an important role in the occurrence of stress reactions and subsequent illnesses.Let’s take a look at some of them.

Usually, people explain unpleasant events in their lives and the causes that cause them in their own way, which is called the explanatory style. Some use the pessimistic explanatory style of , which is characterized by passivity and a sense of vulnerability. Such people are highly susceptible to the effects of stress. Others, with a normal lifestyle , have psychological stamina and tenacity, which makes them resistant to stress, helps to maintain health.

Even when sick, people of the latter type can productively contribute to the treatment being carried out.

People who are prone to depression or have high personal anxiety, like pessimists, are highly sensitive to the development of stress. And those characterized by low personal anxiety are emotionally more stable and calm. The latter require a relatively high level of stressors to induce a stress response in them.

Susceptibility to stress is also associated with a self-esteem factor .People with low self-esteem consider themselves incapable, unable to cope with difficulties and confront the threat. As a rule, they have a high level of anxiety and, accordingly, they are more prone to developing stress.

A high level of personal anxiety can arise in infancy and childhood. It can be associated with the separation of the child from the mother, the lack of maternal love and care, and the resulting feeling of insecurity. That is, early life psychological stresses are negatively reflected in the human psyche, as if deposited in it, and make a person weakly protected from subsequent stresses, which in turn contributes to the development of various diseases.

Doctors have long noticed that people who are often under stress are more susceptible to infectious diseases, such as influenza. Against the background of chronic gastritis, stress can provoke stomach ulcers. During a stressful situation, people often experience various cardiac disorders …

There are many similar examples. “Classical” psychosomatic diseases, in the development of which stress plays an important role, are considered: hypertension, gastric ulcer and duodenal ulcer, bronchial asthma, thyrotoxicosis, ulcerative colitis, rheumatoid arthritis, neurodermatitis.

Psychological stress, experiences and emotions also affect the development of cancer . This was noticed by the doctors of antiquity. In the second century AD, the Roman physician Galen noticed that cheerful women were less likely to develop breast cancer than women who were often depressed. Currently, on the basis of research and clinical observations, many scientists believe that psychological factors, along with biological and environmental, play an important role in the development of the tumor process.

How can psychological stress influence the development of the tumor process? Scientists have found that stress activates the central nervous system, which triggers the stress response: the peripheral nervous system is activated and various hormones are secreted by the endocrine glands. A significant violation of biochemical processes occurs in the body, which leads to undesirable changes in organs and tissues. At the same time, the organs responsible for immunity also suffer.Under stress conditions, the level of hormones in the blood sharply increases – glucocorticoids, a high concentration of which suppresses the body’s immune system, which protects humans and animals from foreign substances and infectious agents that enter the body from the outside, for example, viruses and bacteria, as well as from their own changed cells that have turned in tumor.

That is why people who are in a state of psychological stress are more likely to suffer from infectious diseases. By disrupting the immune system, stress makes the body defenseless against infection.

Several types of specialized cells of the immune system act against cancer cells in the body, which detect and destroy tumor cells. As a result of stress, cellular immune defenses are impaired, which can contribute to the development of tumors. It turned out that under stress, the tension of the immune system and the activity of the body’s natural defenses decreases in people whose state is characterized by gloomy forebodings, anxiety, fear, despondency, despair.Conversely, the immune system is more stable in people who have hope, faith in a successful outcome and destiny, confidence in their ability to cope with a life-threatening situation and have good relationships with others.

Oncological diseases, like all other serious diseases, cause psychological stress in many patients. They are worried about how the disease will go and how life-threatening it is, because there is a misconception among people that cancer is an incurable disease.Negative emotions, detachment or depression accompanying psychological stress can aggravate the course of the disease.

The information available in the world scientific literature on the influence of psychological stress on cancer patients indicates that not only the course of the disease, but also the socio-psychological rehabilitation of the patient, his return to an active full-fledged life in the family and society, reducing the risk of recurrent disease, largely depends on a person’s attitude to the disease, his state of mind, will, an active position aimed at combating the disease.

Is it possible in practice to reduce the negative effect of psychological stress, change the negative internal attitude to a positive one and psychologically strengthen the body’s defenses?

In different countries of the world, in specialized medical institutions and at public oncological organizations, oncological patients work with oncological patients. They provide effective assistance to cancer patients in overcoming stress at different stages of clinical and outpatient treatment, during radiation and chemotherapy, as well as after the termination of treatment in the course of rehabilitation.By removing the harmful effects of psychological stress on health, helping to change the psychological mood and attitude of the patient to the disease, strengthening the body’s defenses, oncopsychologists contribute to more effective treatment, subsequent recovery, the return of patients to an active, full life, and a decrease in the risk of re-disease. Oncological psychologists are also successfully working in a number of Russian cities, including Astrakhan. Patients are provided with effective psychological assistance in questions:

  • overcoming the negative impact of psychological stress during anticancer treatment and after its completion;
  • strengthening the body’s defenses and reducing the risk of re-disease;
  • gaining a sense of psychological security and stability and the fastest return to an active life in the family and society.

I would like to draw your attention to the fact that a person who has been in a state of psychological stress for a long time, as a rule, is not aware of the exhaustion of the nervous system and cannot prevent it. In this case, it is better not to take risks and not try to overcome the state of stress on your own, but to seek help from a psychologist or psychotherapist.

The fear of death and the will to live are far from the same thing. So think about what factors motivate you to live? To live, not to avoid death.Because life is about achieving goals, about getting pleasure, about helping other people, about emotions and impressions, about new knowledge and discoveries. This is joy.

Your health is clean air, water and food. Get up in the morning with joy, go to bed with a smile. You are happy, you smile – it means that you are healthy. Do not heal the disease, heal your life, live according to the laws of nature, reason. When there is no health, wisdom is silent, art cannot flourish, forces do not play, wealth is useless and reason is powerless.
Herodotus of Halicarnassus

90,000 Stress ulcer – causes, symptoms, diagnosis and treatment

Stress ulcer is a defect in the mucous membrane of the gastroduodenal zone, which occurs against the background of severe somatic diseases and critical conditions. Often, the main manifestation of this disease is bleeding from a peptic ulcer; pain syndrome is not typical. The most informative diagnostic method is esophagogastroduodenoscopy; blood tests (general, coagulogram), tests for the presence of occult blood in feces and stomach contents are also carried out.Treatment is aimed at normalizing hemodynamics and eliminating gastrointestinal ischemia, reducing the production of hydrochloric acid. The prognosis in the absence of complications is favorable, but with bleeding, the mortality rate reaches 80%.


Stress ulcer is one of the most common forms of stress-induced mucosal disease, which poses a serious threat to the development of bleeding from the upper gastrointestinal tract. This condition is recorded in about 60% of patients who undergo mechanical ventilation for a long time, and 25% of them have bleeding.The problem of a detailed study of approaches to the treatment and prevention of this pathology is extremely relevant in gastroenterology, surgery and resuscitation, since the mortality rate remains very high. For the first time, the connection between bleeding from the upper gastrointestinal tract and the severity of the underlying disease was established by J. Swan at the beginning of the 19th century. The term “stress ulcer” was proposed by G. Selie in 1936 to denote the connection between the formation of foci of ulceration of the gastric and duodenal mucosa and severe somatic pathology.Until that time, a stress ulcer was considered a primary pathology, and not a manifestation of ischemia of the gastroduodenal mucosa, which led to incorrect approaches to therapy and its poor results.

Stress ulcer

Causes of stress ulcer

The main cause of stress ulcer development is severe illness and critical conditions, accompanied by impaired homeostasis, hypoperfusion of the upper gastrointestinal tract, coagulopathy, arterial hypotension, thrombocytopenia, renal failure.A stress-induced ulcer can be recorded in patients after injuries (including cerebral), burns involving more than 25% of the body surface, major surgical interventions, and sepsis. The combination of these conditions significantly increases the risk of stress ulcers, and bleeding is prognostically extremely unfavorable.

In the pathogenesis of the development of stress ulcers, the leading role is assigned to the effects of endogenous (vasoactive and pro-inflammatory substances, urea, uric acid) and exogenous aggressive factors (bacteria, viruses, toxins, heavy metal salts, pharmaceuticals, etc.)etc.). This leads to a change in metabolic processes in the mucous membrane of the upper gastrointestinal tract and the predominance of factors of aggression over protective mechanisms. Microcirculation and permeability in the mucous membrane are disrupted, the parietal mucus is destroyed, enzyme systems are activated, and the reverse diffusion of hydrogen ions deteriorates. Against the background of such changes, constant contact of the mucous membrane with pepsin, hydrochloric acid, as well as bile and pancreatic enzymes provokes the formation of defects in the wall of the stomach and duodenum.

Symptoms of a stress ulcer

Symptoms of a stress ulcer are often masked by the clinical picture of the underlying disease. The difference between this type of ulcerative lesion of the gastrointestinal tract from other etiological forms is the absence of pain. In the overwhelming majority of cases, the pathology manifests itself with bleeding.

According to statistics, gastroduodenal bleeding from stress ulcers is recorded in 25% of all patients who are in intensive care units, in 5% hemodynamically significant, life-threatening blood loss.However, experts believe that the prevalence of bleeding is even higher, since the stress-induced ulcers are generally shallow, and very often the bleeding is hidden, which does not manifest itself clinically and is detected only with targeted examination. With intense bleeding, the following symptoms can be observed: a sharp general weakness, pallor of the skin, tachycardia, a drop in blood pressure, vomiting of scarlet blood.

Diagnosis of stress ulcers

In the diagnosis of stress ulcers, a correct assessment of anamnesis and identification of risk factors has a leading place.Specialists in intensive care and intensive care units should assume a high risk of stress ulcers in all patients undergoing mechanical ventilation, as well as in those with low cardiac output, in a state of shock (since ischemia of the upper gastrointestinal tract occurs), with a long break in enteral nutrition, as well as taking glucocorticosteroids, non-steroidal anti-inflammatory drugs, antineoplastic agents.

Changes in blood parameters are of great importance: in the first hours after bleeding, high thrombocytosis and a shortening of blood coagulation time are determined, the concentration of erythrocytes and hemoglobin decreases on days 2-3.An analysis of feces for occult blood is mandatory; to exclude false negative results caused by a low pH level – the Gastroccult test (analysis of the contents of the stomach for occult blood).

The most informative method for diagnosing stress ulcers is esophagogastroduodenoscopy. In the absence of bleeding and pain, only EGDS makes it possible to identify ulcerative defects in the mucous membrane of the stomach and the bulbar part of the duodenum. Evaluation of the acidity of gastric contents is not informative, since ischemia, not hyperacidity, is of leading importance in pathogenesis.

Treatment of stress ulcers

Therapy of stress ulcers is carried out in the direction of increasing the protective properties of the mucous membrane, correcting hemodynamic disorders and eliminating ischemia of the upper gastrointestinal tract, as well as reducing the production of hydrochloric acid and pepsin. Early transfer of patients to enteral nutrition is essential. In order to reduce the production of hydrochloric acid, proton pump inhibitors (pantoprazole, omeprazole) are prescribed. Sucralfate is used to form a protective layer between the mucous membrane and the aggressive intraluminal medium.Also, to protect the mucous membrane and reduce the production of hydrochloric acid, an analogue of prostaglandin E1, misoprostol, is used. Somatostatin analogs also have a powerful inhibitory effect on HCl.

The main direction of stress ulcer therapy is hemodynamic stabilization, which is achieved by treating the underlying disease. With massive blood loss, blood transfusion, blood substitute transfusion is performed. At low blood pressure, volume loading is advisable in order to increase the filling pressure of the ventricles; dobutamine is introduced.The role of angiotensin-converting enzyme inhibitors in the regulation of regional blood flow has been proven. However, this direction of treatment is difficult to control due to the lack of the ability to monitor the blood supply to internal organs. With verified gastrointestinal bleeding, endoscopic ligation or clipping of the bleeding vessel, surgical suturing of the ulcer is performed.

Prediction and prevention of stress ulcers

The prognosis for stress-induced ulcers is largely determined by the degree of damage to the gastric mucosa.Stress ulcers rarely lead to gastric perforation, are not prone to recurrence, and in the absence of bleeding, adequate therapy of the underlying pathology leads to their rapid healing. However, with massive gastrointestinal bleeding from a stress ulcer, the mortality rate reaches 80%. That is why all patients who are in intensive care units and have risk factors for this pathology (artificial ventilation of the lungs, coagulopathy, burns of more than 25% of the body surface, traumatic brain injury, sepsis, arterial hypotension, hepatic and renal failure, the use of high doses of corticosteroids) , prevention is being carried out.

Preventive measures include early enteral feeding, proton pump inhibitors, sucralfate, H2-histamine receptor blockers, antacids, and achieving adequate blood pressure and ventricular filling pressure.

90,000 Emotional overeating. Why do we seize stress?

Contents of article

Pizza after a hard day’s work, chocolate after a conflict with a friend, another ice cream for the company with her husband.If you have experienced this, then you are familiar with emotional overeating. Emotional eating is the consumption of food for emotional relief, not because of a physical need. Often this happens due to sadness, disappointment or an unpleasant situation: the boss scolded at work, the long-awaited trip was canceled, the car broke down. The most common example is a blockage at work, there are many important tasks, you do not have time to dine and quietly eat all the candies from the pack.

How do we find comfort in food?

Emotional food is a simple and affordable method for unloading and relieving stress.You can have a quick snack right at work or at home, calm down and get back to your business with renewed vigor. This is a safe method to quickly disconnect from problems, to stop feeling. Get positive emotions and drown out the experiences inside.

Emotional nutrition leads to a set of extra pounds. Anyone, thin, normal, or overweight, can be prone to overeating, while compensating for the extra calories with exercise, fasting days, or dieting. This “now eat cake, tomorrow I’ll go to strength training” method is just a sign of emotional overeating and can fix it for a long time.At first it seems that this is logical and there is nothing wrong with such a lifestyle. But still there is a negative impact. You will use food as the main source of stress relief and forget about other ways, such as support of loved ones or creative pursuits. After all, food is always at hand and no effort is needed.

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How to recognize emotional overeating from a physical need?

Signs of Physical Hunger:

  • hunger in the stomach,
  • feeling of emptiness and rumbling in the stomach,
  • mental and physical strength decreases,
  • weakness and irritability appear,
  • after eating food, hunger disappears.

Signs of emotional overeating:

  • There is a desire to eat when something bad happens.
  • I want to eat something unhealthy, fatty or sweet instead of lunch or after a meal,
  • Can’t get enough of a regular portion, eat more, snack all the time.

How does emotional overeating work?

  1. Trigger or pain point. It can be an event or action that creates a stressful situation or emotional stress (bad news, depression, quarrel, illness).
  2. The desire to get rid of stress, relieve tension. You know exactly what you want to eat. It will be cake, hamburger, candy, pizza, ice cream.
  3. Process. You choose food, order or go to the store, and you consume it quickly and confidently.
  4. Satisfaction with food eaten. You feel full, full stomach and even a little discomfort. At this stage, the hormone dopamine is released, which brings satisfaction and happiness.
  5. Regret. You realize that you have eaten too much.To calm yourself down, numb your shame, you plan on not eating in the evening or going to a tough workout. Such compensation for the eaten only exacerbates the craving for overeating. Since you know in advance that an extra piece of cake can always be worked out later.

Why is it important to combat emotional overeating?

  • Improved health. You will feel lightness in the body, the skin will be cleared of acne and rashes.
  • You will start to lose weight faster. Proper nutrition speeds up metabolism, burning excess body fat.
  • You will feel a surge of energy. Eating healthy and sleeping well will strengthen your mitochondria, which will work more efficiently. Even with a decrease in calories in a healthy diet.
  • You will look younger and healthier. Eating fast food produces free radicals that worsen the condition and tone of the skin.
  • The brain will work faster. With a stable overeating of fatty or sugary foods, mitochondria lose their effectiveness. It leaves with clarity and drowsiness appears, it is difficult to concentrate, think and create something new.
  • Emotional stability will appear. When you understand exactly what your problems are and solve them, you will feel calm and satisfied.

To get rid of emotional overeating, you must first work out your psychological state. Understand what worries you and prevents you from living fully. Take our free online course on Stress Management to learn how to deal with stressful reactions. In this course, you will learn how to deal with burnout.What to do in time pressure and how to get out of stress when communicating with clients or bosses. How to identify the causes of stress and eliminate them in a timely manner. The online course will help you develop your own stress response strategy. After training, you will identify strengths and weaknesses, learn to control negative emotions and work for your own pleasure.

Stomach ulcer in animals

Stomach ulcer is an erosive inflammatory process resulting from the action of pepsin and hydrochloric acid on the damaged area of ​​the gastric mucosa.Lesions can be acute or chronic. Acute mucosal lesions look like multiple areas of erosion, chronic lesions are focal deep ulcers with raised edges.

  • An important point in the treatment of stomach ulcers are devices that suppress vomiting and gastric acid secretion – all our clinics are equipped with them and doctors are ready to start treatment immediately, at the first visit.
  • Our laboratory allows us to suspect the occurrence of deep ulcers, which provides a better adjustment to the course of treatment.
  • Diet is one of the key points of in ulcer treatment. Our veterinary pharmacies will always offer a choice of liquid and dry special diets for cats and dogs, accelerating the healing and recovery of our patients.

Causes of occurrence

Most often, the disease can be provoked:

  • certain drugs (for example, steroids and non-steroidal anti-inflammatory drugs)
  • metabolic disorder (uremia)
  • liver pathology
  • stress
  • endocrine pathologies (hypoadrenocorticism)
  • gastritis
  • heavy metal poisoning
  • Helicobacter Pylori bacteria
  • tumor process – lymphosarcoma, adenocarcinoma

Symptoms are usually quite pronounced: vomiting with and without blood, melena (black, tarry feces containing digested blood), soreness in the abdomen, lack of appetite, anemia of the mucous membranes , weakness and depression, shock.It should be borne in mind that this pathology can sometimes proceed quite quickly and acutely, which can lead to death, therefore it is recommended to seek veterinary help at the slightest suspicion.

Diagnostics includes anamnesis and a whole range of diagnostic measures (clinical and biochemical blood tests, fecal occult blood test, X-ray contrast study with barium, abdominal ultrasound, gastroscopy (the most informative), gastrin level and diagnostic laparoscopy.

Ulcer treatment includes treating the underlying cause of the pathology, suppressing gastric acid secretion and controlling bleeding. To reduce the production of hydrochloric acid, histamine h3 receptor blockers are used. These drugs protect the stomach wall from the aggressive effects of gastric juice and accelerate the healing of ulcerative lesions. Intravenous infusion to combat dehydration in patients with peptic ulcer disease, to correct the electrolyte composition of the blood.A blood transfusion may be recommended for patients with severe anemia.

Antiemetic drugs should be used with caution. Used drugs such as metoclopramide, chlorpromazine. Antacids and adsorbents – help to protect and soothe the affected gastric mucosa, and they also bind harmful and toxic substances.

Antibiotics – indicated in case of bacterial infection (eg Heliobacter Pylori).

Endoscopic surgery – used to remove foreign bodies, stomach tumors or to stop bleeding.

Diet is very important – it helps to restore the normal functioning of the gastrointestinal tract, and the soft consistency of the feed does not injure the irritated gastric mucosa.

Combating stress is possible for dogs and cats in which severe stress is a possible cause of gastric ulcer. Sedatives and pheromones in various forms can be prescribed to animals with a highly excitable nervous system.

An animal with a stomach ulcer is recommended to have regular examination by a veterinarian, as this pathology proceeds with relapses.