Stress affects your gut health!
It does this through a complex arrangement between the gut and the brain.
In today’s article I’m covering visceral hypersensitivity (VH) and the many ways stress affects the gut. We’ll also discuss cutting-edge strategies you can use to quiet your brain and gut to start feeling better today.
Gut Feelings
Have you ever done any public speaking before?
I have, and it’s terrifying!
Having to use the washroom beforehand, getting butterflies in my stomach and feeling tight in my gut. This is what happens to me when I am exposed to a big stressor.
Maybe you can relate?
You might even experience pain or urgency to find a bathroom. So badly that you don’t think you’ll make it in time!
And it’s not just public speaking… its life. It’s writing an important exam, it’s worrying about loved ones, it’s meeting new people or going new places. So what’s happening here?
How Can the Brain and Gut Communicate?
Our nervous system has several different components. One of which is the enteric nervous system – aka the nervous system in our gut!
It helps us digest our food, ensures our bowels are moving and it senses pain when something needs attention. It does this by communicating with our brain. So how is this done? Enter the vagus nerve.
What Happens in Vagus…
The vagus nerve is a highway that forms part of the gut-brain axis.
It’s like a power cord running from the brain down to the gut. Its electrical inputs control our heart rate, our breathing and digestion.
It has two major branches that are separated into the parasympathetic and sympathetic branches. The parasympathetic branches help you feel calm and relaxed or even sleepy.
Being in a parasympathetic state helps you salivate, produce digestive enzymes and move your bowels. It tells your brain that there is no reason to be alarmed and sends blood readily to your intestines for the digestive process.
It is the sweet spot! Like you’re on a beach with no kids and no worries! It is crucial to be in this state when sitting down to eat or resting for the night.
Evil Twin or Necessary Evil?
Unlike the parasympathetic branches, the sympathetic branches make you feel alert, motivated but also stressed, anxious and scared.
It tells your body that you are in danger and need to take action now. It stops salivation, stops the digestive process and diverts blood flow towards your muscles so you can flee.
Picture being hunted by a saber-tooth tiger, or you know, your kids are screaming and your dog just vomited on the carpet.
Don’t get me wrong, this process serves its purpose, especially when we are in real danger. This part of your nervous system is a huge reason why we were successful in escaping our predators and surviving as a species. However, it doesn’t serve us as well in the 21st century. In fact, for many of you, it’s the reason why you have digestive issues in the first place!
Let’s look at how this all started.
Nervous System Gone Wrong
Some things in life have the ability to shape our response to stress. Sometimes something traumatic happens like a car accident, witnessing something terrible or being abused as a child.
When these life-shifting events occur, your nervous system shifts with it. It takes the program for which it was formerly operating with and replaces it. The gut-brain axis changes.
Now you’re left with a nervous system that is constantly tense and something called “sensitization” develops. This is when nerves are stimulated over and over again which leads to a lower threshold for feeling pain. This happens in your gut when you’re exposed to chronic stress, environmental triggers, trauma and infection.
Not all events that lead to pain are traumatic in the traditional sense.
In fact, getting food poisoning or traveller’s diarrhea can throw off your gut for a while. It’s true, 10% of people who have a gut infection will have IBS symptoms 12 months later! And if you have an underlying mood disorder you are more prone to post-infectious IBS.
The theory is that the gut becomes more reactive in a process known as visceral hypersensitivity (VH).
Also, more women are affected by VH than men, which is why IBS is more common in women. To recap, early life or chronic stressors and gut infections, especially if you are a woman, can put you at a higher risk for experiencing disruption in the gut brain axis.
But let’s back up for a second.
What is Visceral Hypersensitivity?
It’s really a combination of two things.
The first thing that goes wrong is that your digestive tract starts interpreting normal sensations as painful ones. Secondly, your threshold for pain reduces and you experience pain out of proportion to the stimulus.
Consider two ridiculous examples:
You put your shirt on in the morning and instead of that soft cotton feel everyone loves, you feel gritty sandpaper. Or how about a paper cut that feels like someone cut your hand off. dramatic, I know, but you get the point.
Clearly this shouldn’t happen!
In the gut, a less dramatic process happens. When normal stretching or expansion of the intestines occurs it causes the sensation of bloating if you have visceral hypersensitivity.
You might have VH if you experience
- Intense heartburn, despite no visible damage to the esophagus
- Stress-induced stomach pain
- Bloating from drinking water
- Being limited to eating 4-5 foods due to discomfort or pain
- Pain from ingestion of hot peppers
- Agony from typical gas-forming foods!
Bottomline: If you have unexplained chronic digestive pain or discomfort then you probably have some level of visceral hypersensitivity and gut brain axis dysfunction.
Speaking of unexplained – have you ever been labeled with IBS? Is it Really IBS though? Read This
Who Are the Players?
As I mentioned before, stress plays a huge role in VH and chronic pain. But stress doesn’t do it alone. We need to first look at the players and the process of visceral VH in order to gain an understanding of how to address it.
Mast cells are one of your immune cells that secrete histamine. In addition to making your eyes water and your skin itch, histamine also causes visceral pain.
Mast cells also secrete inflammatory chemicals called cytokines and something called substance P. These are irritating substances that trigger nerve endings and cause pain! And when you have a gut infection, mast cells swarm in massive numbers to try to kill off the incoming pathogens. The only problem is, long after you’ve fought off that infectious diarrhea, they stick around.
And guess what?
Stress hormones activate mast cells. In turn, mast cells activate inflammation and visceral pain – it’s a no-win situation.
Perhaps the greatest player in modifying the pain response is the gut microbiota.
Gut Microbiota
The microbiota is the term we give to the symphony of bacteria, viruses, parasites and fungi that live within or on us. It is a dynamic and metabolic system that protects the lining of your mucous membranes, your skin and your digestive tract.
The microbiota acts on the immune system to strengthen defences. It prevents foreign pathogens from colonizing our gut. It quiets the gut, reduces pain and even enhances our mood!
It’s thus no surprise that people with chronic visceral pain have a different microbial signature than people without.
The term that describes this imbalance in the microbiota is dysbiosis. This is a problem because it triggers low-grade inflammation and the activation of visceral pain.
I wrote about a specific dysbiosis known as Small Intestinal Bacterial Overgrowth (SIBO) here.
Everything you need to know about SIBO Testing
Now that we’ve looked at the why’s, let’s look at the how’s.
Strategies to Balance The Gut-Brain Axis
Strategy #1 – Eat Mindfully
This is one of my favourite health practices. Why? Because It’s something you always have available. It doesn’t need to be prepped on a Sunday or put through a blender. And you don’t need to pee on a stick three times a day. By doing this you can activate the parasympathetic branches of the nervous system and have profound impacts on your health.
Examples of this include:
- Taking a few deep breaths before a meal (5 seconds in, hold for 5, release for 5)
- Chewing your food thoroughly – aim for 30 chews per bite
- Putting your utensils down between bites
- Focusing on the sights, smells, textures and flavours of your food while you eat
Strategy #2 – Stress Management
Cognitive behavioural therapy and working with a counsellor can help you deal with unresolved trauma and is beneficial in IBS. Also, simple practices like mindfulness and meditation can be helpful as well. Just recently, it was demonstrated that gut-directed hypnotherapy was an effective treatment for IBS.
I think the key here is to do something that guides your neural structure to adapt for the better. There are plenty of meditation apps out there like Calm, HeadSpace, or the one I use – Insight Timer. These might be good places to start.
Strategy #3 – Address Dysbiosis/SIBO
Addressing your dysbiosis or SIBO is critical to getting your pain under control. This can be an underlying cause of many functional gastrointestinal disorders, especially IBS. A healthcare practitioner can help you identify and address this issue.
Strategy #4 – Acupuncture
Acupuncture has been shown to improve visceral hypersensitivity!
It makes sense to treat an electrical issue with electricity. This is done best by using electroacupuncture, in which acupuncture needles are inserted into the abdomen and attached to electrical currents. What this does is overwrite the nervous system to relieve pain and normalize bowel movements.
Animal studies show that electroacupuncture significantly reduces visceral pain, strengthens the intestinal barrier and makes kids eat their veggies! OK I lied about that last one – but thanks for sticking with me!
Acupuncture is effective for treating stomach pain & bloating
Strategy #5 Stabilize mast cells
Generally, addressing the strategies above will solve the mast cell issue. However, This isn’t always the case and sometimes specific nutrients and herbs are necessary to address this.
Final Thoughts
Try these strategies to address the brain-gut axis and visceral hypersensitivity.
Just remember: in order to address your abdominal pain you need to address the gut-brain axis. Also, keep in mind that addressing gut health and visceral pain takes time and can be extremely complex. It may be best to work with a healthcare practitioner who can help identify and treat the root causes of your pain.
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References:
- Moshiree, B., et al. “Central sensitisation in visceral pain disorders.” Gut 55.7 (2006): 905-908.
- Pusceddu, Matteo M., and Melanie G. Gareau. “Visceral pain: gut microbiota, a new hope?.” Journal of biomedical science25.1 (2018): 73.
- Naliboff, Bruce D., et al. “Sex-related differences in IBS patients: central processing of visceral stimuli.” Gastroenterology 124.7 (2003): 1738-1747.
- Sengupta, Jyoti N. “Visceral pain: the neurophysiological mechanism.” Sensory Nerves. Springer, Berlin, Heidelberg, 2009. 31-74.
- Hammer, Johann. “Identification of individuals with functional dyspepsia with a simple, minimally invasive test: a single center cohort study of the oral capsaicin test.” The American journal of gastroenterology 113.4 (2018): 584.
- Flik, Carla E., et al. “Efficacy of individual and group hypnotherapy in irritable bowel syndrome (IMAGINE): a multicentre randomised controlled trial.” The Lancet Gastroenterology & Hepatology (2018).