The gastrointestinal system may be a victim of COVID-19 stress. Here, experts help to navigate those tummy troubles.
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That stomachache you feel with each update on the COVID-19 outbreak? It's real. So, too, are the indigestion and the heartburn. They're symptoms of stress that manifest in the emotive digestive system, the connection between the brain and the gut. Stress-related digestive troubles may be on the rise as people around the globe worry in the midst of a pandemic, experts warn.
"Stress and anxiety can trigger more frequent or stronger contractions in the GI tract which some may perceive as uncomfortable or even painful," says Michigan Medicine gastroenterologist William Chey, M.D., a professor of gastroenterology and nutritional sciences at Michigan Medicine.
In addition to belly pain, stress can trigger a wide range of other gut symptoms including heartburn, nausea, bloating, a change in bowel pattern, or in rare cases, even rectal pain, Chey says. Patients who already have irritable bowel syndrome, a chronic condition marked by stomach pain, cramping and a change in bowel habits, may see an uptick in their symptoms.
"Everyone reacts to stress differently," he says.
Why does the stomach feel stress?
Stress impacts the gut because each person has a "hard wired connection" between the brain in the head and the nervous system housed within the GI tract called the enteric nervous system, Chey says. The enteric nervous system lives within the wall of the GI tract and communicates through the spinal cord with the brain. While the enteric nervous system typically runs the GI tract independently, the brain can influence how it behaves. In times of stress, it may send a distress signal that makes the GI system run differently. In addition, stress makes the nerves in the gut overly sensitive so things that normally aren't even perceived at a conscious level are perceived as unpleasant gut symptoms.
"Everybody knows somebody that during high school before a big exam or an athletic event would have to run to the bathroom," Chey says. "It happens because of the impact of stress or anxiety in the GI tract."
It's normal to get mild, intermittent symptoms with stress or anxiety, Chey adds.
And despite their reputation, ulcers aren't the result of too much stress. Typically, they emerge because of two causes. The first is an infection in the stomach from a bacterium known as H. pylori, and about 30% of U.S. residents get an H. pylori infection, the National Institutes of Health reports. The second cause is from medications, with aspirin, ibuprofen and naproxen being the biggest culprits, Chey says.
Stress eating ramifications
Stress eating leads to tummy trouble, too, as more reach for sugary, high fat, processed foods that can agitate the GI system.
"When things are uncertain or when we're feeling more emotional or stressed, we want to be comforted," says Megan Riehl, PsyD., M.A., a clinical health psychologist specializing in treating patients with gastrointestinal problems. "For a lot of us, there are certain foods that are comforting."
Besides GI trouble, the long term and short term ramifications for unhealthy choices include weight gain, cardiovascular concerns and a sour mood, all of which could lead to future stress.
"If we can receive comfort from healthy habits, then we'll be less likely to seek out emotional comfort from eating food," Riehl says.
Self comfort tips
The first step in self-comfort is to validate the stress and the emotions that have emerged during this uncertain time. "We just don't want to let those emotions overcome us so that we're debilitated," Riehl says.
Riehl and Chey also recommend:
1. Eating healthy and sticking as close as possible to the Mediterranean diet.
2. Creating a schedule for meals and snacks and sticking to it.
3. Getting enough sleep.
4. Remaining physically active, resisting the urge to be a couch potato and binge watch programs.
5. Staying social with online gatherings or with neighbors from afar.
6. Practicing diaphragmatic breathing.
7. Using grounding techniques to remain present focused, such as body scanning to release physical tension in target areas like the shoulders, hands and feet.
"Right now, as we all experience this world stressor, it's so important that we are kind to ourselves and to others," Riehl says.
To schedule an appointment for treatment for GI concerns, call Michigan Medicine's gastroenterology division at 888-229-7408.
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