April 16th is National Stress Awareness Day

Pending deadlines, juggling work and family responsibilities, or perhaps worrying about a first impression — stress comes in many forms and has affected everyone at some point in his/her life. During times of stress, you may have felt butterflies in your stomach or maybe you’ve lost your appetite — that’s because the digestive tract responds to one’s mood.

The nerves in the GI tract, called the enteric nervous system (ENS), communicate with the central nervous system (which includes the brain) via a connection called the gut-brain axis. Moreover, the central nervous system is what triggers the stress response. So it’s no surprise that stress has an impact on the health and performance of the GI system. Below, we’ll outline three ways that stress affects gut health.

1. Stress Can Make Heartburn Symptoms Worse

A study published in 2004 showed that stress can worsen heartburn symptoms. For this study, 60 people with heartburn symptoms were assessed for stressful life events from the previous six months. During the four months of the study, subjects were asked to keep a daily diary of their symptoms, and were also assessed for symptoms of anxiety and depression. The results of the study showed that individuals who had experienced a sustained stressful life event in the six months previous to the study experienced a worsening of heartburn symptoms during the subsequent four months of the study.

2. Stress Can Exacerbate Inflammatory Bowel Disease

Inflammatory bowel disease (IBD) is a group of diseases characterized by chronic inflammation of the large intestine (also called the colon). IBD is not caused by stress, but stress can make symptoms of IBD worse. Stress has been shown to affect the mucosal layer of the intestine in mice, which likely contributes to inflammation in the gut. Stress has also been shown to cause a relapse of symptoms in patients diagnosed with IBD.

3. Stress Can Increase the Risk of Ulcers

Stress has long been suspected as a contributor to the formation of ulcers, but there has been some controversy as to whether stress alone can cause ulcers to form: Two of the most common causes of stomach ulcers includes an infection from the bacteria Helicobacter pylori (H. pylori) and overuse of nonsteroidal anti-inflammatory drugs.

One study aimed at solving the controversial connection between stress and ulcers followed more than 3,300 people in Denmark without a history of ulcers. Researchers collected blood samples and medical data from the patients in 1982. Over the course of 12 years, patients were interviewed twice and asked to report their levels of stress using on a stress index scale. Individuals in the highest third of the stress index had a higher incidence of ulcers, regardless of whether they tested positive for Helicobacter pylori bacteria infection or were taking nonsteroidal anti-inflammatory drugs. These results suggest that stress does have an independent impact on ulcer development.