You did the lab detective work, nourish yourself through an anti-inflammatory diet, restored your gut integrity, healed your dysbiosis, and yet still struggle with digestive distress or pain. WTF (WTFlub)! What’s left?
What is especially useful for those of us experiencing digestive disorders or chronic pain to understand is that we may have a heightened stress response (1). This is especially true if you’ve experienced early-life trauma, which is linked to altering the development of the central nervous, immune, and gastrointestinal systems resulting in maladaptive responses to stressors (2-8).
That said, even later-life traumatic stress predisposes us to develop somatic syndromes such as pain and IBS (9-12). By somatic syndromes, I mean symptoms not connected to an identifiable cause. For example, continuing to have digestive symptoms without a physical trigger like dysbiosis or food intolerances or having an autoimmune condition like inflammatory bowel disease or rheumatoid arthritis that is in remission and yet still experiencing IBS-like digestive symptoms or pain. Does living during this time of COVID count as traumatic stress? You bet it does (13)! Again… WTFlub!
Stress influences symptom severity in gastrointestinal disorders through promoting leaky gut, affecting digestive juice secretions, altering gut motility, increasing pain sensitivity, altering the microbiome, and more (14-16).
Perhaps you are tired of hearing about the negative effects of stress and are yelling right now… “Dude I get it okay… yada… yada… stress bad!” But do you actually get it? Are you actually monitoring how the way you speak to yourself affects your behaviors and emotions (and from that your stress levels)? Have you grieved your losses and processed your traumas? Are you calming your nervous system before you eat? Are you responding to COVID by building-up your resiliency? Knowing and doing are two totally different things.
Perhaps you have a hypervigilant stress response that is increasing pain and digestive distress as a result of ongoing chronic stress that is keeping you in fight or flight. Do you avoid meditation, yoga, or journaling practices because you struggle with being alone with your thoughts? Do you have unresolved grief or trauma that you have ignored and not faced that counseling might support? Do you need to forgive people in your life or forgive yourself? This is especially dangerous right now during COVID where we have access to constant stressors. Building resilience right now is especially important.
That said, I know plenty of folks that practice yoga daily and are still having hypervigilant responses to stress. I know plenty of meditators that still catastrophize worries and speak negatively to themselves. If this is you, you might be using meditation or yoga at times to avoid doing the actual work to heal the roots of your negative stress response. Yes, yes, for sure, for sure, meditation is a MUCH healthier avoidance mechanism than alcohol, drugs, and sugar, and yet… Sometimes these unhealthier coping mechanisms more easily point us to the issue than healthier coping mechanisms do. If that is you… It may be time to explore therapeutic modalities to help you change the way you respond to stress and rewire your brain. You may want to explore Brain Spotting, EMDR, and Internal Family Systems (parts coaching).
Or maybe your ongoing chronic stress response is an inflammatory response from dysbiosis or a food intolerance that you haven’t uncovered yet. Are you “eating healthy” but don’t know what your body is actually needing from you? Or perhaps you are super sensitive to the emotions, stresses, and moods of those around you and need to build strong physical and energetic boundaries.
Or maybe you need to find your passion, reconnect to your joy, and discover more meaning in your life to improve the quality of your life regardless of the symptoms you experience. Changing our outlook can change our stress response which can decrease our symptoms.
Please, don’t discount the effect that stress has on our digestion and our mood. Knowing stress relief is important is different than healing a maladaptive stress response. There is no one-size-fits-all solution. Hunker down and use this opportunity of having more time at home to do the detective work your body and mind so needs right now.
What about you? Share below in the comments… What are your favorite ways to destress? What have you noticed are the ways you avoid healing an over-vigilant stress response? How is your body holding up to the stress of living during COVID?
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(2) Kennedy, P. J., Clarke, G., Quigley, E. M., Groeger, J. A., Dinan, T. G., & Cryan, J. F. (2012). Gut memories: towards a cognitive neurobiology of irritable bowel syndrome. Neuroscience and biobehavioral reviews, 36(1), 310–340. https://doi.org/10.1016/j.neubiorev.2011.07.001
(3) Lennon, E. M., Maharshak, N., Elloumi, H., Borst, L., Plevy, S. E., & Moeser, A. J. (2013). Early life stress triggers persistent colonic barrier dysfunction and exacerbates colitis in adult IL-10-/- mice. Inflammatory bowel diseases, 19(4), 712–719. https://doi.org/10.1097/MIB.0b013e3182802a4e
(4) Moeser, A. J., Ryan, K. A., Nighot, P. K., & Blikslager, A. T. (2007). Gastrointestinal dysfunction induced by early weaning is attenuated by delayed weaning and mast cell blockade in pigs. American journal of physiology. Gastrointestinal and liver physiology, 293(2), G413–G421. https://doi.org/10.1152/ajpgi.00304.2006
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(6) Santos, J., Benjamin, M., Yang P., Prior T., Perdue M. (2000). Chronic stress impairs rat growth and jejunal epithelial barrier function: Role of mast cells. American journal of physiology. Gastrointestinal and liver physiology. 278. G847-54. https://doi.org/10.1152/ajpgi.2000.278.6.G847
(7) Söderholm, J. D., Yang, P. C., Ceponis, P., Vohra, A., Riddell, R., Sherman, P. M., & Perdue, M. H. (2002). Chronic stress induces mast cell-dependent bacterial adherence and initiates mucosal inflammation in rat intestine. Gastroenterology, 123(4), 1099–1108. https://doi.org/10.1053/gast.2002.36019
(8) Wallon, C., Yang, P. C., Keita, A. V., Ericson, A. C., McKay, D. M., Sherman, P. M., Perdue, M. H., & Söderholm, J. D. (2008). Corticotropin-releasing hormone (CRH) regulates macromolecular permeability via mast cells in normal human colonic biopsies in vitro. Gut, 57(1), 50–58. https://doi.org/10.1136/gut.2006.117549
(9) Afari, N., Ahumada, S. M., Wright, L. J., Mostoufi, S., Golnari, G., Reis, V., & Cuneo, J. G. (2014). Psychological trauma and functional somatic syndromes: a systematic review and meta-analysis. Psychosomatic medicine, 76(1), 2–11. https://doi.org/10.1097/PSY.0000000000000010
(10) D’Aoust, R. F., Rossiter, A. G., Elliott, A., Ji, M., Lengacher, C., & Groer, M. (2017). Women Veterans, a Population at Risk for Fibromyalgia: The Associations Between Fibromyalgia, Symptoms, and Quality of Life. Military medicine, 182(7), e1828–e1835. https://doi.org/10.7205/MILMED-D-15-00557
(11) Kolacz, J., & Porges, S. W. (2018). Chronic Diffuse Pain and Functional Gastrointestinal Disorders After Traumatic Stress: Pathophysiology Through a Polyvagal Perspective. Frontiers in medicine, 5, 145. https://doi.org/10.3389/fmed.2018.00145
(12) Ng, Q. X., Soh, A., Loke, W., Venkatanarayanan, N., Lim, D. Y., & Yeo, W. S. (2019). Systematic review with meta-analysis: The association between post-traumatic stress disorder and irritable bowel syndrome. Journal of gastroenterology and hepatology, 34(1), 68–73. https://doi.org/10.1111/jgh.14446
(13) Kira, I. A., Shuwiekh, H. A. M., Rice, K. G., Ashby, J. S., Elwakeel, S. A., Sous, M. S. F., Alhuwailah, A., Baali, S. B. A., Azdaou, C., Oliemat, E. M., & Jamil, H. J. (2020). Measuring covid-19 as traumatic stress: Initial psychometrics and validation. Journal of Loss and Trauma. Advance online publication. https://doi.org/10.1080/15325024.2020.1790160
(14) Konturek, P. C., Brzozowski, T., & Konturek, S. J. (2011). Stress and the gut: pathophysiology, clinical consequences, diagnostic approach and treatment options. Journal of physiology and pharmacology: an official journal of the Polish Physiological Society, 62(6), 591–599. http://www.jpp.krakow.pl/journal/archive/12_11/pdf/591_12_11_article.pdf
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(16) Stockbrügger, R., Coremans, G., Creed, F., Dapoigny, M., Müller-Lissner, S. A., Pace, F., Smout, A., & Whorwell, P. J. (1999). Psychosocial background and intervention in the irritable bowel syndrome. Digestion, 60(2), 175–186. https://doi.org/10.1159/000007644
The key question here is, have we grieved our losses and processed our traumas? This suppressed anger and frustration is the root cause of many ailments. Gut being rightly considered our second brain does get adversely affected by the stress.
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