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Stress and the Gut

Gail Attara, Chief Executive Officer Gastrointestinal Society

Gastrointestinal (GI) and liver conditions affect approximately 60% of individuals, of all ages, in urban and rural communities, across Canada. There are as many as 6 million Canadians with irritable bowel syndrome (IBS) and nearly 10 million who experience substantial upper GI issues, such as gastroesophageal reflux disease (GERD) and functional dyspepsia. Our country also has the highest reported prevalence of inflammatory bowel disease (Crohn’s disease and ulcerative colitis) in the world – about 1 in every 150 Canadians. There are also a significant number of rare GI diseases. These conditions can often become part of a stress cycle, in which the symptoms increase stress and then stress increases symptoms.

Stress is a state of mental or emotional strain or tension that we all experience at times. In some situations, in small amounts, stress is useful. It can equip your body to react quickly and initiate a ‘flight or fight’ response, helping you cope better in dangerous situations. But longstanding stress takes its toll on your body. Whether from many day-to-day mundane stresses, or from the lasting effects of a major past event, it can greatly affect your physical and mental health, leading to problems such as anxiety, increased blood pressure, muscle tension, hormonal changes, and digestive symptoms.

If you have a GI disease or disorder, you are vulnerable to the effects of stress on your existing illness and might experience an increase in pain, aggravation of the disease process, and interference with healing. Research has not shown psychological stress to cause any structural problems in the gastrointestinal system; however, stress can make existing conditions worsen, or increase the likelihood of relapse in patients with inactive disease. Evidence of this exists for functional gastrointestinal disorders, such as IBS, dyspepsia, and GERD, as well as for inflammatory bowel diseases.

An individual coping ineffectively with chronic stress keeps his or her body in an over-activated state, thus disrupting its normal operation, including that of the digestive system. Physical changes include a shift of blood flow away from the intestinal tract, increased muscle tension, and immune system suppression. These changes are significant for those who have GI conditions. In addition, stress can cause diarrhea and nausea in those who don’t have a specific digestive disease or disorder, especially during periods of acute stress.


Managing Stress

Decreasing your stress levels and learning effective stress management techniques can help decrease the severity of your gastrointestinal symptoms and improve your overall quality of life. Here are some helpful suggestions to manage stress.

  1. Eat a well-balanced diet by following Canada’s Food Guideavailable from Health Canada or consulting a registered dietitian to find a food plan that works for you. Inadequate nutrition increases stress on yourbody and decreases its ability to heal.
  2. Become a better breather by learning to breathe more slowly and deeply from your abdomen. Stress can cause shallow breathing, which means that your body won’t get enough oxygen to fully relax unless you consciously make an effort to breathe deeply.
  3. Watch your ‘self-talk’ because much of our anxiety is self-induced, meaning that we often get ourselves wound up worrying about worst-case scenarios or blowing small incidents out of proportion.
  4. Monitor your negative thoughts to see how often you fret about things such as making mistakes or losing your job. Try to substitute each negative thought with a positive, but realistic one.
  5. Get physical because exercise is a well-known tension reducer. Take care to increase exercise slowly and assess your body’s tolerance to this as you do. Use caution though, as high-impact exercises might exacerbate gastrointestinal symptoms in persons with gastroesophageal reflux disease (GERD), hiatus hernia, Crohn’s disease, and ulcerative colitis.
  6. Become a better time manager so time doesn’t manage you. Many of us underestimate the amount of time it will take to do something, which means we’re often running late. Try keeping a time management log for a week to get a better idea of how much time various tasks actually take.
  7. Learn to say no in the right situations. Thinking you can ‘do it all’ creates unnecessary pressure. Learn how to set boundaries for yourself. Politely, yet firmly, turn down additional responsibilities or projects for which you don’t have the extra time or energy.
  8. Take time out for yourself because our minds and bodies require a certain amount of variety or else our overcharged nervous systems will keep speeding right into the next day. Try to take at least one day off each week to do something you really enjoy, whether it’s reading, listening to music, or just hanging out with friends.
  9. Have a good belly laugh sincethis natural stress reliever can help to lower blood pressure, slow your heart and breathing rate, and relax your muscles.
  10. Get professional treatment if you feel that you need more help than the above strategies offer. Professional psychologists have developed a range of methods and useful tools for helping individuals handle stress more effectively.Some of the more frequently used treatment methods include relaxation training (progressive muscle relaxation training, biofeedback, and hypnosis), time management training, lifestyle changes, cognitive behavioural therapy, assertiveness training, deep breathing training, systematic desensitization, brief psychotherapy, and medication therapy.
  11. Use Caution when accessing stress management services to ensure you are receiving treatment from an appropriately trained and licensed professional. A poorly trained therapist may provide ineffective treatment, waste your time and money, fail to detect the presence of a more serious problem, and/or eventually discourage you from seeking real treatment. Many communities have programs covered by basic health care plans and some extended health care plans provide coverage for additional therapy. Ask your physician to refer you to specific resources in your area.



Occasional stress is an inevitable part of life; however, the above tips might help you to manage your stress levels and avoid negative health consequences or worsening of your gastrointestinal symptoms. If you experience chronic stress, or have post-traumatic stress disorder, please consult a medical professional, such as a clinical psychologist or a psychiatrist.


About the GI Society

As the Canadian leader in providing trusted, evidence-based information on all areas of the gastrointestinal tract, the GI (Gastrointestinal) Society is committed to improving the lives of people with GI and liver conditions, supporting research, advocating for appropriate patient access to health care, and promoting gastrointestinal and liver health.


How We Can Help

The GI Society and its partner, the Canadian Society of Intestinal Research, are registered charities that collaborate to provide a number of core programs and services that focus on providing Canadians with trusted medically sound information on digestive health. All of our work is overseen by a medical advisory council consisting of gastroenterologists, hepatologists, surgeons, and pharmacists. This section briefly outlines how we address great need with limited resources.

  1. BadGut® Lectures: Our popular lectures are free to attend and involve a presentation by a medical expert followed by a lively question and answer period. We offer lectures on a variety of topics from coast-to-coast.
  2. The Inside Tract® Newsletter: Our quarterly newsletter, which is available in both English and French (Du coeur au ventreMC), contains current information on GI research, medications, alternative therapies, specific diet and nutrition guidelines, new technologies, helpful hints, Health Canada warnings, and explanations of disease processes.
  3. Website: badgut.org  is filled with information on a wide variety of topics and includes many articles that were previously published in our newsletter, along with videos, infographics, and more to help you learn about digestive symptoms and illnesses.
  4. Information Pamphlets: We publish a series of patient information pamphlets on more than 25 subjects from common GI complaints such as intestinal gas and constipation, to chronic diseases such as inflammatory bowel disease and celiac disease. We also cover information on specialized medications such as biologics and biosimilars and medical cannabis. We ship these to hospitals, clinics, and individuals across Canada free of charge.
  5. Outreach and Patient Advocacy: We work with medical professionals and government officials at all levels to help advocate on behalf of individuals with gastrointestinal and liver diseases and disorders.
  6. Awareness: Misinformation is rampant when it comes to digestive conditions. We aim to dispel these myths, and raise awareness of what these ailments really entail.


Contact Us

Gastrointestinal Society

231-3665 Kingsway

Vancouver, BC  V5R 5W2

604-873-4876 or 1-866-600-4875 (toll-free)

[email protected]






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