Stress and GI issues

Hey!

Today I'm going to talk about a really glamorous topic! This week I've really been struggling with sickness. Mainly, D&V--ew.

I had a huge problem with GI issues whilst I was doing my A level mocks and exams a few years ago. At the time, I went to the doctors to try to figure out what was wrong. I headed the surgery thinking it might have something to do with dairy. I feel like everything is blamed on dairy online. Bad skin? Dairy. Stomach issues? Dairy. Aching toe? Dairy. Anyway, when my doctor suggested there may be some truth in this, I took it and ran. I cut milk, cheese and yoghurt out of my diet completely.

In hindsight, this was the absolute wrong thing to do for so many reasons. Mainly, because cutting out dairy and being overly concerned about traces of it anywhere made me very stressed, but also because my body then developed a real temporary intolerance to it. (Side note: temporary intolerances can be overcome this by gradual reintroduction.)

This dairy demonisation was an example of confirmation bias, something I posted about on my Instagram a few days ago. I went into the surgery believing it was dairy and came out with a strengthened belief. Out of the numerous things it could have been, my brain latched onto the passing comment my doctor made about the possibility dairy could be playing a part. I didn't even consider any other potential causes, because I was so focussed on it being the fault of cow's milk.

What else could it have been?

I had test after test and gave sample after sample to try to figure out what was going on. The doctors said that *something* wasn't right, but couldn't work out exactly what. There was no sign of intolerance or underlying long-term condition, which was good, but it left everybody a bit pickled.

At this time, alongside studying for A-Levels, I was really struggling with my ED recovery and still over-exercising.  From being worried about 18th birthday parties at weekends, to trying to maintain good grades, to stupidly trying to fit in exercise into already hectic days. It goes without saying, I was stressed To The Max.

I also had a job outside of school, ran and edited the school paper, tutored loads of international students and was writing coursework. Physiologically or physically, I rarely rested. Sometimes I felt like recovery was a full time job on its own. Let alone juggling quasi-recovery with 100 other things. It was a massively stressful period.

It's incredibly common for psychological stress to cause digestion problems. It only takes a quick google search of 'the link between stress and GI issues' to find out how entwined the problems are.

If you follow me on Instagram, you might remember me saying how I had D&V on Christmas Day just gone. Although it's very possible that this was food poisoning from Christmas Eve prawns, mum and I have a feeling it could have perhaps been stress-related. I wasn't stressed about Christmas because of eating the food, I was stressed because I just wanted the day to go so perfectly to make up for the ones I'd ruined before. I think I put a bit to much pressure on myself because I was so hopeful to really enjoy the day.

Regarding this week, I've got a couple of things going on making my life very busy. It's nothing major or anything AN related, just regular life stuff. But, considering my symptoms are exactly the same as they have been before, it could well be stress causing my problems again.

Types of Digestive Issues caused by stress:

In the short-term:

Indigestion and heartburn due to the build-up of acid in the stomach.Stomach pains due to cramping of the stomach muscles.Diarrhoea and constipation due to changes in the speed of digestion.

In the long-term, stress can exacerbate existing conditions, including:

Irritable Bowel Syndrome (IBS), which is characterised by stomach cramps, bloating, constipation and/or diarrhoea;indigestion – stomach growls, aches and burns, often accompanied by feelings of bloating, vomiting or nausea.

How are GI issues exacerbated by stress?

Most of us know that we have a sympathetic nervous system ( "fight or flight" response) and a parasympathetic nervous system (calms the body, slows HR etc). Both of these nervous systems interact with another, less well-known component of the autonomic nervous system — the enteric nervous system, which helps regulate digestion.

If you've ever heard somebody say that your stomach is like 'your second brain', they're not far off. The enteric nervous system relies on the same types of neurons and neurotransmitters that are found in the central nervous system (brain and spinal cord). After sensing that food has entered the gut, neurons lining the digestive tract signal muscle cells to initiate a series of intestinal contractions that propel the food farther along, breaking it down into nutrients and waste. At the same time, the enteric nervous system uses neurotransmitters such as serotonin to communicate and interact with the central nervous system.

The fact that these systems are so closely linked, has helped researchers see how psychological or social stress might cause digestive problems. For example, when a person becomes stressed enough to trigger the fight-or-flight response, digestion slows or even stops so that the body can divert all its internal energy to facing a perceived threat. In response to less severe stress, such as public speaking, the digestive process may slow or be temporarily disrupted, causing abdominal pain and other symptoms of functional gastrointestinal disorders.

Of course, it can work the other way as well: persistent gastrointestinal problems can heighten anxiety and stress. If you're suffering from lasting GI issues, its best to go to the doctors to check that there isn't an underlying long-term condition.

What is the resolution to GI issues?

• Go to a doctor. Have the necessary tests done to check that there is no underlying long-term problem.

• Don't jump into an elimination diet. This may cause more stress for somebody with an ED history. It might not be the food.

• If you DO think it could be linked to stress, try to understand what makes you stressed and do your best to control it. Is it home or work life stress (essays, overworking, deadlines, etc.)? What sort of help do you require to help manage this? Perhaps a timetable which factors in breaks? A new relaxing hobby? Support from a tutor? An essay extension?

• As soon as you identify the issue, you can go after a solution.Is it stress caused by your ED, from social events involving food, worry and fear?  Again, question what form of help you need to help you manage this and reduce the stress of recovery? More support from your family? A treatment professional? A new self-help book? As soon as you identify the issue, you can try your best to find a solution.

The main thing: continue to eat. Despite discomfort. Other people can afford to lose their appetite and skip a few meals. With your history of AN, you can't. This week, it's been extremely difficult for me to stomach anything. I havent felt like anything whatsoever. Regardless, I've eaten. I haven't had a single piece of fibrous fruit or veg, and instead been eating plain foods which are easily digestible. I've eaten a lot of white toast, rich tea biscuits, crackers, bagels etc, which the body doesn't have to work hard to break down. The best teas to sooth my stomach are fennel, camomile and peppermint!

You still need to eat. Being sick is not an excuse to restrict or not eat if it happens to reduce your appetite. You simply cannot afford to skip meals and allow your energy levels to slip.

Han x