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Have you ever have to make a “gut-wrenching" decision under pressure? Or were you ever so anxious that you had butterflies in your stomach? If so, then you know how stress can affect your digestive system.

The brain and the gut are connected and constantly in communication. In fact, more neurons reside in the gut then in the entire spinal cord, according to research published in the book Neuroscience.

"Stress can affect every part of the digestive system," says Kenneth Koch, MD, professor of medicine in gastroenterology and medical director of the Digestive Health Center at Wake Forest University Baptist Medical Center in Winston-Salem, North Carolina.

The gut is controlled in part by the central nervous system in the brain and spinal cord. In addition, it has its own network of neurons in the lining of the gastrointestinal system, known as the enteric or intrinsic nervous system. In fact, the system of nerves in your gut is so influential that some researchers consider the gut a second brain, as noted in an article published in Scientific American.

The enteric nervous system, along with its 100 million nerve cells that line your gastrointestinal tract from your esophagus to your rectum, regulates digestive processes like:

  • Swallowing
  • The release of enzymes to break down food
  • The categorization of food as nutrients or waste products

Stress can significantly impact the way your body carries out these processes.

What Happens When Your Body Is Stressed?
When presented with a potentially threatening situation, the sympathetic nervous system — a part of the body’s autonomic nervous system, which regulates bodily functions like the heartbeat, breathing, and blood pressure — responds by triggering a “fight-or-flight response,” releasing the stress hormone cortisol to make the body alert and prepared to face the threat.

Stress causes physiological changes, like a heightened state of awareness, faster breathing and heart rates, elevated blood pressure, a rise in blood cholesterol, and an increase in muscle tension.

When stress activates the flight-or-flight response in your central nervous system, Dr. Koch says that it can affect your digestive system by:

  • Causing your esophagus to go into spasms
  • Increasing the acid in your stomach, which results in indigestion
  • Making you feel nauseous
  • Giving you diarrhea or constipation

In more serious cases, stress may cause a decrease in blood flow and oxygen to the stomach, which could lead to cramping, inflammation, or an imbalance of gut bacteria. It can also exacerbate gastrointestinal disorders, including:

  • Irritable bowel syndrome (IBS)
  • Inflammatory bowel disease (IBD)
  • Peptic ulcers
  • Gastroesophageal reflux disease (GERD)

"Although stress may not cause stomach ulcers or inflammatory bowel disease, it can make these and other diseases of digestion worse," Koch says. So it’s important to take measures to be in control during stressful situations and find ways to keep yourself calm.

6 Ways to Manage Stress
There are both psychological and physical ways to manage stress. But the same stress relieving technique might not work for everyone. Here are six options you can try:

1. Get Regular Exercise
Physical activity relieves tension and stimulates the release of chemicals in your brain called endorphins, which act as natural painkillers. Endorphins improve sleep, which can help relieve stress, according to the Anxiety and Depression Association of America.

"It’s one of the best ways to manage stress and maintain healthy digestion," Koch says. A study published in 2014 in the journal Cognitive Behavioural Therapy examined the relationship between aerobic exercise and attentional focus during exercise on 33 patients with post-traumatic stress disorder (PTSD) and found that 89 percent of patients reported improvements in PTSD and anxiety sensitivity.

2. Consider Psychotherapy
Cognitive behavioral therapy (CBT) is a technique that has been proven to help reduce anxiety and stress by helping you learn to replace negative, distorted thoughts with positive ones. A study published in 2017 in the Journal of Consulting and Clinical Psychology looked at the effectiveness of CBT on quality of life, anxiety, and depression in those with IBD. Patients with IBD who reported low quality of life were randomly assigned a CBT intervention along with standard medical care for three and a half months. When compared with a control group, people with IBD who received CBT reported higher quality of life and lower levels of depression and anxiety.

3. Choose Stress-Busting Foods
A review published in May 2017 in the journal Neuroscience and Biobehavioral Reviews found that eating disorders and obesity can be associated with psychological stress. Cortisol, a hormone released by the adrenal glands, also increases appetite. Stress can affect food preferences, too. Studies have shown that “physical or emotional distress increases the intake of food high in fat, sugar, or both,” according to Harvard Medical School.

But there are certain foods that have been shown to reduce anxiety. Salmon contains omega-3 fatty acids, which are natural mood boosters. Almonds are chock full of magnesium, a mineral that helps manage cortisol levels. And oranges and other citrus fruits contain vitamin C, which can lower blood pressure, according to research published in January 2017 in the journal Scientific Reports.

4. Yoga
This mind-body practice combines physical poses with breathing techniques and meditation. According to a study published in 2018 in the International Journal of Preventive Medicine, women who engaged in hour-long Hatha yoga classes three times a week for 12 sessions achieved significant reductions in stress, anxiety, and depression. Research also shows that yoga can lower blood pressure and heart rate.

5. Meditation
There are many meditation techniques that can help you focus your mind on an object, activity, or though to help you achieve calmness. Although the goal of meditation is not stress reduction, that is a side effect of this ancient practice.

A review published in 2018 in The Lancet Public Health looked at the effects of a mindfulness-based intervention on resilience to stress in college students. Eight weekly Mindfulness Skills for Students (MSS) interventions were randomly administered to students for 75 to 90 minutes, focusing on mindfulness exercises and periods of self-reflection. At the end of the intervention, students in the MSS group reported lower levels of stress.

6. Develop Time-Management Skills
An important part of stress reduction is self-care. For many, this involves managing your time as effectively as possible. A study published in 2017 in the journal Electronic Physician looked at the relationships between time management, anxiety, and academic motivation in 441 nursing school students using self-reported questionnaires and scales. Students who did a poor job managing their time had higher levels of anxiety and less academic motivation than individuals who were better time managers.

You can improve your time-management skills by:

  • Knowing your deadlines
  • Planning ahead
  • Setting goals
  • Avoiding procrastination

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