Digestion and anxiety: what is the link?

The digestive and nervous systems are closely connected to each other, so much so that they influence each other.

«Food represents for many people an immediate and easily usable gratification, a compensation for their anxieties and dissatisfactions. It is no coincidence that in stressful situations the desire for sweets or a hearty pasta increases: carbohydrates have an anxiolytic function”, explains Tiziana Stallone, biologist and nutritionist.

Anxiety can in fact play a key role in our attitude at the table and in orienting our tastes. On the other hand, this emotional state can also interfere with digestive mechanisms, from the mouth to the intestines. We have all experienced how stress or feeling under pressure can increase or make us pass our appetite, push us to chew and swallow food quickly (think of the classic sandwich at the bar devoured in three bites that remains on the stomach when we return to the desk), force us to run to the vending machine in the corridor to pick up a packaged snack that normally we would never dream of eating.

The close link between the digestive and nervous systems

“The emotional state (anxiety, in particular, is an alert in anticipation of a potential danger, sometimes only imaginary) has an important impact on the digestive system. A typical case is that of the pregnant woman who suffers from nausea in the first trimester: looking for distractions in relaxing hobbies, reading, walking is a way to improve the situation, because, on the contrary, anxiety and excessive worries can worsen them. Even when we suffer a fright or feel a great fear, a tension for an exam, the simple fear of arriving late for work because we are stuck in traffic can occur a vagal reaction that causes stomach pain, a strong nausea up to vomiting or a sudden need to run to the bathroom: adrenaline shot into the bloodstream in the stressful situation also acts on the digestive tract and the motility of the intestine is influenced and accelerated from the state of anxiety», underlines Tiziana Stallone.

«Thus, if a state of latent anxiety favors gastric secretion causing hunger, a state of acute anxiety – a very strong pain for a bereavement, a separation, a failure at work – is also able to take away hunger. Vagal reactions, in short, affect both digestion and appetite.” The digestive system and the nervous system are in fact closely connected and psychology comes into play in many physical reactions.

The “second” brain

When we talk about the digestive system we generally refer to that part of the body that serves only to feed. But it is evident that it is a much more complex organ system.

The chemical energy contained in food is transformed into mechanical energy (to carry out activities) and thermal energy (which produces heat). To obtain energy, the body must transform food by digesting them, that is, breaking them down into smaller and simpler parts, until they are reduced to the state of assimilable and transportable molecules through the blood and lymphatic system, providing tissues and organs with what they need to maintain them and make them function.

The process begins in the mouth, with chewing, continues in the stomach where food arrives passing through the pharynx and esophagus. Here the gastric juices continue the separation of the nutritional components, until they pass into the small intestine where, driven by the movements of the walls (peristaltic movements), through the intestinal walls they are absorbed by the blood, after filtering the liver. Waste products, reduced to feces, travel through the large intestine and are eliminated.

But the digestive system plays an important role in the overall functioning of the body: in the intestinal mucosa and in the pancreas, hormones are produced that also act at a distance, up to the brain and adrenals, and can act as neurotransmitters. Furthermore, through lymphocytes, the intestine also plays a defense function against infections (so much so that it is here that allergies and intolerances to food, and diseases such as celiac disease, can start).

For all these reasons, for some time we have been talking about the digestive system, and in particular the intestine, as a “second brain”, and it is intuitive how much stress can affect its functioning.

Psychosomatic medicine

When emotions modify the activity of our organs without us being able to control them, we speak of “somatization”: the intestine (but we also think of dermatitis or headaches, for example) is very sensitive to fears, worries, anger and reactivity causes intense and disordered contractions, with pain and diarrhea or constipation, a sense of fullness of the stomach and abdominal swelling (meteorism). A situation that is often referred to as irritable bowel syndrome (not surprisingly, using an adjective that also indicates an emotional state).

Gastritis is also a typical somatization of the situations that “are on the stomach”. But there may also be other reactions, in other body “districts”: insomnia, sudden sweats, palpitations, tachycardia (irregular pulses), up to panic attacks. But if you undergo specific examinations, you will not find anything wrong with the functioning of the intestine and not even diseases. What comes into play is our mind.

The recent change in psychosomatic medicine has been the shift of the location from which all this mechanism starts. In the past, it was believed that everything started from the brain. But more and more in-depth studies have highlighted that it is the intestine itself that processes emotions, is reactive to external stresses, suffers or is well in full autonomy, producing almost all serotonin – a hormone that regulates peristalsis, but also mood, sleep, pain – releasing it according to the food we eat, but also under the influence of emotions and external stimuli such as climate, medications, activities, etc.

And here the variations of this substance cause anxiety, fear, anguish, depression and so on. A communication that goes in both directions, in short: the brain, for example under stress, sends signals to the intestine, influencing its functioning, but also alterations in the functioning of the intestine cause changes in mood and behavior.

Dyspepsia and stress

The considerations made so far also apply to digestive problems in the strict sense: the medical term is dyspepsia (poor digestion), and the symptoms are:

• heartburn
• acid gastroesophageal reflux
• heavy breath
• pains
• discomfort in case of ingestion of processed, fatty or fried dishes
• sense of heaviness.

About 40 percent of Italians suffer from it, especially the rich and industrialized world, where there is a great abundance of food and many of industrial production. If there are no pathologies, dyspesia is “functional”, that is, they are the events and emotions that – net of excessive meals and incorrect eating habits – interfere with the proper functioning of the gastric system, as well as intestinal. According to experts, this happens in 60 percent of dyspepsia cases.

On the other hand, it is also true that digestive problems themselves can become a source of anxiety. “There are people who have a particular focus on the intestine,” confirms Tiziana Stallone. “It happens, for example, to people who lose what until then has been their social role: the man who retires after a life focused on work, the woman who goes through menopause or sees their children who leave home to study, work or get married finds in her body a place to return to exercise control. With a spasmodic attention to the functionality of the organism, and in particular of the gastrointestinal system: he says that suddenly he can no longer digest well, he checks if and how many times he can go to the bathroom, women feel swollen and heavy and uncomfortable with the clothes that “pull” on the belly, and, in fact, constipation causes a state of anxiety while simultaneously becoming its channeling ».

If the way of consuming meals – hasty, summary, without paying too much attention to what we put on the plate – can be linked to a state of stress, it is necessary to know that, in turn, it can worsen the state of anxiety. The demands of work, having to face appointments, e-mails, commitments can actually lead us not to “disconnect” even during lunch break, nibbling something at the desk, skipping the canteen, popping some snacks during the day. With the consequence, then, of arriving at dinner time hungry, of exaggerating with food, of digesting badly and not sleeping well at night, finding yourself in the morning even more tired and stressed.

A vicious circle that should be interrupted: “If a particularly stressful, one-off day happens, you can also skip the meal without consequences, especially if you do not even have the opportunity to listen to the sense of hunger. But if anxiety is chronic, it is necessary to recover healthier habits and “switch off”. Taking the right time to calmly eat a varied and rich breakfast, a mid-morning snack (for example fruit, and this yes, can also be at the desk), a light but complete meal, away, even if for a while, from the workplace, and then an afternoon snack that allows us to arrive at the time of the evening meal in peace and with the right charge to get to the end of working hours. And without digestive disorders.

Tiziana Stallone adds: “Anxiety in people can arise even if eating habits do not meet the needs of well-being. It happens, for example, when the person imposes restrictive dietary rules: no longer touching pasta and bread, skipping a meal to lose weight, adopting a “mono-food” diet according to the fashion of the moment (only proteins, only vegetables, and so on) is often a source of nervousness – with the classic comment of relatives and friends “Leave her alone because she is on a diet and is intractable” – which is added to that due to the rhythms of life, to work or family concerns. If you need to lose weight, it is better to ask your doctor for advice instead of relying on do-it-yourself or word of mouth.”

Another consideration for those who abolish pasta, bread and desserts in toto: “The stabilization of mood needs carbohydrates that, among other things, favor the absorption of tryptophan, an essential amino acid that we must take from foods (especially protein ones) and that, among other tasks, modulates the synthesis of many hormones, such as melatonin, responsible for the quality of sleep, Cortisol, a stress hormone, is the precursor of serotonin, the hormone of good mood, thus intervening in the regulation of mood, perception of pain, sleep, appetite and impulses. Combining macronutrients correctly and regularly, without missing carbohydrates or proteins, gives the body a biochemical stability of mood ».

How not to “somatize”

Are there any remedies for somatizations? The answer is both simple and complex. In an ideal world, staying away from causes, especially stressful situations. In the real one, trying at least to limit the damage, working on ourselves, on the way we relate to others and on lifestyle, practicing activities that allow us to “discharge” tension:

• physical activity
• sport
• yoga
• walks in the open air and in nature
• dance
• listening to music
• attendance of exhibitions, theater and conferences (depending on taste, anything that gives us pleasure, in short)
• Readings
• gardening.

In addition, it is good to take care of the diet (with indications tailored to the patient, also taking into account any overweight, tastes, specific problems, etc.), do not smoke, limit alcohol and coffee, drink plenty of water to promote digestion itself and good general hydration of the body, practice meditation and follow relaxation techniques based on breathing control, treat posture and discomfort caused by wrong positions and so on.

You can also resort to mild tranquilizers, such as herbal supplements, herbal teas (the classic chamomile) and drinks (warm milk before sleeping). In more complex cases, following the doctor’s indications, there are also drugs: for example, those that intervene on the production of serotonin or those that act on the symptoms, such as prokinetic drugs for the stomach.