How Does Stress Affect the Gut and Sleep?

We have all heard phrases like, "I have butterflies in my stomach" or "I just go with my gut" or "My stomach really does have a mind of it's own". From a sociological standpoint, we all instinctively know that there is a connection between the gut and the brain. The medical applications would be significant if this were true. But is it true? Can this link be scientifically validated?

Before we talk about the link between stress and the gut, let's talk a little about stress. Not all stress is bad. There is good stress called eustress which is essential to keep us motivated and have the physiological energy to wake up in the morning. Good stress provides a healthy challenge. Stress is damaging when the physical body cannot compensate, or when the mind percieves the situation as overwhelming.

For example, disrupted sleep is a stressor to the body and can change cortisol levels throughout the day contributing to symptoms of anxiety, fatigue and depressed mood. Research shows that 3 nights of disrupted sleep is enough to elevate cortisol at night which further perpetuates sleeplessness. Changes in cortisol levels can result in increased inflammation in the GI tract, increased cravings for sugar due to imbalances in insulin, and a slowed metabolism which may contribute to weight gain.

You may begin to see that this begs the "chicken or egg" question. I usually work with my patients to break these unhealthy cycles. The benefit of naturopathic medicine is that we work with each person's individual physiology. So rather than giving one pill that sedates you for sleep, but does not promote a restful and refreshed feeling in the morning, I use gentler and more specific therapies. Non invasive is sometimes misnomered as weaker, however, when used appropriately, they can have profound effects. For example melatonin is great for an inability to fall alseep, but it does not work for people who wake up multiple times during the night. There are some herbs that work much better for this other type of insomnia.

Stress and Increased Intestinal Permeability

So for those of you who are interested in the scientific link between stress and the gut, this is how it works:

• Stress triggers the limbic system of the brain to release CRF and ACTH
• CRF and ACTH travel to the adrenal glands where they stimulate release of cortisol and adrenaline
• Cortisol and Adrenaline can activate immune cells that live in the gut wall to burst. These cells are called mast cells and release histamine when they burst.
• Histamine stimulates the lymphocytes (immune cells) to start fighting, leading to an inflammatory response. The inflammed tissue in the gut is less intact and becomes more permeable, allowing particles that should stay in the gut, to leak out to the blood stream. When these foreign particles leak out to the blood stream, they further trigger more of an immune system reaction in the rest of the body.
• This is how intestinal permeability can lead to auto-immune and allergic processes. This also explains how stress increases inflammation in the gut itself, leading to symptoms such as bloating, diarrhea, constipation, intestinal pain, mucous in the stools, etc. 

How to Help?

It is important to consider these principles when addressing intestinal health:

• Remove (stressors, mibrobes, toxins and allergens)
• Repair damaged intestinal mucosa
• Restore healthy, beneficial bacteria that are essential to keeping the immune system balanced
• Replace any necessary enzymes, HLC, or bile salts that may be deficient

Again being specific is important as studies show that certain probiotics in different dosages are more effective for certain conditions than others. I have patients who take the most common Accidophilus without much improvement, therefore it is helpful to seek professional help if your symptoms are not resolving. When used approprately, good quality nutritional supplements work well. My goal as a naturopathic doctor is to help promote your body to heal itself. Remember, our bodies are designed to be well. They have built in mechanisms to heal. It is when we suppress symptoms, emotions, or the body's cry for attention, that we push ourselves into more chronic sickness. When we address what is getting our attention, face it, love it, show it compassion and take steps to support healing, you'd be surprised at how resilient your body is.