The Impact of Stress on Gut Health

The gut-brain axis describes the two-way communication between the gastrointestinal (GI) tract and the brain and involves many organ systems, including the hormone, immune, and nervous systems.^1,2 The communication signals along this axis help maintain normal GI function and can originate in the gut, the brain, or both.³

A diverse range of friendly microorganisms reside in the gut, known as the gut microbiome, and neurological and mood disorders, including anxiety and depression, often involve gut and gut microbiome–related symptoms.^4-6 In addition, GI disorders with an imbalanced gut microbiome, in which the balance of healthy bacteria is disrupted, may also have brain and mental health–related symptoms,^7,8 and in turn, psychological stress may impact microbiome balance and GI function.^3,9

In the following video, functional medicine expert David Rakel, MD, talks about the connection between stress and GI function:

(Video Time: 2 minutes) Dr. David Rakel is the founder and director of the University of Wisconsin (UW) Integrative Medicine Program and associate professor with tenure in the Department of Family Medicine at the UW School of Medicine and Public Health.

Stress & An Upset Gut

Stressful life events may alter GI function and may significantly change the gut microbiome’s structure and activity, leading to an imbalance known as gut dysbiosis.^10,11 In turn, gut microbiota may influence stress-related responses in the body.^1,11 Research studies suggest a close interaction between the gut microbiome and the body’s neurologic and hormonal responses to stress.¹¹ For example, the following neurotransmitters are active in the brain as well as the gut, influencing the movement of food through the digestive tract, nutrient absorption, the immune system, and the gut microbiome:¹² 

• Serotonin
• Norepinephrine
• Epinephrine
• Dopamine

In addition, stress-related conditions such as anxiety and depression have been shown to have a close relationship with the gut microbiome.¹ Studies suggest that:

• Anxiety and depressive disorders may be characterized by a higher abundance of inflammatory microbiota and less beneficial bacteria in the gut.⁵
• Negative emotions and stressful life events have also been associated with other GI disorders such as colitis, Crohn’s disease, and dyspepsia.¹³

Functional Medicine Approach

Functional medicine uses personalized treatment strategies to address root causes of chronic conditions, and stress is but one modifiable lifestyle factor that may be addressed in an intervention. Managing external stress-related factors while optimizing gut health may jointly address some chronic health conditions. Overall, transforming the body’s response to stress may lead to more positive health outcomes, and some techniques have the potential power to bolster immune function,¹⁴ strengthening overall resilience. 

Research studies have evaluated the effectiveness of stress management for GI disorders such as inflammatory bowel disease (IBD), a chronic intestinal inflammatory condition associated with dysfunctional interactions between the gut and the brain.^15,16 Many of these studies have suggested that stress management techniques such as mindfulness meditation have beneficial effects on inflammation, stress levels, anxiety status, and quality of life.^15,16

Within the functional medicine framework, practitioners partner with patients to develop personalized treatment plans that best fit each patient’s current conditions and concerns. Click on the banner below to find a functional medicine practitioner near you to learn more about lifestyle-based interventions that help address life stress and support gut health.