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A stressful event like speaking in public, going to a job interview can give you butterflies in your stomach that may literally make you want to run to the bathroom. Stress affects every aspect of our lives including digestion. This includes indigestion, heartburn and irritable bowel syndrome. When put in a stressful situation, the body releases hormones known as corticotropin-releasing hormone or CRH. This, in turn, signals the adrenal gland to pump out adrenaline and steroids that help with the body's flight or fight response. Here are a few ways stress affects the gastrointestinal system.Here are a few ways stress affects the gastrointestinal system.
- Stress kills appetite: Stress eating is a real problem that results from the contradictory reactions of hormones. The hormones released by stress kill a person's appetite, but at the same time, the steroids released by these hormones make the person crave unhealthy foods like ice-cream, chocolate or potato chips. These foods aren't easy to digest and can cause indigestion, gas buildup and heart burn.
- Stress leads to ulcers: Ulcers are caused by bacteria, but stress strengthens the infection and disturbs the balance of hydrochloric acid and protective secretions in the stomach. This increases the risk of ulcer formation in the stomach. Once the ulcers are present in the stomach, stress can worsen the symptoms.
- Stress alters the gastrointestinal pathophysiology: Stress can cause changes in gastrointestinal secretions and reduce the amount of oxygen available to the digestive system. It also impairs gastroduodenal motility and amount of enzymes being secreted by the pancreas. Additionally, it interferes with the passage of food through the intestinal tract and alters colonic motility. Stress also affects the absorption of nutrients from the stomach and increases the blood flow to the digestive system by four times the normal amount thus decreasing metabolism rates.
- Stress affects irritable bowel syndrome: Stress in itself does not cause irritable bowel syndrome but can worsen the situation. This is because stress can make the colon contract and cause abdominal pain. These contractions are usually uncoordinated and can lead to constipation. It also makes the body more sensitive to pain thus increasing discomfort.
- Stress lowers immunity: A large part of the immune system is housed in the gut. Stress reduces the secretion of enzymes in the gut and leaves the digestive system vulnerable to bacterial infections. By weakening the immune system in the gut, stress also increases the risk of suffering from infections in other parts of the body.
In healthy individuals, the liver contains little or no fat. In overweight or obese people, gradual fat accumulation leads to significant liver disease. Interestingly, these individuals may be consuming minimal to no alcohol. So, alcohol, which is the main cause for liver damage, does not have a significant role to play.
The non-alcoholic fatty liver disease (NAFLD) has 4 significant stages as outlined below. It is a chronically progressive disease and may take years to reach the final stages of cirrhosis and fibrosis.
1. Simple fatty liver (steatosis): This is usually identified when diagnostic tests are done for some other suspected conditions. There are usually no symptoms obvious in this stage, other than the buildup of fat in the liver.
2. Non-alcoholic steatohepatitis (NASH): The second stage where the liver is inflamed to a greater extent due to fat accumulation.
3. Fibrosis: The next degree of inflammation where blood vessels may be narrowed leading to scarring in the liver with impaired liver functions.
4. Cirrhosis: This is the most severe stage that occurs due to years of cumulative inflammation. The liver shrinks in size, is scarred, and liver functions are markedly impaired and can also result in liver cancer.
Risk factors for NAFLD: The exact reason why a person develops NAFLD is not established, but some of the risk factors include
1. Obesity, with more weight concentrated around the abdomen
4. High cholesterol levels
5. Age greater than 50
Symptoms: This will depend on the stage in which it is identified. While there are no symptoms in the early stages, in some people there could be a dull, aching below the ribs, unexplained weight loss, weakness, and extreme tiredness. As it progresses to cirrhosis, there could be jaundice, fluid accumulation in the abdomen and feet, and itching of the skin.
Management: While there is no treatment aimed at curing the disease per se, there are ways to manage the symptoms, as noted below.
1. Weight loss: Reducing excess accumulated fat will help reverse symptoms and prevent further progression of the disease. A BMI of 18 to 26 is considered optimal.
2. Dietary changes: Modify your diet to a carbohydrates and protein rich and reduced fats and sugars. Increasing fiber through fruits and vegetables is highly recommended.
3. Exercise: Whatever your choice of workout, it will do wonders for NAFLD. Keep a target of an hour or two of moderate to intense exercise per day to reduce weight.
4. Smoking: This is another risk factor and can also help prevent other effects of NAFLD such as diabetes and heart disease.
NAFLD is highly controllable with these changes and other damages can be reversed too. If you wish to discuss about any specific problem, you can consult a gastroenterologist.