Digestion: a disturbing factor stress

Mental stress disrupts digestion. Cramps, gas, diarrhea and constipation can result. Is there really an abdominal brain?

The neurogastroenterologist Martin Storr finds no organic causes for the symptoms in most of the patients who come to his office hours. The diagnosis is then irritable bowel syndrome. Up to 20 percent of the population suffer from it. The so-called irritable stomach, also known as functional dyspepsia, is even more common.

Both phenomena present physicians with great challenges - especially since the symptoms can merge into one another. "Functional complaints are like a complicated puzzle and always require individual treatment," says Storr. Important but elusive pieces of the puzzle are stress and psychological stress.

Irritable bowel syndrome is not an imagination

Even if no organic problem can be proven, the suffering of those affected is often enormous - especially if their complaints are not taken seriously. "Irritable bowel syndrome is not an imaginary disease," emphasizes Storr. Studies have shown that the patient has the smallest inflammation in the intestinal mucosa and the wall of the organ is more permeable. In addition, the bowel moves irregularly.

In the case of irritable bowel or stomach irritation, communication between the head and stomach is likely to get mixed up. The so-called abdominal brain, a network of nerve cells in the intestinal wall, controls digestion independently. Information flows in both directions via messenger substances, immune cells and the nerve fibers of the intestinal-brain axis.

Hypnotize the bowel

"Mental strain and stress activate the intestinal activity via the abdominal brain, trigger cramps, flatulence, diarrhea and constipation," says Professor Winfried Häuser, an expert in psychosomatics at the Saarbrücken Clinic. "The complaints, in turn, increase inner tension and a bad mood."

Studies have shown that intestinal hypnosis can break the cycle. "The patient learns to positively influence his bowel function through suggestions and inner images," explains Hauser. For example, by imagining the intestines as a calm flow. Or let warmth and light flow into your stomach through your hands.

Relaxation has to be learned

Hauser advises first practicing several times under expert guidance and only then with a CD alone at home. "If you listen to it regularly, the texts act on the intestinal-brain axis via the subconscious." Anyone who already has experience with relaxation procedures will usually feel an improvement quickly. But not everyone responds to hypnosis. If there is no success after four weeks, Häuser advises a change of strategy, for example to cognitive behavioral therapy.

Medicines can complement the therapy, but only relieve the symptoms and usually have to be taken consistently for several weeks. "We discuss with each patient individually which treatment is best for them," says Storr. Many indigestion remedies are available from pharmacies without a prescription. Storr: "In the case of short-term complaints, there is nothing wrong with self-medication. Longer-lasting symptoms must always be clarified by a doctor."

Interview with Ralf Weckop, specialist pharmacist for nutritional advice. He owns a pharmacy in Tönisvorst.

Mr. Weckop, what is your advice to patients with unexplained digestive problems?

First of all, I clarify which symptoms are in the foreground and whether they are acute or chronic problems. I have to find out whether the patient shouldn't go to the doctor right away.

What if a visit to the doctor is not necessary?

Then we consider where the problem is coming from and how it could be influenced. For example, by illuminating diet and lifestyle habits. When constipated, patients usually eat too little in fiber and drink too little. Intestinal function can be regulated with flea seeds and wheat bran. Experience has shown that gas and bloating decrease when people simply leave out what doesn't suit them.

How do drugs help?

Herbal combination preparations attack in several places, for example have an antispasmodic, anti-gas and anti-inflammatory effect. And agents with artichoke or bitter substances stimulate the production of digestive juices. Before I dispense any medication, however, I always ask the patient whether they are doing anything else for themselves.

What could that be?

In addition to regular exercise, rest and relaxation are important. Likewise, mindfulness of everything you eat while eating.