Stress and Common Gastrointestinal Disorders

For generations, stress was blamed for duodenal and gastric ulcers. It is now known that the principle cause of these diseases is infection with an organism known as Helicobacter pylori, and not the result of suffering in silence for years from the burdens of a pressurized and put-upon life.

While this discovery has been a revolutionary step forward in treatment of the troubles of the gut, it has had one disadvantage. It has tended to obscure the importance of stress as a cause of other gastro­intestinal problems.

Nausea and vomiting may be associated with gastritis, and may well be an early symptom of anxiety and tension. The guts may also be overactive or underactive during periods of tension. If the sympathetic effects of the autonomic nervous system predominate, then there is a decreased movement of the guts. If the para-sympathetic effects are in the ascendancy, there are increased gut movements.

The anxious patient usually complains of diarrhoea and 'intestinal hurry'; the increased movement of the gastro-intestinal tract results in a sensitive gastro-colic reflex. No sooner does someone complete a meal than the distension of the stomach causes reflex movements throughout the guts and creates the need to visit the lavatory. This is the origin of the old soldiers' term 'windy', meaning frightened or over-anxious. If too afraid, a soldier's guts were unreliable, and excessive wind (or worse) might be the consequence. By 1939, society had become less euphemistic, and the description 's**t-scared' had largely replaced it.