The modern, fast-paced way of life in the 21st century has led to an increasing discussion about stress as one of the main challenges to individual safety and health. The SARS-CoV-2 virus pandemic has undoubtedly been one of the major stress-inducing factors worldwide, with a significant impact on both the mental and physical health of people around the globe. The digestive system is not exempt from the effects of stress, and numerous digestive conditions and problems are linked to an individual’s exposure to stress.
WHAT IS STRESS?
The concept of stress was first introduced at the beginning of the last century by a Canadian physician Hans Selye, who defined stress as the “total sum of an organism’s expenditure throughout its lifespan.”
Stress is the body’s response to a situation that an individual perceives as threatening to their physical or psychological well-being. All the physiological and psychological changes, as well as changes in an individual’s behavior that occur under the influence of a stressful stimulus, are called stress responses. Every stress disrupts the body’s balance, known as homeostasis, and the body responds in various ways and events that aim to restore this balanced state. In response to stress, numerous changes occur in the body, such as an increase in blood pressure, heightened muscle tension, a racing heart, headaches, and more. Among the psychological reactions are fear, anxiety, agitation, and changes in cognitive abilities. Stress can be acute or chronic. Acute stress occurs as a response to immediate danger and a current stressful event, while chronic stress arises from prolonged exposure to stressful situations, such as unemployment, marital problems, or extended periods of excessive work demands. A state of stress, therefore, is any condition in which individuals feel threatened in any way (physically, mentally, or socially), or perceive that their loved ones are in danger. The severity and duration of stress responses are mutually influenced by the characteristics of stressors, their intensity, and duration, as well as the individual’s personality traits, their assessment of their ability to cope with stress, and their assessment of the amount of social support they can expect when dealing with stress. Reactions to the same stressors can be completely different in different individuals. If an individual believes they can easily overcome a stressful situation and will have significant social support in doing so, the intensity and duration of stress reactions will be weaker.
THE IMPACT OF STRESS ON THE DIGESTIVE SYSTEM
The digestive system is intricately connected to our brain, and in scientific and professional circles, the term “gut-brain axis” is increasingly used to emphasize the bidirectional connection between these two systems. Events in the gastrointestinal system send signals to the brain through the central nervous system, which can trigger mood changes, while mood signals are sent from the brain to the gut. When a person is exposed to stress, this axis conveys stress signals to the digestive system. The brain releases stress hormones, and the digestive system has receptors for these hormones, leading to a response in the digestive system to stress. The complexity of the connection between stress and the digestive system is further enhanced by the fact that the digestive system has its own enteric nervous system, which contributes to the body’s response, i.e., the digestive system’s response to stress. However, it’s essential to emphasize that not everyone reacts to stress in the same way, and reactions and symptoms can vary.
Stress can lead to a range of gastrointestinal issues, including cramps, bloating, loss of appetite, diarrhea, constipation, and nausea. In addition to these, stress can exacerbate symptoms in individuals with pre-existing gastrointestinal disorders, most commonly in cases of irritable bowel syndrome, inflammatory bowel diseases, peptic ulcers, and gastroesophageal reflux disease (GERD). While stress is not considered a direct cause of these conditions, it can act as a trigger for their onset or worsen the existing symptoms. Unfortunately, this can create a vicious cycle: experiencing these digestive problems can lead to even more stress. Conversely, repeated stress can lead to gastrointestinal problems or worsen the existing ones.
HOW TO FIGHT AGAINST STRESS?
While we often can’t control the sources of stress, especially the acute ones, we can work on our stress response and how we deal with stress. A healthy lifestyle, positive changes in daily habits, mental hygiene, altering our perspective and understanding of situations, and promoting a culture of health rather than illness are crucial elements in combating stress and its related disorders. Some measures to alleviate the consequences of stress and cope with it more effectively include:
- Maintaining a regular, varied diet with an adequate intake of water.
- Engaging in physical activity.
- Reducing or eliminating the consumption of caffeine, nicotine, and sugar.
- Getting enough sleep and rest.
- Allocating time for family, friends, entertainment, and relaxation.
- Recognizing your own boundaries.
- Seeking professional help if a person cannot cope with the situation on their own.
EXPOSURE OF HEALTHCARE PROFESSIONALS TO STRESS
Research shows that healthcare professionals are among the top 20 professions most exposed to stress. Over the past three years, the COVID-19 pandemic has further subjected healthcare workers to stress, particularly in the stress category of “disasters,” which can have severe and long-lasting consequences. It remains to be seen what the long-term effects will be now that the pandemic has been declared over. The physical and mental health of healthcare workers was severely tested during the pandemic. However, even in non-pandemic periods, healthcare professionals face numerous stressors, including heavy workloads, patient and family pressures, dissatisfaction with working conditions, excessive administrative burdens, responsibility, and often the carryover of work-related stress to their personal lives. Raising awareness of professional value, continuous education, cultivating a positive work environment, improving working conditions, and the support of colleagues are some of the factors that can have a positive impact on reducing stress among healthcare professionals.
Stress is the modern “ailment” of our time. The challenges presented by the 21st century increasingly emphasize the importance of addressing stress as a trigger for certain diseases and conditions within patient care. As with other chronic illnesses, prevention is crucial in the fight against stress. However, seeking professional help when needed should not be overlooked.
- Matulović I, Rončević T, Sindik J. Stres i suočavanje sa stresom – primjer zdravstvenog osoblja. Sestrinski glasnik/Nursing Journal 17 (2012) 174–177.
- Foster JA, Rinaman L, Cryan JF. Stress & the gut-brain axis: Regulation by the microbiome. Neurobiol Stress. 2017 Mar 19;7:124-136.
- World Health Organization. Doing What Matters in Times of Stress. An Illustrated Guide; 29 April 2020, Publication. Dostupno na: https://www.who.int/publications/i/item/9789240003927. Pristupljeno 10. lipnja 2023.g.