Psychological stress has been a major side effect due to urbanization, mostly due to WORK related stress. Other confounding factors being overcrowding, lack of social support, family disintegration, alcoholism, substance abuse, crime and increased health problems.
- The brain and the gastrointestinal system are connected bidirectionally forming a BRAIN-GUT AXIS, hence each influencing the well being of others. Increased stress levels lead to various GI problems including:
- Gastroesophageal Reflux Disease
- Peptic ulcer disease
- Functional Dyspepsia
- Irritable bowel syndrome
- Chronic constipation
Together they form a spectrum of diseases due to an altered brain-gut axis.
Stress exposure alters the gut motility, the gut permeability and the gut blood flow. Hence patient may have worsened gastric problems including ulcer disease and exhaustingly searching for aetiology excluding H pylori and Analgesic abuse. The patient may have worsening bowel alteration day by day, worried more as the doctor says his blood tests and colonoscopic findings are normal. Prevalence of IBS in India is 5-6 % which is less than 14 % of USA, but it should be kept in mind that IBS is a missed diagnosis in India, many of them not communicating their problems with doctors and colleagues or doctor misdiagnosing it and pushing them away instead of treating the root cause.
HOW TO CONQUER THE B-G AXIS?
GUT MICROBIOME is the major mediator between the two poles. Altering the gut microbiome by taking probiotics, prebiotics, faecal microbiota transplantation, restricting intake of antibiotics and taking food rich in bacteria like yoghurt helps in targeting both mental and gastrointestinal health.
A proper psychological evaluation and management definitely help in treating these difficult to treat diseases. The patient should regularly follow up with his gastroenterologist and sincerely follow his advice.