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Stress and its Effects on the Body

We currently face much more stress than we ever have before.  We worry about our jobs, paying the bills, our parents, our children, our health, our diets, world news, and everything in between.  Life moves at a quicker pace and we worry about everything we need to keep up with.  There are also life circumstances, many beyond our control, that add to the anxiety we feel.  Situations like death, divorce, illness, disability, financial issues, and social issues have the potential to increase the day to day stress we already feel.

How Does Stress Affect the Body?

Feeling stressed and overwhelmed does not feel good mentally or emotionally, but what many of us forget is that it is not good for our bodies either.  In the short term stress can cause muscle tension and headaches.  It can cause sleeping problems and the inability to relax. In the long term increased stress can increase the risk of heart disease and stomach ulcers.  It can also lead to other problems in the digestive tract and aggravate IBD conditions such as ulcerative colitis.

Stress and Ulcerative Colitis

Ulcerative colitis is thought to be linked to genetics, smoking, environmental factors, and also psychological stress.  Patients with ulcerative colitis have experienced inflammation and damage to the mucosal barrier in the bowel due to an inappropriate immune response, which can be linked back to increased stress and anxiety. Researchers and many doctors believe that ulcerative colitis is linked to an autoimmune process.  This means that when the immune system is overactive and oversensitive it attacks healthy tissues and organs in the body.  When this process occurs, conditions such as intestinal bleeding develop.

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The Fight or Flight Response

The body’s fight or flight response is a natural way for the body to react to stress of all types, whether it is a physical threat, an emotional threat, or an on-going worry such as finances or health issues. It is thought that the fight or flight response is an innate way for the human body to protect itself, dating back to primitive times when survival was much more difficult. The fight or flight response was designed to happen occasionally when there was imminent danger. However, due to our current lifestyles, this response is continually activated.  The continual activation of the fight or flight response has caused many people undue anxiety, depression, and a vast array of other health problems.  One of these problems is inflammatory bowel disease, specifically ulcerative colitis. Many changes happen in the body during the fight or flight response. The body becomes more efficient at pumping blood and delivering oxygen.  It also slows digestion and releases glucose and fatty acids into the body for quick energy sources.

Natural pain endorphins are also released.  This process involves secretion of the hormone adrenaline and a molecule called cytokine.  Together, adrenaline and cytokine activate the immune system, causing inflammation.  For patients who have been in a remission of their colitis symptoms, this inflammation causes a re-occurrence of symptoms, also referred to as a flare.

Stress and the Autoimmune System

Cytokines are released in the fight or flight response.  Through cytokines, ulcerative colitis can be directly linked to stress.  These molecules cause the production of inflammatory mediators, as well as nitric oxide.  With these actions alone, cytokines cause direct injury to the mucosa in the digestive system and tissue damage.  Cytokines increase inflammation and prohibit the death of cells that should die.  Intestinal mucosal biopsies have shown that UC patients have increased inflammatory cytokines.  Studies show a greater concentration of pro-inflammatory cytokines in the blood samples of ulcerative colitis patients, compared to those in a control group and patients with colorectal cancer.

Not only do cytokines destroy and inflame healthy mucosa in the digestive tract, they also prevent healing.  Under normal circumstances, when there is damage to the mucosa in the bowel, neighboring cells can heal and close the gaps.  However, in patients with higher cytokine levels caused by the fight or flight response, this healing was significantly slowed by 30 percent.

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Adrenaline and Ulcerative Colitis

Adrenaline has many important functions during the fight or flight response, including increased vision abilities, increased heart beat and circulation, and decreased metabolism and digestion.  It is also one of the hormones known to increase inflammation in the body.  Adrenaline constricts blood flow to non-vital areas of the body, such as the digestive system.  This means that blood is concentrated to the heart, brain, and lungs.  In the event of a serious event causing the fight of flight response, this is an effective and helpful body function. However, when someone is in a constant, or near constant state of stress, having blood constantly shunted away from the mucosa of the digestive system that is already being damaged by cytokines, is a recipe for disaster.  While tissues in the digestive tract are being inflamed and damaged by cytokines, adrenaline adds insult to injury by depriving those tissues of much needed blood.  Blood and is needed in these areas for proper healing.  Together, cytokines and adrenaline work to cause multiple injuries to the already sensitive and inflamed bowel tissues, causing and perpetuating ulcerative colitis.

There is still a lot about ulcerative colitis that we do not understand.  Research is underway to understand more about how cytokines are linked to ulcerative colitis, stress, and bowel damage.  Evaluating and understanding how cytokines play a role in ulcerative colitis can lead to more targeted and successful treatment therapies. Until more is known about the link between stress and ulcerative colitis, patients should work to reduce stress in their lives.  They can also take part in stress-reducing practices like meditation, support groups, prayer, yoga, regular exercise, journaling, and deep breathing.

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