Stress and the Gut

Stress and the Gut - photo by carl dwyerThose of us who have IBD know we are stressed out.  Getting the diagnosis is one the most stressful days in our lives. Psychologically, I had a hard time accepting I had a gut disease and a very serious one.  I knew my life would change and that stressed me out.  My whole family was stressed out.   I was making myself sick with worry, so I finally had to get a prescription for Xanax while finding a path to a new attitude. It’s so cliché, but how we choose to internalize our stress is a choice.   ok, ok, but I had a hard time believing this It took me 6 months to pull myself out of my depression and make a commitment to do something before the disease ruled my life.


Like many of us, we experience two kinds of stress related to our bowels.  Some folks have only a sense of urgency when stressed, others have a sense of urgency ALL the time.    I had the double whammy.  Stressful situations often hit me hard and as my disease progressed, I felt a sense of urgency all the time with bad diarrhea.  At some point, IBDers are in the bathroom all the time.  It’s the first thing you look for in a theatre or new building – you plan your route.   I  urge you to click on one of my links to a book called – The Second Brain, by Michael Gershon, M.D if your Gastroenterologist hasn’t already recommended it.  It will explain in detail how our gut has a mind of its own.

But, here’s something I never realized before:  my gut ecology was also causing me a lot of anxiety and stress.  Maybe that’s why IBD’s are on the rise and so are anti-depressants ?! .  I think I started to figure it all out after finally getting my IBD and health under control  – I now feel relaxed and unstressed in a way I’ve never felt before.  I am happier and non reactive, even while having major marital and career issues.  I don’t have to run to the bathroom out now when stressed  – this is a major change.  In retrospect, I didn’t know how bad I was feeling, until I felt better.

The more I research, the more I understand that biology had a lot to do with my moods and periodic depressions .  Vitamin B and Serotonin is produced in the gut and processed but those with of us with IBD, our intestinal villi is compromised.   So it makes me wonder just how much nutrition, serotonin and vitamins was I getting ?   Let’s see what Serotonin and B vitamins do:


 From Wikipedia, the free encyclopedia


Serotonin (pron.: /ˌsɛrəˈtnɨn/) or 5-hydroxytryptamine (5-HT) is a monoamine neurotransmitter. Biochemically derived from tryptophan, serotonin is primarily found in the gastrointestinal (GI) tract, platelets, and in the central nervous system (CNS) of animals including humans. It is popularly thought to be a contributor to feelings of well-being and happiness.[5]

Approximately 90% of the human body’s total serotonin is located in the enterochromaffin cells in the alimentary canal (gut), where it is used to regulate intestinal movements.[6][7] The remainder is synthesized in serotonergic neurons of the CNS, where it has various functions. These include the regulation of mood, appetite, and sleep. Serotonin also has some cognitive functions, including memory and learning. Modulation of serotonin at synapses is thought to be a major action of several classes of pharmacological antidepressants.

Serotonin secreted from the enterochromaffin cells eventually finds its way out of tissues into the blood. There, it is actively taken up by blood platelets, which store it. When the platelets bind to a clot, they disgorge serotonin, where it serves as a vasoconstrictor and helps to regulate hemostasis and blood clotting. Serotonin also is a growth factor for some types of cells, which may give it a role in wound healing.

Serotonin is mainly metabolized to 5-HIAA, chiefly by the liver. Metabolism involves first oxidation by monoamine oxidase to the corresponding aldehyde. This is followed by oxidation by aldehyde dehydrogenase to 5-HIAA, the indole acetic acid derivative. The latter is then excreted by the kidneys. One type of tumor, called carcinoid, sometimes secretes large amounts of serotonin into the blood, which causes various forms of the carcinoid syndrome of flushing, diarrhea, and heart problems. Because of serotonin’s growth-promoting effect on cardiac myocytes, persons with serotonin-secreting carcinoid may suffer a right heart (tricuspid) valve disease syndrome, caused by proliferation of myocytes onto the valve.

In addition to animals, serotonin is found in fungi and plants.[8] Serotonin’s presence in insect venoms and plant spines serves to cause pain, which is a side effect of serotonin injection. Serotonin is produced by pathogenic amoebae, and its effect on the gut causes diarrhea. Its widespread presence in many seeds and fruits may serve to stimulate the digestive tract into expelling the seeds

Serotonin is a neurotransmitter, and is found in all bilateral animals[citation needed], where it mediates gut movements and the animals’ perceptions of resource availability. In the simplest animals, resources are equivalent with food, but in advanced animals, such as arthropods and vertebrates, resources also can mean social dominance. In response to the perceived abundance or scarcity of resources, an animal’s growth, reproduction or mood may be elevated or lowered[citation needed].

 Gauge of food availability (appetite)

Serotonin functions as a neurotransmitter in the nervous systems of simple, as well as complex, animals. For example, in the roundworm Caenorhabditis elegans, which feeds on bacteria, serotonin is released as a signal in response to positive events, e.g., finding a new source of food or in male animals finding a female with which to mate[citation needed]. When a well-fed worm feels bacteria on its cuticle, dopamine is released, which slows it down; if it is starved, serotonin also is released, which slows the animal down further. This mechanism increases the amount of time animals spend in the presence of food.[9] The released serotonin activates the muscles used for feeding, while octopamine suppresses them.[10] Serotonin diffuses to serotonin-sensitive neurons, which control the animal’s perception of nutrient availability. When humans smell food, dopamine is released to increase the appetite. But unlike in worms, serotonin does not increase anticipatory behaviour in humans; instead, the serotonin released while consuming activates 5-HT2C receptors on dopamine-producing cells. This halts their dopamine release, and thereby serotonin decreases appetite. Drugs which block 5-HT2C receptors make the body unable to shut off appetite, and are associated with increased weight gain,[11] especially in people who have a low number of receptors.[12] The expression of 5-HT2C receptors in the hippocampus follows a diurnal rhythm,[13] just as the serotonin release in the ventromedial nucleus, which is characterised by a peak at morning when the motivation to eat is strongest.[14]

Effects of food content

In humans, serotonin levels are affected by diet. An increase in the ratio of tryptophan to phenylalanine and leucine will increase serotonin levels. Fruits with a good ratio include dates, papayas and bananas. Foods with a lower ratio inhibit the production of serotonin.[citation needed] Research also suggests eating a diet rich in carbohydrates and low in protein will increase serotonin by secreting insulin, which helps in amino acid competition.[15] However, increasing insulin for a long period may trigger the onset of insulin resistance, obesity, type 2 diabetes, and lower serotonin levels.[16][17] Muscles use many of the amino acids except tryptophan, allowing more muscular individuals to produce more serotonin.[18] Myoinositol, a carbocyclic polyol present in many foods, is known to play a role in serotonin modulation.[19]

In the digestive tract (emetic)

The gut is surrounded by enterochromaffin cells, which release serotonin in response to food in the lumen. This makes the gut contract around the food. Platelets in the veins draining the gut collect excess serotonin.

If irritants are present in the food, the enterochromaffin cells release more serotonin to make the gut move faster, i.e., to cause diarrhea, so the gut is emptied of the noxious substance. If serotonin is released in the blood faster than the platelets can absorb it, the level of free serotonin in the blood is increased. This activates 5HT3 receptors in the chemoreceptor trigger zone that stimulate vomiting.[20] The enterochromaffin cells not only react to bad food, but they are also very sensitive to irradiation and cancer chemotherapy. Drugs that block 5HT3 are very effective in controlling the nausea and vomiting produced by cancer treatment, and are considered the gold standard for this purpose.[21]

Here’s what Vitamins do in our bodies:

Vitamins, which are organic substances found in plant and animal sources, help our bodies function properly. They’re crucial to the activities of our cells, our organs, immune systems and general energy supply. They may even help ward off cancer.

What exactly does that mean, though, to consume vitamins? What happens when we swallow foods containing vitamin molecules? How do we absorb them in order to reap their healthful effects?

Well, that depends on the type of vitamin we’re talking about. There are two kinds: fat-soluble and water-soluble.

In terms of overall digestion, what’s going on is pretty standardized. The digestive tract starts at the mouth; there, we chew food and drench it in saliva to begin the process of breaking it down into pieces small enough for our bodies to absorb. That food moves through the esophagus into the stomach, where molecules of carbohydrates, fats, proteins, vitamins and other nutrients are further broken down, usually by stomach acids. The nutrients then move to the small intestine, the large intestine (colon), the rectum, and finally the anus, from which the remaining, non-nutritional matter is expelled.

The small intestine is where vitamin absorption happens (along with most other types of absorption). Water-soluble vitamins, such as vitamin C, have “active transports” for absorption — molecules that pick them up in the small intestine, in a section called the jejunum, which is located about midway through. These transports carry the vitamin molecules through the intestine’s cell walls and deposit them in the body, where they can enter the bloodstream. Because they dissolve in water, they don’t require stomach acids to enable absorption; this also means they leave the body every day in your urine, so you need to consume these vitamins every day in order to maintain a full supply.

The B vitamins are also water-soluble and need to be replenished every day, although their absorption works a bit differently. They’re bound to proteins and therefore require a protein breakdown triggered by stomach acids. Absorption of most of the B vitamins happens further down in the small intestine, in the ileum.

The other type of vitamin, the fat-soluble ones such as A, D, E and K, need to dissolve in fat before they can make it into the body. The process requires fat-digesting bile acids that come from the liver and live in the small intestine. When the bile acids break down the fat the vitamins are dissolved in, the vitamins move with the fat through the intestinal wall, into the body, and finally end up in the liver and in body fat, where they’re stored until they’re needed (much like fat).

Reprinted from Discovery Health and Fitness:


  • How Does Digestion Work and How Can I Improve Mine? WHFoods.
  • Nutritional Aspects of Fish: Vitamins. BIM.
  • Vitamins and Minerals. TeensHealth.
  • Water Soluble Vitamins vs. Fat Soluble Vitamins. MedicineNet.
  • Your Digestive System and How It Works. National Digestive Diseases International Clearinghouse.

Reprinted  from August 2004.  Evelyn F. Crayton, Extension Assistant Director for Family and Community Programs, Professor, Nutrition and Food Science, Auburn University

B vitamins:

  • Help the body use energy from food.
  • Keep the nerves in good condition.
  • Keep the skin healthy.
  • Are found in a variety of foods.
  • Are water soluble.

B1 also known as thiamine:

  • Helps the nerves.
  • Helps the appetite.
  • Helps the body digest food.

Not enough thiamine in the diet will eventually lead to a condition called beriberi (inflammation and degeneration of the nervous system, the digestive system, and the heart).  Clinical signs of deficiencies include:

  • Mental confusion.
  • Anorexia (loss of appetite).
  • Muscular weakness.
  • Ataxia (uncoordinated voluntary muscle movement).
  • Peripheral paralysis.
  • Ophthalmoplegia (paralysis of the eye muscles).
  • Edema (wet beriberi).
  • Muscle wasting (dry beriberi).
  • Tachycardia (rapid heartbeat).
  • Enlarged heart.

B2 also known as riboflavin:

  • Keeps the skin healthy.
  • Keeps the eyes healthy.
  • Helps the body use protein, fat, and carbohydrates. These give you energy.

Without enough riboflavin in the diet, lesions may occur.  Clinical signs of deficiencies include:

  • Cheilosis (cracks in the corner of the mouth, scaley lips).
  • Angular stomatitis (inflammation of the mouth).
  • Scrotal and vulval skin changes.
  • Seborrheic dermatitis (oily skin problems).
  • Normocytic anemia (reduced numbers of normal red blood cells).

B6 also known as pyridoxine:

  • Helps the body use protein; assists in protein metabolism.
  • Helps the body make blood cells.

In adults, dietary deprivation of vitamin B6 may cause:

  • Depression.
  • Confusion.

B12 also known as cyanocobalamin:

  • Helps the body grow.
  • Maintains health in patients with pernicious anemia.

Dietary deficiency of B12 is rare. Clinical signs of deficiency include:

  • Sore tongue.
  • Weakness.
  • Demyelination of the spinal cord and brain and the optic and peripheral nerves (the loss of sheath tissue which normally covers the nerve fibers).


  • Keeps the skin healthy.
  • Keeps the tongue healthy.
  • Keeps the nerves in good condition.
  • Participates in many metabolic processes, including fat synthesis, tissue respiration, and the breakdown of carbohydrates to produce energy.

A niacin deficiency results in:

  • Pellagra (dermatitis, inflammation of the mucous membrane).
  • Dementia (confusion, apathy).

Folic acid:

  • Builds blood cells.
  • Works with B12
  • Prevents anemia in pregnancy
  • Makes new cells for developing babies
  • Supplements are often recommended during pregnancy

Not enough folic acid may result in

  • Anemia
  • Birth defects of the spinal cord
  • Red and sore tongue
  • Reduced sense of taste



2 thoughts on “Stress and the Gut

  1. lucy vuckovic

    I have IBD, was diagnosed a year ago. am currently taking my second lot of steroids which ive been on since before Christmas. I have had the worst craving for sugar and have put on 1-2 stone from eating far too much junk food. I haven’t had any direction from my GP about diet and supplements… I am going to suggest that I see a dietician. my iron levels are low and have been prescribed iron tablets but would rather take spatone which I believe is more natural. Do you have any advice on where I can go from here. I seriously need some advice on my diet and vitamin/mineral supplements to take.

    I have found it enormously encouraging and helpful reading this website.
    Thank you

    1. michellegallik Post author

      In addition to eating liver of all kinds and cooking on cast iron skillets, I would recommend using a Swiss company, Salas called Floravital. Here’s what their website has to say:

      Floravital contains organic iron (II) from ferrous gluconate, vitamins B2, B6, B12 and C which contribute to the reduction of tiredness and fatigue and to normal energy-yielding metabolism. In addition, iron contributes to normal red blood cell (supported by vitamins B6 and B12) and haemoglobin formation. Furthermore, vitamin C increases iron absorption.
      Floravital liquid contains iron from ferrous gluconate which is a particularly absorbable form.
      Floravital is easy to take and helps safeguard the balance of iron and vitamins B1, B2, B6, B12 and C. As these nutrients are already dissolved, they are absorbed more quickly by the digestive system


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