Why do we suffer abdominal pain after we get very angry or stress?

Why do we suffer abdominal pain after we get very angry or stress?

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You also realize probably, when we get so much anger or high levels of stress, after some point we have terrible stomach ache, like really heavy pain. Why is that? How stress or anger can effect our stomach? What is the mechanism?

Cortisol produced from the zona fasciculata of the adrenal cortex is directly caused by stress.

According to

Cortisol stimulates gastric-acid secretion. Cortisol's only direct effect on the hydrogen ion excretion of the kidneys is to stimulate the excretion of ammonium ions by deactivating the renal glutaminase enzyme. Net chloride secretion in the intestines is inversely decreased by cortisol in vitro.

This increase in gastric-acid secretion can irritate the lining of the GI tract, especially if there are ulcers or inflammation, resulting in pain. In addition, the fight-or-flight response causes

inhibition of stomach and upper-intestinal action to the point where digestion slows down or stops.


Those things, paired with increased muscle tension and vasoconstriction cause pressure changes in the GI tract, which can cause pain.

Irritable Bowel Syndrome (IBS) and Functional Bowel Disorders

Functional dyspepsia (FD) is a condition that can include pain above your belly button, bloating, and nausea (often without vomiting). This disorder has also been called “nonulcer dyspepsia” or “nervous stomach.” A feeling of fullness in the stomach can prevent people with functional dyspepsia from eating a normal meal. Pain and/or bloating for many hours after eating are also common symptoms. Unlike irritable bowel syndrome, the pain does not get better after going to the bathroom.

How stress affects your gut

If you ever suffer from tummy troubles during a stressful episode, this is because your anxiety levels are connected to your digestive system.

'There's evidence that the brain and the gut communicate with each other via numerous systems (neural, hormonal and immunological) and do not function independently,' says Dr Ashton. 'Because of this interconnected relationship it means that if one system is disturbed it will result in the other system being disturbed. In simplest terms: mental stress at work = tummy upset.'

What you need to know about typhoid

The infection is often passed on through contaminated food and drinking water, and it is more prevalent in places where handwashing is less frequent. It can also be passed on by carriers who do not know they carry the bacteria.

Annually, there are around 5,700 cases in the United States, and 75 percent of these start while traveling internationally. Globally, around 21.5 million people a year contract typhoid.

If typhoid is caught early, it can be successfully treated with antibiotics if it is not treated, typhoid can be fatal .

Share on Pinterest Typhoid is an infection caused by Salmonella typhimurium bacteria that is spread from human to human.

Typhoid is an infection caused by the bacterium Salmonella typhimurium (S. typhi).

The bacterium lives in the intestines and bloodstream of humans. It spreads between individuals by direct contact with the feces of an infected person.

No animals carry this disease, so transmission is always human to human.

If untreated, around 1 in 5 cases of typhoid can be fatal. With treatment, fewer than 4 in 100 cases are fatal.

S. typhi enters through the mouth and spends 1 to 3 weeks in the intestine. After this, it makes its way through the intestinal wall and into the bloodstream.

From the bloodstream, it spreads into other tissues and organs. The immune system of the host can do little to fight back because S. typhi can live within the host’s cells, safe from the immune system .

Typhoid is diagnosed by detecting the presence of S. typhi via blood, stool, urine, or bone marrow sample.

Symptoms normally begin between 6 and 30 days after exposure to the bacteria.

The two major symptoms of typhoid are fever and rash. Typhoid fever is particularly high, gradually increasing over several days up to 104 degrees Fahrenheit, or 39 to 40 degrees Celsius.

The rash, which does not affect every patient, consists of rose-colored spots, particularly on the neck and abdomen.

Other symptoms can include:

Rarely, symptoms might include confusion, diarrhea, and vomiting, but this is not normally severe.

In serious, untreated cases, the bowel can become perforated. This can lead to peritonitis, an infection of the tissue that lines the inside of the abdomen, which has been reported as fatal in between 5 and 62 percent of cases.

Another infection, paratyphoid, is caused by Salmonella enterica. It has similar symptoms to typhoid, but it is less likely to be fatal.

The only effective treatment for typhoid is antibiotics. The most commonly used are ciprofloxacin (for non-pregnant adults) and ceftriaxone.

Other than antibiotics, it is important to rehydrate by drinking adequate water.

In more severe cases, where the bowel has become perforated, surgery may be required.

Typhoid antibiotic resistance

As with a number of other bacterial diseases, there is currently concern about the growing resistance of antibiotics to S. typhi.

This is impacting the choice of drugs available to treat typhoid. In recent years, for example, typhoid has become resistant to trimethoprim-sulfamethoxazole and ampicillin.

Ciprofloxacin, one of the key medications for typhoid, is also experiencing similar difficulties. Some studies have found Salmonella typhimurium resistance rates to be around 35 percent.

Typhoid is caused by the bacteria S. typhi and spread through food, drinks, and drinking water that are contaminated with infected fecal matter. Washing fruit and vegetables can spread it, if contaminated water is used.

Some people are asymptomatic carriers of typhoid, meaning that they harbor the bacteria but suffer no ill effects. Others continue to harbor the bacteria after their symptoms have gone. Sometimes, the disease can appear again.

People who test positive as carriers may not be allowed to work with children or older people until medical tests show that they are clear.

Countries with less access to clean water and washing facilities typically have a higher number of typhoid cases.


Before traveling to a high-risk area, getting vaccinated against typhoid fever is recommended.

This can be achieved by oral medication or a one-off injection:

  • Oral: a live, attenuated vaccine. Consists of 4 tablets, one to be taken every second day, the last of which is taken 1 week before travel.
  • Shot, an inactivated vaccine, administered 2 weeks before travel.

Vaccines are not 100 percent effective and caution should still be exercised when eating and drinking.

Vaccination should not be started if the individual is currently ill or if they are under 6 years of age. Anyone with HIV should not take the live, oral dose.

The vaccine may have adverse effects. One in 100 people will experience a fever. After the oral vaccine, there may be gastrointestinal problems, nausea, and headache. However, severe side effects are rare with either vaccine.

There are two types of typhoid vaccine available, but a more powerful vaccine is still needed. The live, oral version of the vaccine is the strongest of the two. After 3 years, it still protects individuals from infection 73 percent of the time. However, this vaccine has more side effects.

The current vaccines are not always effective, and because typhoid is so prevalent in poorer countries, more research needs to be done to find better ways of preventing its spread.

Eliminating typhoid

Even when the symptoms of typhoid have passed, it is still possible to be carrying the bacteria.

This makes it hard to stamp out the disease, because carriers whose symptoms have finished may be less careful when washing food or interacting with others.

People traveling in Africa, South America, and Asia, and India in particular, should be vigilant.

Avoiding infection

Typhoid is spread by contact and ingestion of infected human feces. This can happen through an infected water source or when handling food.

The following are some general rules to follow when traveling to help minimize the chance of typhoid infection:

Ways to Stop the Bloating

Once the air is in your system, the best way to get it out is to try to belch or release flatulence. Holding the air in will simply lead to further pain, and that pain will likely contribute to further anxiety and discomfort. Most gas caused by hyperventilation is scentless, so embarrassment should be less severe, but gas caused by indigestion can be highly scented so finding a bathroom may be in your best interests.

There are a few over the counter medications that can reduce the feeling of bloating, especially if it's caused by indigestion. Some people find that Pepto-Bismol and other antacids provide some relief. The relief is only temporary, however, and may not affect those that experience bloating from air swallowing.

If you feel the bloating is occurring as a result of hyperventilation, you'll also need to make sure that you're not promoting further hyperventilation. While hyperventilating, the body has a tendency to want to breathe in more air, faster. Fight this feeling and try to slow down your breathing, resisting the urge to yawn a lot or breathe quickly.

Irritable Bowel Syndrome

Priyanka Chugh, MD, is board-certified gastroenterologist with a background in internal medicine. She practices with Trinity Health of New England​ in Waterbury, Connecticut.

Irritable bowel syndrome (IBS) is a functional gastrointestinal (GI) disorder. Symptoms include crampy abdominal pain, bloating, constipation, and/or diarrhea. The severity of symptoms varies from mildly annoying to debilitating.

In a person with IBS, the muscles in the colon (part of the large intestine) that move digested food along are exceptionally sensitive to certain stimuli or triggers. IBS is diagnosed based on symptoms (especially chronic abdominal pain and altered bowel habits) and an evaluation of the GI tract to rule out other diagnoses.

The causes of IBS aren’t well understood, and it’s often managed with a combination of diet and lifestyle modifications and medications. IBS is a chronic condition that can be controlled, but not cured.

Screening Tests Related to IBS

Frequently Asked Questions

The causes of IBS are complex and somewhat unknown. There may be an interplay between pain sensitivity, gut motility problems, low-grade inflammation, and gut bacteria and hormones dysfunction in brain and gut communication. IBS sometimes develops after an infection in your digestive tract or after trauma. It also tends to run in families, and research suggests that gene mutations play a role.

Doctors may recommend dietary (fiber, low-FODMAP diet) and other lifestyle changes (exercise, sleep) and therapies. There are also over-the-counter (OTC) and prescription medications that can be used to target symptoms of diarrhea, constipation, or pain. Therapies can include cognitive behavioral therapy, gut-directed hypnotherapy, and relaxation training.  

IBS is a diagnosis of exclusion. Your doctor will run blood and fecal occult tests and ask about your family and personal medical history. After ruling out infections and other digestive diseases, you may be diagnosed with one of three types of IBS based on symptoms:

Eating smaller, more frequent meals and gradually increasing fiber, especially soluble fiber (nuts, beans, fruit), can help improve symptoms in IBS.   Your doctor may suggest temporarily avoiding fatty foods and other common triggers or following a low-FODMAP diet, which eliminates hard-to-digest carbohydrates for six to eight weeks and then slowly reintroduces them.

If you are a beginner, it is best to start this way.
1. For first 15 days, just sit straight, breathe normally and observe breathing for 3 minutes. That’s all.
2. For next 15 days, Do simple Pranayama that I have explained here or do Anulom Vilom pranayam for 1 minute.
3. For next 15 days, increase this Anulom Vilom pranayam for 2 – 3 minutes based on your comfort.
4. Only after this initial preparation for 6 – 8 weeks, you can think of adding one more pranayama to your schedule.

From health and Ayurvedic perspective, I would not recommend a pranayam schedule for more than 10 minutes per day.
The purpose of Pranayam is to get the mind concentrated and to get the body still and ready for meditation.
Once you achieve this, you should move on to meditation, Japa etc.

Stress and the Digestive System

You don't need a PhD in physiology to know that stress can be hard on the stomach. We've all done our own experiments on the subject, intentionally or not. Remember how you felt the last time you spoke in public? Those butterflies weren't in your head.

The impact of stress on the stomach goes far beyond indigestion, however. In recent years, doctors have uncovered a remarkably complex connection between the brain and the digestive system. The entire system is extremely sensitive to our moods. In fact, experts now see stress as a major player in a wide range of digestive problems, including irritable bowel syndrome, indigestion, and heartburn.

People with digestive problems often scoff at the idea that stress could be at the root of their problems. To them, it sounds like "blaming the victim." Robert Sapolsky, a Stanford University stress expert and author of the best-selling book Why Zebras Don't Get Ulcers (Henry Holt and Co., 2004), says his discussion of stress and irritable bowel syndrome prompted "semi-irate" letters from readers.

But experts who study the link between stress and digestion aren't searching for people to blame. Instead, they're looking for scientific explanations for some of life's most common maladies. By understanding how stress affects our bodies, they're opening new avenues for prevention and treatment of many conditions.

We all talk about "gut feelings," but few of us really appreciate the amazingly strong connections between the brain and the digestive system. The stomach and intestines actually have more nerve cells than the entire spinal cord, leading some experts to call the digestive system a "mini brain." A highway of nerves runs directly from the real brain to the digestive system, and messages flow in two directions. Consider this: 95 percent of the body's serotonin -- a hormone that helps control mood -- is found in the digestive system, not the brain.

As Sapolsky writes in Zebras, there are sound reasons why our digestive system should pay such close attention to our brains. In times of stress, our bodies are designed to focus on the things that can help us stay alive. When our ancestors had to fight off hyenas or run away from cave bears, they didn't want to waste any energy on less important things like proper digestion.

When the brain feels severely stressed, it unleashes a cascade of hormones that can put the whole digestive system in an uproar. The hormones have different and sometimes contradictory jobs. For example, the hormone CRH (short for corticotropin-releasing hormone) is one of the body's main alarm bells. In stressful situations, the brain pumps out CRH to tell the adrenal gland to start making steroids and adrenaline, chemicals that can give you the strength and energy to run or fight your way out of trouble.

CRH also turns off appetite, which explains why some people can't eat anything when they're stressed. At the same time, the steroids triggered by CRH can make a person hungry, which is why some people fight stress with ice cream, chocolate, or potato chips.

Clearly, different people have different responses to stress, and there's no way to say for sure how specific situations will affect digestion. But there are some general rules of thumb. Over the short term, stress can cause stomach aches, nausea, and diarrhea. In the long term, prolonged stress can aggravate chronic diseases such as irritable bowel syndrome and heartburn.

From irritable bowel syndrome to ulcers

Stress is especially troubling for people who have digestive problems without any clear physical cause -- "functional gastrointestinal disorders" in medical speak. In these cases, every part of the system looks healthy and normal, but they still don't work as they should. These disorders are extremely sensitive to stress. They're also extremely common. According to a report from the University of North Carolina, roughly 25 million Americans have a functional gastrointestinal (GI) disorder.

The classic example of a functional GI disorder is irritable bowel syndrome (IBS), a very common and perplexing malady often characterized by painful cramps, bloating, and constipation alternating with diarrhea. The National Institutes of Health estimates that as many as one in five Americans has some signs of IBS.

Nobody knows how IBS gets its start, but there's no doubt that stress can worsen symptoms. For one thing, stress can make the colon contract, leading to stomach pain. It's not completely clear why people with IBS sometimes become constipated. One possibility is that stress can occasionally make the contractions uncoordinated and unproductive. Stress can also make the mind more aware of sensations in the colon, and since people with IBS may feel more discomfort due to extra-sensitive pain receptors in the gastrointestinal tract, even normal contractions can feel really unpleasant.

IBS can flare up over everyday annoyances, especially those that make a person feel tense, angry, or overwhelmed. But as reported in a 2004 issue of Psychosomatic Medicine, IBS -- like other chronic conditions -- is even more sensitive to the stress that comes from major life changes, such as a death in the family or a loss of a job.

Here's a quick look at other digestive conditions that can be aggravated by stress:

  • Indigestion. Your stomach growls, aches, or burns. Sometimes you feel bloated or nauseated, and you vomit or belch. These could all be signs of an ulcer, but millions of people without ulcers have these symptoms, too. Doctors call this "functional dyspepsia," but it's better known as indigestion. Indigestion is the second most common functional GI disorder, after IBS. As reported by the Cleveland Clinic, all of the symptoms of indigestion tend to worsen in times of stress. On the bright side, they usually fade when a person has a chance to relax.
  • Heartburn. There are many possible causes for heartburn, from overproduction of stomach acid to overindulgence in pizza. Whatever its cause, stress can definitely make heartburn worse. A study published in a 2004 issue of Psychosomatic Medicine found that heartburn sufferers who had recently gone through a major life-changing event were especially likely to develop severe symptoms within four months. Researchers speculated that stress could pump up the stomach's production of acid or make the esophagus extra sensitive to pain.
  • Ulcers. Past generations thought ulcers were a sign of stress, and they weren't far from wrong. It's now known that most ulcers are caused by a bacterial infection. Some researchers theorize that stress may help the infection take hold, perhaps by disturbing the stomach's delicate balance of hydrochloric acid and protective secretions, making it more vulnerable to ulcers. Sapolsky believes that stress is a factor in 30 to 65 percent of all ulcers, but some medical experts think the connection remains hypothetical.
  • Ulcerative colitis and Crohn's disease. These conditions -- known together as inflammatory bowel disease (IBD) -- are most definitely not caused by stress. But once the diseases take hold, a bout of stress can worsen symptoms.

Setting your mind on relief

If your digestive system isn't running smoothly, don't suffer in silence. According to a report from the University of North Carolina, as many as 80 percent of people with IBS or another functional gastrointestinal problems never discuss their symptoms with a doctor. That's unfortunate, because doctors can often prescribe medications to get the digestive system back on track. A doctor can also check for underlying diseases that might explain the symptoms.

If your doctor can't find a physical explanation for your digestive troubles, you may need to calm your mind before you can calm your stomach. Ask your doctor if you would be a good candidate for cognitive behavioral therapy, interpersonal therapy, relaxation therapy, or another form of counseling. You can do your part to battle stress by eating well, exercising regularly, and getting plenty of sleep. For more tips on stress relief, click here.

Digestive problems might be a message. Roughly translated, that message is "Live well and learn to relax." This is one time when you definitely want to listen to your gut.

Sapolsky, Robert M. Why Zebras Don't Get Ulcers.Third Edition. Henry Holt and Co. 2004.

Naliboff, B.D. et al. The effect of life stress on symptoms of heartburn. Psychosomatic Medicine. 2004. 66: 426-434.

Cleveland Clinic. Indigestion. December 22, 2009.

University of North Carolina Center for Functional GI and Motility Disorders. What are FGIDs? 2007.

National Digestive Diseases Information Clearinghouse. National Institutes of Health. Irritable bowel syndrome. September 2007.

National Digestive Diseases Information Clearinghouse. National Institutes of Health. Indigestion. November 2008.

Neuroscience, 2nd edition. Purves, Dale et al. Sinauer Associates, 2001.

Milla, P. et al. Motility disorders in childhood: Working group report of the First World Congress of Pediatric Gastroenterology, Hepatology, and Nutrition. 35:S187-S195. August 2002. Journal of Pediatric Gastroenterology and Nutrition.

American College of Physicians. New drugs -- and some respect -- for IBS. 2003.

National Women's Health Information Center. Inflammatory bowel disease. August 17, 2009.

Unhelpful ways to deal with anger

Many people express their anger in inappropriate and harmful ways, including:

    anger explosions – some people have very little control over their anger and tend to explode in rages. Raging anger may lead to physical abuse or violence. A person who doesn’t control their temper can isolate themselves from family and friends. Some people who fly into rages have low self-esteem, and use their anger as a way to manipulate others and feel powerful. For more information, see ‘ What is violence against women?

T he cancer itself often causes pain. The amount of pain you have depends on different factors, including the type of cancer, its stage (extent), other health problems you may have, and your pain threshold (tolerance for pain). People with advanced cancer are more likely to have pain.

Cancer surgery, treatments, or tests can also cause pain. You may also have pain that has nothing to do with the cancer or its treatment. Like anyone, you can get headaches, muscle strains, and other aches or pains.

Pain from the cancer itself

Pain from the cancer can be caused by a tumor pressing on nerves, bones, or organs.

Spinal cord compression: When a tumor spreads to the spine, it can press on the nerves of the spinal cord. This is called spinal cord compression. The first symptom of spinal cord compression is usually back and/or neck pain, and sometimes it is severe. Pain, numbness, or weakness may also happen in an arm or leg. Coughing, sneezing, or other movements often make the pain worse. If you have this kind of pain, it is considered an emergency and you should get help right away.

Spinal cord compression must be treated right away to keep you from losing control of your bladder or bowel or being paralyzed. If you’re treated for the compression soon after the pain begins, you can usually avoid serious outcomes. Treatment for spinal cord compression usually involves radiation therapy to the area where the tumor is pressing on the spine and steroids to shrink the tumor. Or you may be able to have surgery to remove a tumor that’s pressing on the spine, which may then be followed by radiation.

Bone pain: This type of pain can happen when cancer starts in or spreads to the bones. Treatment may be aimed at controlling the cancer, or it can focus on protecting the affected bones. External radiation may be used to treat the weakened bone. Sometimes a radioactive medicine is given that settles in the affected areas of bone to help make them stronger. Bisphosphonates are drugs that can help make weakened bones stronger and help keep the bones from breaking. These are examples of treatments that are aimed at stopping the cause of the bone pain. You may still need pain medicines, but sometimes these treatments themselves, can greatly reduce your pain.

Bone pain can also happen as a side effect of medicines known as growth factor drugs or colony-stimulating factors (CSFs). These drugs may be given to help prevent white blood cell (WBC) counts from dropping after treatment. CSF drugs help the body produce more WBCs which are made in the bone marrow. Because the bone marrow activity is higher with these drugs, bone pain may occur.

Pain from cancer surgery, treatments, and tests

Surgical pain:Surgery is often part of the treatment for cancers that grow as solid tumors. Depending on the kind of surgery you have, some amount of pain is usually expected and can last from a few days to weeks. Talk to your doctor about pain medicines you may need after surgery so you won’t be in pain when your surgery is over. You may need stronger pain medicine at first after surgery, but after a few days or so you should be able to control it with less strong medicines.

Phantom pain: Phantom pain is a longer-lasting effect of surgery, beyond the usual surgical pain. If you’ve had an arm, leg, or even a breast removed, you may still feel pain or other unusual or unpleasant feelings that seem to be coming from the absent (phantom) body part. Doctors are not sure why this happens, but phantom pain is real it’s not “all in your head.”

No single pain relief method controls phantom pain in all patients all the time. Many methods have been used to treat this type of pain, including pain medicine, physical therapy, antidepressant medicines, and transcutaneous electric nerve stimulation (TENS). If you’re having phantom pain, ask your cancer care team what can be done.

Side effects of chemotherapy and radiation treatments: Some treatment side effects cause pain. Pain can even make some people stop treatment if it’s not managed. Talk to your cancer care team about any changes you notice or any pain you have.

Here are some examples of pain caused by cancer treatment:

    . This refers to pain, burning, tingling, numbness, weakness, clumsiness, trouble walking, or unusual sensations in the hands, arms, legs, and/or feet. Peripheral neuropathy is due to nerve damage caused by certain types of chemotherapy, vitamin deficiencies, a tumor pressing on a nerve, or other health problems such as diabetes and infections. When caused by chemotherapy, it's sometimes called chemotherapy-induced peripheral neuropathy (CIPN). Some non-cancer medications can also have peripheral neuropathy as a possible side effect. Be sure to talk to your health care team about other health problems and medications you are taking, and be sure to tell your doctor right away if you notice any symptoms that you think may be from peripheral neuropathy. (stomatitis or mucositis). Chemotherapy can cause sores and pain in the mouth and throat. The pain can cause people to have trouble eating, drinking, and even talking.
  • Radiation mucositis and other radiation injuries. Pain from external radiation depends on the part of the body that’s treated. Radiation can cause skin burns, mucositis (mouth sores), and scarring – all of which can cause pain. The throat, intestine, and bladder are also prone to radiation injury, and you may have pain if these areas are treated.

Procedures and testing: Some tests used to diagnose cancer and see how well treatment is working can be painful. When you are scheduling a procedure or test, ask your health care team if pain is expected. If you need such a procedure, concern about pain should not keep you from having it done. Any pain you have during and after the procedure can be treated. You may be told that the pain from the procedure can’t be avoided or that it won’t last long. Even so, you should ask for pain medicine if you need it.

Gastrointestinal Problems

Gastrointestinal medical problems, like irritable bowel syndrome, can develop as a result of anxiety. In fact, IBS is arguably the most common form of GI difficulty directly related to anxiety, Rojas says. Having IBS can mean experiencing a number of symptoms, such as gas, abdominal pain, bloating, and constipation, she says. In addition to seeking treatment for your mental health, staying active can be an effective way to manage the condition. Look for fun ways to get your blood pumping like chasing your pup around the dog park or going roller blading with a group of friends.


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