Imagine, your stomach, which was once your steadfast companion in everyday life, suddenly turns against you. Bloating, cramps and unexpected bathroom breaks become your companions. In such moments, clarity is sought, answers are needed and a guide is welcomed with open arms.

India Today spoke to gastrointestinal surgeon Dr Saroj Dubey to find out more about the solution to this problem.

So, what are the elusive solutions? First and foremost, it is important to understand the symptoms. Stress-induced gastritis and IBS often masquerade as other conditions, confusing even the most seasoned health enthusiasts.

Dr Dubey said, “Stress-induced IBS, indigestion and gastritis usually cause symptoms like change in bowel habits, persistent abdominal pain, flatulence, hyperacidity, anorexia, etc. The patient will constantly feel some kind of discomfort in the stomach. It is difficult for the patient to differentiate between the symptoms. The doctor will have to get all the relevant tests done. If all the tests are normal and still the patient has unexplained symptoms and is not responding to medications, the treating doctor will consider stress and anxiety as the cause of the symptoms.”

But wait, there’s more to it. It’s not just about understanding the symptoms; it’s about tackling the root cause, stress being the main culprit. Gastrointestinal warriors are not alone in this battle; they are equipped with strategies to deal with stress, from mindfulness techniques to customized diet advice. After all, a happy gut is resilient, ready to face any challenge life throws at it.

Dr Saroj Dubey told us that stress can affect the gastrointestinal system. Whether it is professional stress or personal stress and anxiety, it can equally affect the gut. Overthinking, anxiety, depression, excessive rumination, and feelings of lack or rejection all send signals through the brain gut axis. Another problem nowadays is excessive googling about symptoms on the internet, which causes panic and anxiety. Students are often affected due to the pressure of studies, and during exam time we see a rise in cases of gastritis, stomach pain, unexplained vomiting, etc.

And what about the culinary front line? This guide doesn’t shy away from the topic. It offers specific dietary recommendations, carefully crafted to soothe a stressed stomach and support overall gut health. Because what we put on our plate matters, especially when the digestive system is at risk.

Dr. Dube said, “In dietary recommendations, many patients are intolerant to milk or dietary products, and some may show intolerance to wheat, etc. Depending on this, we may need to restrict certain foods. Some specific diets are sometimes helpful, such as a low FODMAP diet – limiting certain fermentable oligosaccharides, disaccharides, etc.”

But perhaps most importantly, mental health is not sidelined in this story. In the case of gastro-related illnesses, addressing stress and anxiety is of paramount importance. The guide explains how mental health support is integrated into treatment plans, working alongside healthcare professionals to ensure holistic care for every warrior.

Dr. Saroj Dubey said, “There is a very close connection between our mind, thoughts, stress and our gastrointestinal system through the brain-gut axis. Stress and anxiety affect our gut flora and gut microbiota, changes in this gut flora lead to gastrointestinal diseases. There is a constant communication between the brain and gut through neurotransmitters and messengers. Stress also alters gut motility and causes inflammation which plays a key role in diseases like IBS, dyspepsia, gastritis, etc.”

He also said that mental health check-ups are also important in cases of anxiety, depression, etc. Apart from advising lifestyle measures and meditation, etc., we may also have to refer patients to trained psychologists, counsellors and psychiatrists. We tell them that along with the medicines prescribed by us, they have to follow the advice of the psychiatrist as well.

Dr Saroj Dubey also told us that recently there has been a lot of interest in the brain-gut axis, and understanding how the mind and gut influence each other. This has brought a lot of hope regarding treatment options. Also, a lot of research has been done on gut microbiota and research on this will shed more light on how gut bacteria and flora can be altered to improve gut-related problems.

Stress Management Techniques:

Dr Saroj Dubey told us that among the stress management techniques that patients have found useful are practising mindfulness and meditation. Most anxiety and stress is caused by thoughts and worries about the future or the past, and stress related to thinking about the worst-case scenario or disaster. When we are more mindful and present, we train ourselves to live in the moment, and this helps reduce stress and anxiety. Any form of meditation that is simple and accessible such as breathing meditation is very useful as it calms the mind, activates the vagal tone or parasympathetic system and helps achieve a sense of peace and stability

Talking about the evaluation process, he said that initially they thoroughly evaluate all patients with gastro symptoms with blood tests, ultrasound, abdominal CT scan if needed, endoscopy, colonoscopy, etc. If these reports are within normal limits and the patient is still not responding to medical treatment, they consider the possibility of stress and anxiety. In some, it may be obvious, while for many it may be at a subconscious level. Initially, they explain to patients that anxiety is the problem, and if they make lifestyle changes it will help. But even after that, if it does not improve, we start giving patients anti-anxiety or even anti-depressants, which often start working immediately.

Finding joy and strength:

Dr Saroj Dubey told us that the principles she discusses and mentions in her book ‘Rx for Resilience’, including mindfulness, acceptance, and embracing the present moment, are applicable to any challenging situation, and also to patients with chronic illnesses.

Dr. Dube said, “Patients are often stressed because they start worrying about future problems or issues, leaving the present moment. Another important factor is that patients waste a lot of energy in denial and resistance. They are mostly in a state of denial and resistance, which further aggravates the problem. When we fully accept the situation, we can use all our energy and resources in healing and getting better.”

“There are many such situations. A patient whose brother had earlier died of liver complications started having gastro-problems like vomiting, abdominal pain, weight loss and severe acidity. All the tests including endoscopy, CT scan, etc. were normal. I explained to the patient that she was probably constantly thinking about her brother’s illness and imagining that something similar could happen to her. I explained that if she was more present and mindful, she would soon respond better to the medication. I also sent her for counselling. After a month, the patient’s medication led to weight gain and she had to stop the medication. She told me that her brother’s death made her think the worst and she started worrying about what would happen to her children and family if she too suffered from such complications. There are many other such instances where staying in a state of acceptance and non-resistance has helped patients recover faster”, Dr Dubey told us.

This digestible guide is not just a survival kit, it’s a steadfast companion in the search for relief. Armed with knowledge, fortified with practical tips, and buoyed by a splash of humor, it encourages you to face each day with resilience and optimism.

So, don’t be afraid of the complexities of your digestive system. Embrace this journey, and be equipped with the tools you need to navigate it with grace and determination. Together, we move forward as a community of warriors, united in the pursuit of digestive health and living a life well lived.