Upload
bravinderreddy
View
301
Download
4
Tags:
Embed Size (px)
DESCRIPTION
An overview of stress response and its effects on the gastrointestinal systemDr B Ravinder ReddyCare Hospital, Hyderabad
Citation preview
Dr B Ravinder Reddy
Consultant Gastrointestinal & General Surgeon
Chief – Division of Clinical Nutrition
Care Hospitals
Hyderabad
MBBS, MS, FRCS (Edinburgh), FRCS (Glasgow)
Greetings From Care Hospital, Hyderabadwww.carehospitals.com
Dept.of Surgical Gastroenterology & Division of Clinical Nutrition
Stress
Gastrointestinal Tract
What is stress?
Is a biological term
Any stimulus or fear of pain that disturbs the normal equilibrium
Stimulus can be…
Physical
Stimulus can be…
Mental
Stimulus can be…
Emotional
Any stimulus that triggers a stress response
Stressor
Stressors can be…
Internal
External Thoughts
Beliefs Attitudes
Loss Tragedy Change
Stressors can be…
Positive
Negative
Positive Stress
EustressThis occurs when the level of stress is high enough to motivate a person into action to get things accomplished
Eustress
• Performing in a competition (play / sports / dance / debate)
• Taking a test• Moving into a new place / home• Giving a presentation
Negative Stress
DistressOccurs when the level of stress causes the body and the mind to respond negatively
Distress
• Failing an examination or test• Loosing money on stock market• Fighting with friend or family
member• Dealing with separation or divorce• Being late
Distress
The commonest cause of distress amongst professionals is related to their respective work!
If work is …
FulfillingMeaningful Rewarding
But work can often be…
ChallengingUnpredictable Hard
Thankless
What happens when a person is stressed?
Body’s Responds In An Automatic Way
Body’s Response to Stress
• Heart rate increases• Muscles tighten• Sweating increases• Adrenaline increases• Pupils dilate• Hearing improves
Fight / Flight Response
What happens if the stress continues?
Body becomes extremely tired or fatigued!
Fatigue can be…
Physical
Physiological Simple Tiredness Extreme Tiredness Chronic Tiredness
Mental Fatigue Metabolic Fatigue Immunologic Fatigue
Why do these changes happen?
Hans Selye’s GAS Theory
Causes physiological & psychological response.
Stress
These in turn induces a kind of adjustment….
General Adaptation Syndrome
General Adaptation Syndrome
Stress
Adaptation
Resistance
General Adaptation Syndrome
Stress
Exhaustion
Resistance
Disease
Effects of Stress
Short Term Long Term
Short Term Effects
• Blood is diverted from less vital organs to more vital ones
• Heart rate increases to supply more blood quickly
• Blood pressure increases to supply blood efficiently
• Respiratory rate increases to get more oxygen from the atmosphere
Short Term Effects
• Glycogen in liver & muscles is converted to provide more glucose
• Even more glucose is formed from non- carbohydrate substances, like proteins
How does this acute stress manifest?
Acute Stress: Signs & Symptoms
• Cold skin + gooseflesh, flushing of skin and feeling of warmth
• Breathlessness & dry mouth
• Difficulty in speaking, swallowing
• Abdominal discomfort + stomach ulcers• Loose stools
Acute Stress: Signs & Symptoms
• Increased blood glucose levels• Reduced energy stores
• Headache, back ache & neck pain• Increase in diseases like eczema,
psoriasis, arthritis
• Difficulty in concentrating & memory disturbances
Acute Stress: Signs & Symptoms
• Sleeplessness• Loss of appetite
• Decreased sexual drive
• Anxiety & Depression• Outbursts of anger
Long Term Effects Persistent Stress
Secretion of Stress Hormones
Body Experiences Extra StressDue to High Levels of Hormones
Irreversible Physiological Damages
Chronic Stress – Signs & Symptoms
• Chronic head ache & mood swings• Anxiety & memory disturbances
• Increased heart attacks & strokes because of increased blood pressure, sugar & cholesterol
• Substance abuse• Sleeplessness
Chronic Stress – Signs & Symptoms
• Weight loss
• Increase in allergies including asthma
• Irritable bowel disease• Inflammatory bowel disease
• Decreased sexual drive
Brain & GIT are highly inter-related
Gastrointestinal symptoms are very common
Effect of Stress
Stress & Gastro Intestinal Tract
Stress & Gastrointestinal Tract
• Digestion is disturbed
• Stomach emptying is delayed
• Large intestine empties faster (IBS)
Stress & Gastrointestinal Tract
• Increased incidence of ulcers
• Increased incidence of constipation and associated fissures & hemorrhoids
• Increased incidence of various cancers
Management of Stress
PRAISES
Self Help
PRAISES
P: Physical exercise (Time spent meeting the basic physical needs and self care / health care activities)R: Recreational activities (Time spent in the pursuit of fun or relaxation)A: Artistic activities (Time engaging in creative pursuits, or enjoying the creativity of others (eg, listening to music, drawing, going to movies / plays)
PRAISES
I: Intellectual time spent expanding or
engaging the mind by means of direct or
indirect learning activities
S: Spiritual efforts made to connect with
anything larger than the individual or family
(eg, religion, community)
PRAISES
E: Employment time devoted to the pursuit of financial goals
S: Social time spent with others
(eg, parenting, friends, associations)
Positive Attitude Helps
Same Positive Attitude…