Stress & Gastrointestinal Problems
- 1. Dr B Ravinder ReddyMBBS, MS, FRCS (Edinburgh), FRCS (Glasgow)Consultant Gastrointestinal & General SurgeonChief – Division of Clinical NutritionCare HospitalsHyderabadbravinderreddy@doctor.com
- 2. Dept.of Surgical Gastroenterology & Division of Clinical NutritionGreetings From Care Hospital, Hyderabadwww.carehospitals.com
- 4. What is stress?Is a biological termAny stimulus or fear of pain that disturbs the normal equilibrium
- 8. Any stimulus that triggers a stress responseStressor
- 9. Stressors can be… InternalExternal Thoughts
- 10. Beliefs
- 11. Attitudes
- 12. Loss
- 13. Tragedy
- 14. ChangeStressors can be… NegativePositive
- 15. Positive StressEustressThis occurs when the level of stress is high enough to motivate a person into action to get thingsaccomplished
- 16. EustressPerforming in a competition (play / sports / dance / debate)Taking a testMoving into a new place / homeGiving a presentation
- 17. Negative StressDistressOccurs when the level of stress causes the body and the mind torespond negatively
- 18. DistressFailing an examination or testLoosing money on stock marketFighting with friend or family memberDealing with separation or divorceBeing late
- 19. DistressThe commonest cause of distress amongst professionals is related to their respective work!
- 20. If work is …MeaningfulFulfillingRewarding
- 21. But work can often be…UnpredictableChallengingHardThankless
- 22. What happens when a person is stressed?Body’s Responds In An Automatic Way
- 23. Body’s Response to Stress Heart rate increases Muscles tighten Sweating increases Adrenaline increases Pupils dilate Hearing improvesFight / Flight Response
- 24. What happens if the stress continues?Body becomes extremely tired or fatigued!
- 25. Fatigue can be… PhysiologicalPhysical Simple Tiredness
- 28. Mental Fatigue
- 30. Immunologic FatigueWhy do these changes happen?
- 31. Hans Selye
- 32. Hans Selye
- 33. Hans Selye’s GAS TheoryStressCauses physiological & psychological response.These in turn induces a kind of adjustment….General Adaptation Syndrome
- 36. Effects of StressLong TermShort Term
- 37. Short Term EffectsBlood is diverted from less vital organs to more vital onesHeart rate increases to supply more blood quicklyBlood pressure increases to supply blood efficientlyRespiratory rate increases to get more oxygen from the atmosphere
- 38. Short Term EffectsGlycogen in liver & muscles is converted to provide more glucoseEven more glucose is formed from non- carbohydrate substances, like proteins
- 39. How does this acute stress manifest?
- 40. Acute Stress: Signs & SymptomsCold skin + gooseflesh, flushing of skin and feeling of warmthBreathlessness & dry mouthDifficulty in speaking, swallowingAbdominal discomfort + stomach ulcersLoose stools
- 41. Acute Stress: Signs & SymptomsIncreased blood glucose levelsReduced energy storesHeadache, back ache & neck painIncrease in diseases like eczema, psoriasis, arthritisDifficulty in concentrating & memory disturbances
- 42. Acute Stress: Signs & SymptomsSleeplessnessLoss of appetiteDecreased sexual driveAnxiety & DepressionOutbursts of anger
- 43. Long Term EffectsPersistent StressSecretion of Stress HormonesBody Experiences Extra StressDue to High Levels of HormonesIrreversible Physiological Damages
- 44. Chronic Stress – Signs & SymptomsChronic head ache & mood swingsAnxiety & memory disturbancesIncreased heart attacks & strokes because of increased blood pressure, sugar & cholesterolSubstance abuseSleeplessness
- 45. Chronic Stress – Signs & SymptomsWeight lossIncrease in allergies including asthmaIrritable bowel diseaseInflammatory bowel disease Decreased sexual drive
- 46. Brain & GIT are highly inter-relatedGastrointestinal symptoms are very common
- 47. Effect of StressStress & Gastro Intestinal Tract
- 48. Stress & Gastrointestinal TractDigestion is disturbedStomach emptying is delayedLarge intestine empties faster (IBS)
- 49. Stress & Gastrointestinal TractIncreased incidence of ulcersIncreased incidence of constipation and associated fissures & hemorrhoidsIncreased incidence of various cancers
- 50. Management of StressSelf HelpPRAISES
- 51. PRAISESP: Physical exercise (Time spent meeting the basic physicalneeds and self care / health care activities)R: Recreational activities (Time spent in the pursuitof 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)
- 52. PRAISESI: Intellectual time spent expanding or engaging the mind by means of direct or indirect learning activitiesS: Spiritual efforts made to connect with anything larger than the individual or family (eg, religion, community)
- 53. PRAISESE: Employment time devoted to the pursuit of financial goalsS: Social time spent with others (eg, parenting, friends, associations)