When my mum died in 2013, I was somewhat prepared for the emotional fallout, but no one told me grief could impact my health to the point I could no longer digest food.
Within two weeks of her passing, food would lie for hours in my stomach whenever I ate, refusing to move. I tried drinking more water to help aid digestion, but all that happened was I would bloat, burp and eventually throw up.
As someone who lost her mother to gastrointestinal tract cancer, I was convinced a tumour was to blame and made an urgent GP appointment. My GP examined me, listened to my symptoms and told me it was doubtful I had a tumour.
“I think your brain and your gut just aren’t communicating. I’ve seen it before with grief and stress. You’re going to be alright, I just need to prescribe some medication until your brain and gut start speaking again,” he said.
He prescribed an antidepressant – for my stomach – and a tablet to help move food through my body. Within a week, I could eat without throwing up, and a few months later, I no longer needed pills to give my digestion a nudge.
It turns out that there are many ways that grief can affect the gut, as Dr Sarah Robbins, Gastroenterologist and Founder of Well Sunday, explains: “Grief can have an impact on the gut-brain axis, the communication network between the gut and the central nervous system.
“This can affect the enteric nervous system, the network of millions of neurons within the gut which acts as a ‘second brain’ and contributes to the regulation of digestive function.”
Dr Robbins explains five ways that grief may affect your gut and digestion.
Delayed gastric emptying
Delayed gastric emptying is when food does not move from the stomach into the intestine as quickly as it should. It is a condition that often occurs due to trauma or conditions such as diabetes, but it can also happen in times of stress.
Robbins explains, “Delayed gastric emptying occurs when the pair of nerves that connects the brainstem to the gastrointestinal tract, the vagus nerve, is damaged or does not function properly. This makes it difficult for the brain to send messages through the nervous system that ensure the muscles in the stomach work normally.”
Another factor that can affect gut motility is serotonin production. “Serotonin, produced in the gut, can regulate gastric motility and sensation, and changes in serotonin production can contribute to symptoms such as indigestion, bloating, and nausea,” Robbins said.
Delayed gastric emptying should be investigated by your GP, who can advise if medications are needed to aid digestion.
Upsetting the balance of the gut microbiome
The gut hosts a diverse community of microorganisms known as the gut microbiome. The gut microbiome produces neurotransmitters and hormones that affect the brain’s function, behaviour, and immune system.
“The gut microbiome plays an essential role in the gut-brain axis. Studies have shown that negative emotions like sadness can change the gut microbiome’s composition and diversity, reducing beneficial bacteria and increasing harmful bacteria,” Robbins explains.
“This disruption in the gut microbiome impacts the gut-brain axis, resulting in increased gut symptoms during times of grief.”
Dr Robbins recommends optimising the gut microbiome through diet, probiotics and stress reduction to help alleviate GI symptoms and promote gut health.
Loss of appetite and nausea
If you feel sick or can’t eat while grieving, know you’re not alone. When the body perceives stress, it activates the “fight or flight” response. This diverts blood flow away from the digestive system towards the muscles and organs needed for physical activity.
Unfortunately, this can reduce the production of digestive enzymes, resulting in a loss of appetite and nausea.
“Stress can also affect the regulation of hunger and hormones that indicate whether or not you feel ‘full,’ such as ghrelin and leptin, leading to changes in appetite and food intake,” Robbins said.
Robbins suggests you try a balanced diet that includes a variety of nutrient-dense foods to help manage stress, consisting of a variety of fruits, vegetables, whole grains, lean proteins, and healthy fats, which contribute to a healthy and diverse gut microbiome.
Changes in eating habits
Emotional eating is common in times of stress, and when grief feels overwhelming, sometimes food is a source of comfort.
Robbins says that emotional eating can exacerbate stomach discomfort: “Overeating and consuming foods high in calories, fat, and additives can stimulate the reward centres in the brain, leading to an intense feeling of pleasure and craving. Because these foods tend to be higher in fats, sugars, and additives, they can increase diarrhoea, bloating, and abdominal distention.”
Robbins advocates eating regular meals to help maintain normal digestive function and avoid periods of emotional eating or overeating, which may contribute to gut symptoms.
Irritable bowel syndrome
Psychological stress, such as grief, is an important factor in developing irritable bowel syndrome (IBS). Clinical research shows that IBS combines an irritable bowel and an irritable brain. You may already have IBS and find symptoms of abdominal pain, bloating, and change in bowel habits flare in times of distress due to the increase of stress hormones such as cortisol and adrenaline.
While no single medicine or diet works for IBS, Dr Robbins recommends limiting processed, sugary, high-fat foods. These “contribute directly to gut symptoms such as diarrhoea, bloating, and abdominal pain and negatively impact the gut microbiome.” She also recommends avoiding excessive caffeine and alcohol and practising mindfulness to help decrease stress.