Thursday, July 23, 2009

Stressed enough for hissy fits

Reducing stomach problems and wind may be a case of mind over matter

Eveline Gan

It's mid-week and your work is piling up. As your deadlines approach and you begin to panic, you may feel an increased urge to belch or break wind.

When a person is stressed, it is not unusual for him or her to have physical ailments as well, said Dr Tay Woo Kheng, a senior consultant psychiatrist at Changi General Hospital.

"The brain is connected to other parts of the body through a set of nerves. So what happens to the brain will also affect the body," he explained.

Dr Tay added about 60 to 70 per cent of his patients who are stressed and anxious say they also have physical discomforts such as heart palpitations, giddiness, difficulty in breathing, and muscle aches and pains.

Likewise, extreme stress can wreck havoc on a person's gastrointestinal tract, triggering a host of symptoms such as excessive flatus, bloatedness, intense stomach cramps, constipation or diarrhoea, said Dr Kong San Choon, a consultant at Singapore General Hospital's department of gastroenterology and hepatology.

An expert on functional bowel disorders, Dr Kong said that the conditions, chronic abdominal troubles that have no serious underlying medical cause, afflict as much as 10 per cent of the local population. Three quarters of sufferers are women.

The exact cause is unknown but stress is one of the major triggers. One explanation is that stress affects a person's eating habits and lifestyle.

"A highly-stressed individual may not make the best dietary choices. Some diets can result in a person having more gas," Dr Kong explained.

Gas-producing foods include carbonated drinks, alcohol, beans, cabbage, onions, broccoli and those that contain insoluble fibre such as bran.

Stressed individuals are also likely to rush through their meal. "They end up swallowing not only food, but air too, A person who eats very quickly also tends to overeat because he doesn't allow the brain to register that he has eaten. All these lead to bloating and excessive gas build up," explained Dr Kong.

While non-life threatening, the problem is embarrassing and uncomfortable. For some sufferers - such as 45-year old Leticia - it can even be "debilitating".

For three years, the healthcare assistant suffered from chronic stomach pains, excessive gas and constipation because of a functional bowel disorder.

"A lot of the time, the stomach pains were so intense that I could not concentrate at work," she said.

"The frustrating part is that doctors couldn't really pin-point the cause even after I'd gone for medical examination and tests," said Leticia, who noted that the problem got worse when she was worried about her ill mother.

Her condition improved after she learned how to manage stress. It's now under control.

Ironically, the more sufferers are stressed by their physical symptoms, the worse their condition becomes.

"When they have abdominal pain or changes in their bowel habits, they worry excessively about the symptoms. Thus, they become more stressed and experience even more stress-related physical symptoms, leading to a vicious cycle," said Dr Tay.

That said, if the problems are affecting your daily routine, it is good to see a doctor to rule out the possibility of a serious medical condition, said Dr Kong.


Dr Kong San Choon, a consultant at Singapore General Hospital's department of gastroenterology and hepatology, recommended keeping a food and lifestyle diary for two weeks to see what triggers the bowel disorders.

Although anti-spasmodic medication can relieve abdominal discomfort, Dr Kong said some natural ingredients may also help.

He recommended that adding more soluble fibre such as oats to one's diet will help to maintain healthy bowel movements. In addition, peppermint tea and oil, known for their muscle relaxant properties, can ease abdominal cramps.

To help maintain a healthy digestive system, Dr Kong recommended the consumption of probiotics, or foods that contain beneficial bacteria similar to those found in the body.

"But you'll have to take them with food on a daily basis for at least two to four weeks to see an effect," he said.

Dr Tay Woo Kheng, senior consultant psychiatrist at Changi General Hospital, added that learning to manage stress through relaxation exercises and lifestyle changes can help to reduce the severity of symptoms.

Did you know?
Dr Kong sheds some light on flatulence.

  • It is normal for an average adult to break wind up to 20 times a day.
  • While all flatulence smell, some smell worse than others. This is especially if you consume a lot of eggs — which contain sulphur — or naturally strong-smelling foods such as belachan or durian.
  • There's no harm in holding in flatulence, but Dr Kong warned that the longer you hold it in, the louder it will sound when it is released. He said: "Each time you hold in the gas, intra-abdominal pressure increases. At some point, you may just involuntarily break wind."

From TODAY, Health – Tuesday, 21-Jul-2009
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