A digestible guide for gastrointestinal warriors to find solutions for symptoms

Imagine, your stomach, once a steadfast ally in the daily grind, suddenly turns against you. The familiar discomforts of bloating, cramps, and unpredictable bathroom visits become constant companions. In such moments, clarity is sought, answers are needed, and a guide is welcomed with open arms.

India Today spoke with Dr Saroj Dubey, a gastrointestinal surgeon, to get a closer look at the solutions to this problem.

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

"Stress-induced IBS , Dyspepsia and gastritis usually cause symptoms like change in bowel habits, constant abdominal pain, bloating, hyperacidity, anorexia etc. The pts will constantly feel some kind of abdominal discomfort. It is difficult for the patient to differentiate between symptoms. The doctor has to get all relevant tests done. If all tests are normal and yet the patient has unexplained symptoms and is not responding to medications, the treating doctor will evaluate for stress and anxiety is the cause of the symptoms", said Dr Dubey

But wait, there's more. It's not just about decoding symptoms; it's about tackling the root causes, stress being a chief culprit. Gastrointestinal warriors are not alone in this battle; they are armed with strategies to combat stress, from mindfulness techniques to tailored dietary advice. After all, a happy gut is resilient, ready to face whatever life throws its way.

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 a feeling of lack or rejection all send signals through the brain's gut axis. Another problem nowadays is excessive googling of symptoms on the internet, which causes panic and anxiety. Students are often affected due to the pressure of studies, and during exam times we see a surge in cases of gastritis, abdominal pain, unexplained vomiting etc.

And what of the culinary frontlines? This guide doesn't shy away from the topic. It serves up specific dietary recommendations, carefully curated to soothe stressed stomachs and support overall gut health. Because what we put on our plates matters, especially when the digestive system is under siege.

"Amongst dietary recommendations, many patients are intolerant to milk or dietary products, and some may show intolerance to wheat etc. Depending on that, we may need to restrict certain food items. Certain specific diets are sometimes helpful, like the low FODMAP diet-limiting certain fermentable oligosaccharides, disaccharides etc", said Dr Dubey.

But perhaps most importantly, mental health isn't sidelined in this narrative. In the realm of gastro-related illnesses, addressing stress and anxiety is paramount. The guide outlines how mental health support is seamlessly integrated into treatment plans, collaborating with healthcare professionals to ensure holistic care for every warrior.

A digestible guide for gastrointestinal warriors to find solutions for symptoms

"There is a very close connection between our minds, thoughts, stress and our gastrointestinal system through the Brain-Gut axis. Stress and anxiety affect our gut flora and gut microbiota, alteration of this gut flora causes gastrointestinal diseases. There is constant communication between the brain and gut through neurotransmitters and messengers. Stress also alters gut motility and causes inflammation which plays an important part in diseases like IBS, Dyspepsia, Gastritis etc", said Dr Saroj Dubey.

He also said that mental health workups are also important in cases with overt anxiety, depression etc. Apart from advising lifestyle measures and advocating meditation etc, we may also need to refer the patients to trained psychologists, counsellors and psychiatrists. We tell them that along with the medications we prescribe, they also need to follow what the psychiatrist advises.

Dr Saroj Dubey also told us that there has been a lot of recent interest in the Brain-Gut axis, and understanding how the mind and gut influence each other. This promises a lot of hope regarding treatment options. Also, the gut microbiota has been under a lot of research and research on this will throw more light on how gut bacteria and flora can be altered to improve the gut-related issues.

STRESS MANAGEMENT TECHNIQUES:

Dr Saroj Dubey told us that among the stress management techniques which patients have found useful are practising mindfulness and meditation. Most anxiety and stress is caused due to future or past thoughts and worries, and stress regarding thinking about the worst-case scenario or catastrophising. When we become more mindful and present, we train ourselves to be at this moment, and that helps in alleviating stress and anxiety. Any form of meditation which is simple and accessible like breathing meditation is very useful as it calms the mind, activates the vagal tone or parasympathetic system and helps in achieving a sense of peace and calmness

About the evaluation process, he said that initially, they evaluate all patients with gastro symptoms thoroughly with blood investigations, ultrasound, Ct scan abdomen if needed, endoscopy, colonoscopy etc. If these reports are within normal range and the patient is still not responding to medical treatment, then they consider the possibility of stress and anxiety. In some, it may be obvious, while for many it may be occurring at a subconscious level. Initially, they explain to the pts that anxiety is the problem, and if they make lifestyle changes it will help. But even after that, if it doesn't improve, then we start pts on antianxiety or even anti depressants, which often start working immediately.

FINDING JOY AND STRENGTH:

Dr Saroj Dubey told us that the principles that he discussed and outlined in her book 'Rx for Resilience' about mindfulness, acceptance and embracing the present moment apply to any challenging situation, and also to pts who have any chronic disease.

"The patients are often stressed because they leave the present moment and start worrying about future problems or issues. Another important factor is that pts waste a lot of energy in non-acceptance and resistance. They are mostly in a state of denial and resistance, which aggravates the issue. When we completely embrace the situation, we can use all our energy and resources in healing and getting better", said Dr Dubey

"There are many situations. A patient whose brother had died of liver complications in the past started facing gastro-issues 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 like that may also happen to her. I explained that lf she remained more present and mindful, she would soon respond better to the medicine. I also sent her to counselling. After a month, the patient's medicine gained weight and was off medicine. She told me that her brother's death made her start imagining the worst, and she was worried about what would happen to her children and family if she too developed complications like that. There are many other examples where being in a state of acceptance and non-resistance have helped in swift recovery of the patients", Dr Dubey told us.

This digestible guide isn't just a survival kit, it's a steadfast companion in the quest for relief. Armed with knowledge, fortified with practical tips, and buoyed by a sprinkle of humour, it emboldens you to face each day with resilience and optimism.

Dr Saroj Dubey

So, fear not the twists and turns of your digestive saga. Embrace the journey, armed with the tools to navigate it with grace and fortitude. Together, we forge ahead as a community of warriors, united in the pursuit of digestive wellness and a life well-lived.