Is Stress Causing My Abdominal Pain?

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Gastroenterologists see patients with digestive symptoms.  We also see patients who are suffering from all manners of stress and anxiety.  It can be vexing to determine if there is a causative relationship between both sets of symptoms.

It’s a chicken and egg phenomenon.  Do the stomach aches cause the stress or is it the other way around?

Even seasoned practitioners may find it difficult to unravel this conundrum.  And so do our patients. 

Why does my stomach hurt?

First, it’s true that physical complaints may have no connection to psychological distress.  I think that medical professionals at times impute a psychological basis for physical complaints either hastily or erroneously.  You can imagine how frustrating this feels to patients when physicians draw this conclusion prematurely.  Doctors need to be very mindful of treading carefully over this delicate terrain.

The mind-body connection is real and complex.  Certainly, anxiety can directly cause or contribute to a wide array of medical symptoms that cross into various medical specialties.   Every physician, for example, has seen patients with headaches, fatigue, depression, abdominal pain, chest pain, palpitations and nausea which are manifestations of stress and anxiety.  When this is the case, the healing mission is eased if the patient is open to a psychological origin.  Conversely, if a patient denies an underlying stress and anxiety origin that is truly present, then the physician’s task will be more challenging.

Recently I saw a patient suffering with nausea and vomiting. This patient volunteered that he knows that his anxiety is responsible for his digestive issues.  I think he is right and his insight creates healing pathways for him.

These are tough issues. The prospect for success is increased when doctors and patients are openminded in considering a full range of explanations for troubling symptoms. Patients are entitled to an appropriate evaluation to consider a medical diagnosis.  Just because a patient has stress and stomach aches, doesn’t mean he or she doesn’t have an ulcer.  And physicians shouldn’t on the first visit, advise a patient who is worried about chest pain to see a psychiatrist.  And when all reasonable medical diagnoses have been excluded, and there is reason to suspect that stress is the culprit, the medical professionals need to help patients open up to this view so they might achieve the relief of their suffering that they deserve.  Shouldn't this be the goal?