Stress and Gastrointestinal Motility in Humans: A Review of the Literature

Abstract

Clinical observations and uncontrolled single case experiments have suggested an effect of psychological stress on gastrointestinal motility. These observations encouraged a large number of experimental studies focusing on the influence of psychological stress on gastrointestinal motility. These controlled studies have shown that different kinds of stressors increase esophageal motor activity and induce secondary (nonpropulsive) esophageal contractions. Cold pressor test and transcutaneous electrical stimulation inhibited gastric emptying, auditory feedback and performance tasks inhibited the occurrence of interdigestive migrating motor complexes, and a noise stressor increased intestinal transit time. Furthermore, psychological stress (psychological stress interview, frustrating cognitive tasks, and anger) and physical stress (cold pressor test) stimulated large‐bowel contractions and electrical spiking activity. The present studies give some evidence that patients with functional motility disorders respond differently to stressors as compared to healthy controls. In spite of these findings with short‐acting stressors, there is no proof that stress has an effect on the manifestation of functional motility disorders. Nevertheless, this does not allow the conclusion that stress does not play any role in the manifestation of motility‐related gastrointestinal disorders. In particular, there are no studies on the action of chronic stress on gastrointestinal motility. Thus further research is needed to elucidate the influence of stress, especially of chronic stress, on gastrointestinal motility.