Is Your Gut Making You Sad? One Doctor’s Advice


The following is adapted from an interview with Dr. Jono Kealey, assistant professor of behavioral medicine at Tufts Medical Center, and author of My Stomach Problems Are All in My Head.

I have stomach problems that are so bad that I’m depressed and I don’t want to go out. I thought I had a stomach ulcer, but it turned out to be a virus. Is it really possible that there are so many different signs of various stomach issues that they come in personas?

If you think about it, the condition might give you what you need: Not great all-around health but near-perfection when it comes to the symptoms you prefer. That’s different than being in the realm of full-blown, downright debilitating illness. We need one sign, one symptom, or a collection of symptoms to classify our symptoms, and if you have that symptom, it automatically fits in with the whole set.

Most often, people with gastrointestinal problems develop one of three clusters of symptoms:

1. Lymphedema: an excess of lymph fluid around the genitals, caused by exposure to an infection such as herpes or Epstein-Barr virus.

2. Vomiting, gas, abdominal cramping, indigestion: problems where eating is more difficult.

3. Constipation: failure to hold air or refuse further food, usually caused by damage to the colon wall.

These can be caused by low iron and high estrogen, lactose intolerance, and polyps.

Vomiting is much more common than any of the other symptoms, but you can lose more weight through discomfort through the eating process than if you were even sick, but we don’t often consider it significant enough to have you in a state of depression or bring a whole different range of other health issues with it.

Lymphedema is very rare, but there are people who experience the presence of bloated breast tissue around their privates for years before ever having breast cancer.

If you’re experiencing abdominal pain or gas, think about it this way: If you have your stomach loose like that when you eat, you’re dealing with blood and organs perforating the space between the stomach and your lungs. Imagine if you had a stomach like that even once. It would be distressing on its own. A lot of people have their stomachs in a similar position because they have regular problems with heavy bleeding or constipation from damage to the lining of the colon. Think about the amount of damage to the gastrointestinal tract as if it were a pair of leg arteries; they’re there all the time.

So if you have any form of pain, you’re likely to have these issues.

You’re very likely going to have a return of your symptoms if you ignore them: You’re likely to get more fatigue, ulcers, bleeding, swallowing problems, and constipation that often last several months if you don’t take preventative measures.

You’re also going to get diarrhea, which is pretty common, and your ovaries are usually damaged by excess estrogen, so you’re more likely to end up with endometriosis.

Some people with these sorts of symptoms may end up needing to get blood transfusions. Other people may have stable things for quite a while. A lot of other health issues tend to come into play because of these symptoms and cause the situation to blow up in your face.

For example, one person called my hospital and said, “I’m having trouble eating and, if you’ll just stop talking to me, I’ll eat.” That was a response to what happened when they were really sick, and you’re dealing with what you need when you need it, so sometimes people are going to suffer for weeks or months or years, but others are going to just go through these things and, as long as they have the coping strategies for the things they need at the time, they’re going to be OK.

If you or a loved one has any questions about eating, gastrointestinal symptoms, or digestion, please email me directly at [email protected] and I’ll do my best to answer any questions I can.

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