When Nerves Go Straight to Your Gut — The Stomach Slows and the Bowel Hurries

"I always get stomach ache before an exam."
"Give a presentation and I'm looking for a toilet."

People who say this hear one thing often. "Aren't you a bit sensitive?"

But listen further and something odd turns up. It feels stuffed, like food is stuck — and yet down below it is urgent. Sounds contradictory.

It isn't. In the body it happens exactly like that.

Tense up and digestion goes to the back of the queue

Tense up and the body does the urgent jobs first. Heart faster, blood to the muscles, eyes wide.

Digestion isn't urgent at a moment like that. So it goes to the back. Blood and signal to the stomach drop, and the stomach slows.

That is where the stuffed feeling comes from. It genuinely isn't going down. Nothing is wrong with what you ate — the stomach has been outranked.

But the bowel goes the other way

Here is the interesting part.

Tense up and the brain releases a signalling substance. That signal slows the stomach. And the same signal does the opposite in the large bowel. It steps its movement up.

So you get this combination.

The stomach slows and the bowel hurries.

That is what "it feels stuck but the toilet is urgent" actually is. Two places moving in opposite directions. Every time I see it I think how neatly the body is made — it means drop the load and run. In earlier times that was how you survived.

Except our tension doesn't end in seconds any more. The meeting runs an hour, and there's one every week.

And the gut answers back

It doesn't only run one way.

There are far more nerves going up from gut to brain than down from brain to gut. When the gut is uncomfortable that signal goes up, and the body reads it as tension again. Then the gut is uncomfortable again.

The loop closes. So "tense, therefore stomach ache" gets mixed, over time, with "stomach ache, therefore tense." Even the person can't say which came first.

So in the consulting room

I don't just use stomach medicine. The stomach isn't broken.

I look at where in the loop to slow things. Sometimes sleep, sometimes years of tension, sometimes the gut itself is raw and keeps sending signals up. (Immunity is decided in the gut)

Settling the gut becomes settling the tension. And the reverse. It's a loop, so you can take either side. What you do have to look at is which side is easier for this person.

That said, if you're losing weight, or there's blood, or pain wakes you at night, the order is different. Then tests come first.

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Stomach ache when you're nervous isn't sensitivity.

It is the stomach and the bowel moving in opposite directions — and that is the body made well, not badly. It's just that our tension runs too long now.

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Written by Dr. Heo Ji-young (PhD in Korean Medicine Pathology, Kyung Hee University · former Research Professor of Herbology, Kyung Hee University)