Effects of occupational stress on the gastrointestinal tract

Abstract

The aim of this review is to provide a general overview of the relationship between occupational stress and gastrointestinal alterations. The International Labour Organization suggests occupational health includes psychological aspects to achieve mental well-being. However, the definition of health risks for an occupation includes biological, chemical, physical and ergonomic factors but does not address psychological stress or other affective disorders. Nevertheless, multiple investigations have studied occupational stress and its physiological consequences, focusing on specific risk groups and occupations considered stressful. Among the physiological effects of stress, gastrointestinal tract (GIT) alterations are highly prevalent. The relationship between occupational stress and GIT diseases is evident in everyday clinical practice; however, the usual strategy is to attack the effects but not the root of the problem. That is, in clinics, occupational stress is recognized as a source of GIT problems, but employers do not ascribe it enough importance as a risk factor, in general, and for gastrointestinal health, in particular. The identification, stratification, measurement and evaluation of stress and its associated corrective strategies, particularly for occupational stress, are important topics to address in the near future to establish the basis for considering stress as an important risk factor in occupational health.

Keywords: Stress, Occupation, Gastric alterations, Gastrointestinal tract diseases, Health risks

Core tip: In workers, the combination of personality patterns (anxiety/depression), stress and negative emotions contribute to gastrointestinal tract (GIT) alterations. In particular, jobs that produce privation, fatigue, chronic mental anxiety and a long past history of tension, frustration, resentment, psychological disturbance or emotional conflict have been shown to produce gastric ulcers. Irritable bowel syndrome and functional dyspepsia also have significant co-morbidity with mood alterations. Workers with unipolar depression have been shown to be more prone to present irritable bowel syndrome-like symptoms. Moreover, three systems are known to participate in the GIT alterations of workers: sympathetic autonomic nervous system, the hypothalamic-pituitary-adrenal axis and genetic factors.