Photo Credit: InspirationGP

Understanding the multiple causes of holiday-related digestive health issues is essential to clinicians in helping patients maintain overall well-being.

The holiday season often involves gatherings, gifts, and dietary indulgence. However, changes in diet and increased stress and anxiety can disrupt even the healthiest digestive systems. For individuals with digestive disorders such as irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), functional dyspepsia, and gastroesophageal reflux disease (GERD), symptoms frequently worsen during the holidays, according to the Gastrointestinal Society & Canadian Society of Intestinal Research. Understanding the causes of digestive health issues during the holidays is essential to maintaining overall well-being. 

Seasonal Stress 

In a 2023 American Psychological Association poll, 89% of U.S. adults reported holiday-related stress caused by time constraints, financial pressures, gift-giving, and family gatherings. 

“Stress can disrupt communication between the brain and the gut, and gastrointestinal conditions themselves can be stressful,” said gastrointestinal psychologist Kathryn N. Tomasino, PhD. Specifically, stress triggers the release of cortisol, adrenaline, and norepinephrine, which can slow digestion and disrupt gut flora balance. This can lead to indigestion, heartburn, and irritable bowel syndrome with abdominal pain, bloating, excessive gas, diarrhea, or constipation. In severe cases, stress may cause inflammation in the gastrointestinal tract, potentially harming the stomach lining and leading to ulcers or GERD.¹

For their patients, GI Associates recommends an integrated approach to holiday stress management encompassing mental, physical, and dietary aspects: 

• Planning ahead to avoid last-minute rushing; 
• Setting realistic holiday expectations; 
• Maintaining a healthy diet and regular exercise routine; 
• Getting seven to nine hours of quality sleep per night; 
• Practicing mindfulness techniques; 
• Taking time for self-care; and 
• Seeking professional help if needed. 

Increased Anxiety 

For patients who regularly experience anxiety, the holiday season brings an increased risk for anxiety-related digestive health issues. 

“There’s a direct relationship between your brain, your mind, your level of anxiety, depression, and general state of well-being and how your gut functions,” said Northwestern Medicine Chief of Gastroenterology and Hepatology John E. Pandolfino, MD. 

The National Alliance on Mental Illness reported that 64% of individuals with mental health conditions experience worsened symptoms, such as anxiety, during the holidays. Anxiety has been shown to disrupt gut bacteria balance and lead to dysbiosis, which is associated with IBS and IBD.²  

Studies also indicate that individuals with generalized anxiety disorder (GAD) exhibit reduced microbial richness and diversity compared to healthy controls, exacerbating digestive issues.³     

Consequently, patients with GAD face an even higher risk for digestive issues during the holiday period.  

Addressing increased patient anxiety is essential to assisting patients with anxiety in maintaining their digestive health during the holiday season. 

Holiday Diet Challenges 

The holiday season often negatively impacts dietary habits, leading to digestive distress: 

• Excess alcohol: Alcohol exacerbates reflux and indigestion and increases dehydration risk due to its diuretic effect. 
• Heavy foods: High-calorie meals slow digestion, leading to reflux, bloating, and sluggish bowels. 
• Decreased fiber: Traditional holiday foods tend to lack dietary fiber, causing constipation and abdominal discomfort. 
• Excessive portions: Overeating distends the stomach, increasing reflux, bloating, and discomfort. 

To counteract these challenges, clinicians should remind patients to: 

• Limit alcohol intake; 
• Stay hydrated; 
• Maintain a balanced diet rich in fiber; 
• Avoid overeating; and 
• Stay active. 

The holiday season should be a time of joy and celebration. Maintaining digestive health through stress management, anxiety reduction, and healthy dietary choices can help ensure a happy and comfortable holiday season. 

To learn more about holiday-related health issues, click here.