Work Culture is Making Americans Sick in the Stomach 

As a gastroenterologist, I see all types of disorders of the gut. From diarrhea to vomiting and everything in between, my patients often suffer from symptoms and conditions that seem inescapable and never-ending because they are so physically exhausting. 

Yet, remarkably few of these are caused by actual structural issues within the digestive system. Many of the most common digestive health symptoms are a result of environmental conditions and triggers like our diet, lifestyles and stress levels. Increasingly, I’m seeing more and more patients in my practice with distressing physical symptoms that are a direct result of work-related anxiety and stress. 

The reality is that many companies are unwittingly creating a vicious cycle whereby demands on their workers are producing illness that eventually comes back to harm their own bottom line in the form of medical costs or lost productivity. We need to rethink corporate cultures in America because it is literally eating us from the inside out. 

Mind-Gut Axis

The connection between mental health and digestive health issues is well-documented. A recent study on an animal model published on Nature.com hints that this link might be tied to the gut microbiome, which it found can be reshaped by periods of chronic stress and lose its ability to fight off pathogens. When this happens, people can experience debilitating symptoms ranging from constipation to diarrhea, bloating and gas. 

This also works in reverse as digestive health issues wear on patients, leading to exhaustion, mental health strain, and lower productivity, putting patients in a vicious cycle that is hard to break. Research published in The American Journal of Gastroenterology looked at 36 separate studies on gastroesophageal reflux disease (GERD) to assess any correlation with psychiatric conditions. By compiling the results, it found that up to one out of every three patients with GERD experience anxiety and depression – meaning that there is likely a direct relationship between this digestive condition and mental health.  

Work-Related Anxiety and Stress on the Rise 

Similarly, the growing levels of anxiety and stress on the job are undeniable. A 2021 survey by Gallup reported that more than half of workers are feeling some type of stress on the job, while a more recent 2023 poll by the Robert Walters Group found that more than a third of workers felt that stress “very often”. 

This affects workers of all types and income levels. By virtue of my Silicon Valley practice, I treat a large number of young, highly-educated workers in a fiercely competitive corporate environment. While some might discount the concept of well-compensated staffers working behind desks having stress, an outsized number of the patients that walk through my door are overburdened by expectations, performance, finances or other job-related issues. And it’s having a devastating effect on their digestive health. 

Anecdotally, I know this is true in other fields too.  Work-related stress and anxiety is not just a white collar problem. Customer service, retail, and food service employees often face demanding customers, tight schedules, and low pay. Medical assistants, paramedics, or construction supervisors might experience elevated stress levels when caring for others or managing complex tasks. 

While the relationship between mental and gut health is getting widely recognized (especially DGBIs, Disorders of Gut Brain Interaction), the impact of workplace stress on digestive problems is also gaining clarity. In the case of frontline workers, a study published after the pandemic showed that a stressful event could lead to persistent digestive health issues for up to six months. 

Our modern day lives – no matter what our occupation – are producing undue amounts of stress and anxiety that are chipping away at our mental and physical health as well as corporate earnings.  

Wake-Up Call for Employers 

Of course, asking employers to reduce the pressure they put on employees is a challenging call-to-action. When I help patients see the impact of work-related anxiety and stress on their bodies and ask them how they can lessen it, many laugh or roll their eyes. There is no reasonable way for them to ask for support from their employer. And, while some employers have begun to offer employees access to tools like meditation apps and even more options for mental health services, GI often requires specialty-trained behavioral health clinicians who often work closely with registered dietitians and gastroenterology providers. 

But there is a direct (and therefore motivating) correlation between company bottom-line performance and gut health. Studies show that one in four working age Americans have a diagnosed digestive health disease, making it one of the most expensive conditions to treat in this country – more than heart disease or diabetes combined. With the clear connection between mental health and digestive health, it is nearly assured that – left unchecked – the prevalence of these conditions and their resulting costs will only increase. 

Aside from the obvious hard costs that stressing out your workforce can have on the bottom line, there are hidden costs to these conditions as well. Studies have shown that more than 24% of patients with IBS reported instances of absenteeism and over 86% reported presenteeism – or the act of being at work but less productive or unable to function because of symptoms.  

The message is clear: a less stressful workplace produces healthier employees, leading to lower healthcare costs and improved productivity. 

Adding Digestive Health Support

There are other ways that companies can help mitigate digestive health conditions on behalf of their workers. 

An uncomfortable truth for many busy community GI practices is that we are ill-equipped to treat digestive health issues that arise from stress, anxiety, depression, diet, and other environmental conditions. We know that the best interventions for these types of conditions is a collaborative multidisciplinary approach with behavior change, involving GI-specialized licensed psychologists and dieticians. This goes beyond the traditional methods offered by gastroenterologists in the community, which typically focus on procedures and prescription medications. Unfortunately, nationwide there is a critical shortage of behaviorists (especially GI specific) and dietitians due to limited professionals and poor insurance coverage, restricting access. As a result, traditional GI clinics are unable to support the needs of patients with these chronic issues and improvements in clinical symptoms and quality of life is unsatisfactory. This lack of supply creates an opening for employers to fill the void and offer comprehensive digestive services directly to their employees. 

Companies can also look to create GI-friendly workplaces. These include bathroom modifications like more single stall restrooms, floor-to-ceiling dividers for privacy, or even squatty potties to help alleviate stress on the bowels. 

Simple moves like healthier snacks, easy access to hydration stations, flexible breaks, mindful eating spaces signal better support or consideration for workers. Employers can institute policies that relieve the burden of digestive health issues on employees like flexible breaks and work hours and improve their overall physical health (access to gym, health club memberships etc). 

Whatever works for your organization, prioritizing GI health is not only a matter of compassion and well-being but also a smart business move. By creating a workplace environment that supports digestive health and working to reduce overall employee stress, companies can boost morale, reduce absenteeism, and increase productivity. 

Remember, a happy gut leads to a happy employee, and happy employees lead to a thriving and successful organization.

Dr. Treta Purohit is a gastroenterologist and hepatologist, currently working as Medical Director at Oshi Health and in GI practice at San Jose Gastroenterology. She brings a thoughtful approach to patient care, combining her medical expertise with digital health delivery innovations to improve access, patient outcomes and experiences. Dr. Purohit has published in many peer-reviewed journals and has received Presidential Poster Awards at the American College of Gastroenterology meetings for her research.

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