# How Chronic Stress Is Making Your Gut Hypersensitive | Will Bulsiewicz

An episode of [Live Well Be Well with Sarah Ann Macklin | Health, Lifestyle, Nutrition](https://invisiblenetwork.ai/podcast/1508380100), 22 May 2026, 5:12.

Audio: https://anchor.fm/s/1033d1554/podcast/play/120273181/https%3A%2F%2Fd3ctxlq1ktw2nl.cloudfront.net%2Fstaging%2F2026-4-20%2F201d70ca-ce4f-9580-cf7c-7dc8daafa06a.mp3

Do your gut symptoms ever feel so painful you worry something is seriously wrong? In this conversation, we talk about why digestive pain can feel intense, even with issues like trapped wind and constipation, and how the gut’s huge nerve supply plays a role.This clip explores the science of gut pain, including how the intestines sense discomfort differently to our fingertips, and why having around 500 million nerves in the gut can amplify pain signals. We also discuss visceral hypersensitivity, where the gut becomes over-reactive and normal sensations can start to feel painful. I’m exploring with my guest why some gastroenterologists use very low-dose antidepressants for gut symptoms, including SSRIs to influence serotonin, tricyclic antidepressants (often preferred for diarrhea-predominant issues), and SNRIs like Cymbalta for targeting pain, especially when constipation is also present. Throughout, we keep it clear that these medications are not the primary treatment for constipation, but can be part of managing discomfort. Will Bulsiewicz in conversation with Sarah Ann Listen to the full episode here. Watch the full episode on YouTube here. *** This episode is sponsored by: NOWATCH: The compassionate health tracker Connecting body and mind with unique stress recovery insights so you can live fully today15% off with code LWBW15 at https://nowatch.com/ DIOME: Rest deeper. Stay grounded.Rested is available now and Grounded lands later this month.👉 Get 20% off with code SARAH20 at DIOME.CO *** The Great British Veg OutHow to support your gut, energy, and hormones by eating more — not less. 👉 https://sarahmacklin.substack.com/p/the-great-british-veg-outReset Your HealthIf your body feels off after stress, travel, or burnout — this is where to start. 👉 https://sarahmacklin.substack.com/s/reset-your-health-in-30-days 👉 Practical beats perfect.Here’s a free 5-recipe PDF I use to support energy and stress during busy weeks.https://sarahannmacklin.com/5_free_recipes 👉 If this resonates, you can join the thousands who readThe Compassionate Cure each week.https://sarahmacklin.substack.com/ *** Let’s be friends! 📷 Instagram: https://www.instagram.com/sarahannmacklin/ 📹 Subscribe: http://www.youtube.com/@livewellbewellsarah 🐦 Twitter: https://x.com/SarahAnnMacklin 📱 TikTok: https://www.tiktok.com/@livewellbewellpodcast💌 Newsletter: https://sarahmacklin.substack.com/

## Transcript

[0:02] This is a beware moment, the most replayed moments from my
[0:05] latest conversation. It's a glimp into the wider
[0:08] episode, which you can find LinkedIn the show notes below.
[0:12] Because sometimes one small moment is enough to reconnect to
[0:16] living well and being well. I honestly think that gut pain
[0:25] is one of the worst. It's so underestimated and how
[0:29] painful some gut, gut symptoms can be, like even things like,
[0:32] you know, trapped wind can be so painful for so many people. 100%
[0:37] people who have severe Constipation or have symptoms
[0:40] from Constipation, they feel pain that is on par with
[0:44] requiring a surgery. They think they need surgery.
[0:48] And part of the Saran is the number of nerves that carpet our
[0:52] intestines. So, you know, they're not as
[0:54] finely tactile as my fingers are.
[0:56] So for people who are listening to the podcast but not on
[0:59] YouTube, I'm holding up my hands and I'm rubbing them together
[1:02] like an ASMR video. And please stay with us, though,
[1:08] don't fall asleep. But you are allowed to get nice
[1:10] and relaxed and settle in. So they're not as tactile as our
[1:14] fingers. Our fingers, we can, we can
[1:17] interpret precise touch. They can't do that.
[1:20] They're much more simple, but there's tons of them.
[1:21] There's 500 million nerves in our gut.
[1:23] It's more nerves than we have anywhere in our body except for
[1:26] our brain. Five times more nerves than you
[1:30] will find in your spinal cord. And they're constantly feeling
[1:33] and sensing. And they do.
[1:35] They're they're that that sense is with a purpose.
[1:39] And when there's something that's wrong, it sends this pain
[1:42] signal. And the pain signal is meant to
[1:44] tell you that something is wrong.
[1:45] That's the entire reason we were wired this way.
[1:48] So this is the reason why the pain can be quite intense
[1:53] because you have so many nerves. They can and they can.
[1:56] The other thing too is when you suffer with chronic digestive
[1:59] issues, particularly within the context of having a damaged gut
[2:02] microbiome, you can develop something called visceral
[2:05] hypersensitivity. And that is like, imagine for a
[2:10] moment that we're listening to a song that we both love, and I
[2:15] walk over to the sound system and I turn it up so loud that
[2:18] it's making your ears bleed. That thing that was totally fine
[2:21] and in fact kind of enjoyable before has actually become
[2:25] problematic because it's like way too loud.
[2:28] And that's visceral hypersensitivity as these nerves
[2:30] start jumpy, getting jumpy and reactive to things that they
[2:32] shouldn't even react to. And.
[2:34] We will get to the the solutions of Constipation.
[2:37] But before I forget, when you said that, is that why some
[2:39] gastroenterologists actually prescribe a low dose of SSRI for
[2:44] people that do have that hypersensitivity to a gut?
[2:47] Because there's some really interesting research there to
[2:49] show actually in different types of protocols of the gut, that
[2:52] can also be one really helpful step to help the sensitivity of
[2:56] the gut calm a bit more. Yeah, that's right.
[2:59] So actually, Sarah Ann, you've read my, my new book Plant
[3:03] Powered Plus and chapter 8. Yes, you're good.
[3:07] You've done your homework. Chapter 8 of my new book is
[3:10] actually my favorite chapter and it's about the brain, gut
[3:13] connection. And in this chapter I discuss my
[3:16] relationship with one of the most famous gastroenterologists
[3:19] in like basically in the, in the history of my profession.
[3:22] His name is Doctor Douglas Strassman and he so he's my
[3:26] friend, he's my mentor, and he's actually the one who what you
[3:29] just described of using SSRIs, which are selective serotonin
[3:34] reuptake inhibitors. These are the drugs that we
[3:37] think of as being used for mood disorders like depression and
[3:41] anxiety because they increase serotonin levels.
[3:43] But it turns out that you can apply these drugs to gut issues
[3:47] at a very low dose. And he's the one who really
[3:51] started us in this sort of process.
[3:54] He started this back like late 80s, early 90s.
[3:58] He was starting to unpack some of these concepts that we're
[4:01] talking about that now finally are becoming more mainstream. 10
[4:05] years ago, I would talk about this and no one knew what I was
[4:07] talking about and thought it was crazy.
[4:09] So, but yeah, So you could use SSRI's to increase serotonin.
[4:14] You could use tricyclic antidepressants, which are
[4:16] actually wonderful for people who have diarrhea type issues.
[4:20] In fact, they're preferred to the SSRI because SSRI's make
[4:22] people poop more. And you could also use the what
[4:26] we call SNR is selective norepinephrine reuptake
[4:30] inhibitors like Cymbalta, which are actually very good at
[4:34] targeting pain. So if you wanted to target pain
[4:37] and you had Constipation, actually the ones like Cymbalta
[4:41] are the perfect choice. It's not your primary treatment
[4:44] for Constipation, but you're using it to help to control the
[4:46] discomfort that calms. Thank you for listening to this
[4:51] Be Well moment. If it resonated, the full
[4:54] conversation is LinkedIn, the show notes, and I hope it gave
[4:58] you a small pause to take a moment for you and to reconnect
[5:01] to living well and being well. If you loved it, please do leave
[5:05] a review, follow the show or share this maybe with someone
[5:08] you love.

Shows are listed from Apple Podcasts' charts and directory, and Podcast Index where it is used. Every show and episode belongs to its publisher and plays from the publisher's own feed; this site hosts none of them.