Your Gut and Brain are Talking. What’s the role in IBS.

Many of you have asked for more information on how the gut and brain relationship plays a role in IBS symptoms. To dive into this topic a bit more, I reached out to two colleagues in the field to share a bit with you about this connection. You may also enjoy this post about The Role of a GI psychologist in IBS and this post about Dealing with the Emotional Scars of IBS and SIBO. When to get help, as they both review information about the gut-brain relationship in IBS.

The gut-brain relationship is quite complex and I will only touch upon a few key topics in this post today.  An area of emerging science is the role of our gut microbes and their impact on the gut/brain communication pathway. Gut microbes are capable of producing neurotransmitters, “chemical messengers”,  that can play a role in mood regulation. Stress itself can impact the motility of our gut, likely playing a role in IBS symptoms for some. Think of the gut, brain and microbes pathway as circular–they all can impact each other.

One example to illustrate the gut and brain connection, is when you experience stress or anxiety. These emotions can lead to the release of stress hormones, adrenaline and norepinephrine. Chronic stress appears to change the microbes that inhabit our gut. Feeling angry can impact the release of acid into the stomach, increase blood flow to the gut, and make the stomach contract. Feeling scared? Maybe you might find yourself suddenly running to the loo.

From a diet standpoint, we know that what we eat impacts our gut microbe composition and what the microbes create (metabolites). Metabolites can impact the nervous system. A diet with a variety of fibers (from fruits, vegetables, and grains) and polyphenols (berries, chocolate, coffee, red wine, kiwifruit)–can have prebiotic effects, increasing the health promoting microbes in our gut. This is all an emerging area of study, so stay tuned.

The two gut health experts I interviewed today are both ironically, “Megan R’s” 🙂 …

Megan Rossi, PhD, leads research at King’s College London investigating nutrition-based therapies in gut health, including pre- & probiotics, dietary fibres [fiber], the low FODMAP diet and food additives notes, “It’s now irrefutable that there is a two-way communication between our gut and brain, more formally known as the gut-brain axis. This bi-directional conversation explains why when we are stressed or nervous (think about the last time you went for an interview), those emotions are often physically expressed in the form of gut symptoms. This also explains why often, when many of my IBS patients are relaxed on holidays, they notice their gut symptoms are significantly improved if not completely disappear.”

Megan Riehl, PsyD. MA, GI psychologist at University of Michigan says, “The gut and brain constantly communicate with each other and sometimes, they overshare!” [I love this quote!]

In IBS, the brain and gut connection can be a bit dysregulated. Excess gas in the gut signals loudly to the brain that, “Hey there’s a problem!”  This results in extra pain sensation in those with IBS, a symptom called visceral hypersensitivity.

Dr. Riehl, continues, “The over-sharing between the gut and brain in IBS, can make an symptoms feel catastrophic to the individual with IBS, resulting in what scientists call the fight or flight response. The brain starts firing questions, What if I don’t make it to the bathroom? Why is this happening to me? I just shouldn’t even try to go out of my house.” These feelings keep the brain on high alert, in a pattern, I like to describe as ‘the GI stress cycle.‘ ”

How can we calm down this connection?
Dr. Rossi, continues, “Thankfully research has now demonstrated that we can consciously relax this gut-brain communication through mindfulness strategies. This is revolutionising the management of IBS, where it’s not just about diet, but a more wholistic view on managing symptoms should be taken. In fact, clinical trials have shown that yoga, gut-directed hypnotherapy and cognitive behaviour therapy can all significantly improve IBS symptoms to the same degree as the gold standard low FODMAP diet.”

Learn more about gut directed hypnotherapy and cognitive behavior concepts in this article.  For tips on how to implement diaphragmatic breathing techniques, a deep breathing method that can settle down the gut brain connection, check out my post with Dr. Riehl here.

Introduce mindfulness and gut/brain treatments at your own pace

Dr. Rossi, suggests, “If you’re not quite ready for more intensive mindfulness therapies, I often recommend people start with 15 minutes listening to a mindfulness app each day, for at least 8 weeks.  Consistency and habit forming are key to seeing the benefits.”

For another resource, Dr. Rossi has a new book coming out where she discusses many mindfulness strategies, in “The Gut Health Doctor: an easy to digest guide to health from the inside out.”  Available in the UK, Dr. Rossi’s evidence-based pocket guide to gut health with Penguin is now available on preorder

Get the latest science-based information on Gut/Brain treatments:

Many researchers and experts are on social media or have websites to help your learn more about the gut/brain connection in relation to GI symptoms. Remember, consult with experts that truly follow the science–not just pretend to do so!

Dr. Megan Rossi can be found on Twitter: @TheGutHealthDoctor and via the Web:

Dr. Megan Riehl can be found on Twitter: @DrRiehl

To find a GI psychologist to work with, search this listing.

For a practitioner trained in gut-directed hypnotherapy, search this listing.

As a final word, from the dietitian perspective, if your diet changes are causing stress, you are likely stressing out your gut too. Work with a dietitian to provide guidance for the least restrictive diet to help manage your nutrient needs while also  managing your IBS symptoms. If you find stress, anxiety, and even anger related to your IBS an issue for you, consider seeking help from a GI psychologist. To manage your total health, physical and emotional well-being should be part of your treatment plan.

7 replies on “Your Gut and Brain are Talking. What’s the role in IBS.

  • Barb

    I have been diagnosed with IBS since the early ’80s but my DNA analysis revealed that I’m genetically predisposed to develop celiac disease, crohn’s disease, and ulcerative colitis and my microbiome analysis revealed the microbiome changes are due to crohn’s disease and/or ulcerative colitis, not IBS. I have had an autoimmune connective tissue disease for decades and I practiced yoga and meditation for decades, since I was 14 years of age. I’m now 64. I’m no longer able to practice yoga due to arthritis, synovitis, etc. Neither yoga nor meditation improved my gut symptoms but the FODMAP diet does. It’s obvious, based on my experience, that IBD is too often misdiagnosed as IBS and stress may have nothing to do with it.

    • katescarlata

      IBD is far less common than IBS–but yes, it is always possible for a misdiagnosis. Medicine is a bit of an educated guessing game at times. Diagnosis for IBD is typically confirmed via biopsy of the intestine–not sure there is evidence to definitively diagnose with microbiome analysis at this time.

      • Barb

        I need to clarify. I should have said my microbiome analysis revealed my microbiome showed changes associated with crohn’s disease and/or ulcerative colitis, not IBS. Also, I meant to say low FODMAP diet. I have had two biopsies done during colonoscopies. The first reported changes seen in ulcerative colitis but I’m still diagnosed with IBS.

  • Dee Shea

    What a wonderful and so informative article Kate! You always offer links so we can learn more, which I am so appreciative of. I have come a long way with my IBS thanks to you, your blogs, your classes and my visits with Toni. I have been connected with a Behavioral therapist for 9 years now. Thanks to her also that I have made such great gains. Keep up your outstanding dedication to IBS.
    With much gratitude
    Dee Shea

  • Melanie Blank

    This is a great article-thanks, Kate. I am interested in Dr. Rossi’s new book. Amazon UK doesn’t deliver to the US. I am wondering how US readers can easily get it. I will have to see what “our” Amazon says.

    • katescarlata

      I know–I do have followers in the UK–so added the link for them. I asked Dr. Rossi if it would be available in the US–and she is not sure at this time. Glad you liked the post!

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