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 https://www.amazon.co.uk/gp/product/0241355087?tag=prhmarketing2552-21
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: www.theguthealthdoctor.com
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.