The Gut Brain Axis: 5 Ways to Improve IBS Symptoms Through Your Mental Health
Have you heard of the gut-brain axis (or gut-brain connection)? What is it and how can we improve it to reduce irritable bowel syndrome (IBS) related symptoms? In this blog post, I got through the ins and outs of that connection and simple ways to work on it!
What is the gut-brain axis?
The gut-brain axis refers to the intricate connection between the gut and the brain. These two parts of the body are in constant communication through the nervous system, hormonal messaging, and our immune system. This connection plays a significant role in our overall health and well-being.
The main nerve that connects our gut and brain is the vagus nerve. Think of it as a direct messaging line between the two areas. It picks up information via the local neurotransmitters, hormones, and immune response in the gut and relays these via signals to the brain, and vice versa. The vagus nerve is highly involved in the parasympathetic nervous system and impacts many bodily functions involved in this system. The parasympathetic nervous system is what tells our body to "rest and digest” as opposed to the sympathetic nervous system which triggers the "fight or flight" response, pulling resources away from our digestive tract to help us become more alert and make decisions.
The hormonal messaging that occurs back and forth between the gut and brain includes hormones ghrelin, PYY, GLP-1, and CCK. Ghrelin is our hunger or appetite hormone, and although produced in the stomach, it can cross the blood-brain barrier and influence or intake. GLP-1 and PYY are created by specialized endocrine cells in the intestines. GLP-1 has receptors in multiple places throughout the body, including the vagus nerve, and has affect on brain neuronal circuits in the hypothalamus involved in appetite control. It is highly involved in glucose stabilization. PYY increases satiety and slows gastrointestinal motility (movement of food through our GI tract). In the brain, PYY affects food intake, energy homeostasis, anxiety, mood and stress resilience. CCK is involved in satiety (absence of hunger for a period of time) in the brain, slows gastric emptying, and signals the production of pancreatic enzymes to breakdown our food. CCK also helps to regulate levels levels of dopamine and the activity of serotonin, therefore influencing mental health and behavior.
Emerging evidence suggests that the immune system is also closely linked to the gut-brain axis. The gut-associated lymphoid tissue (GALT) is the largest mass of immune tissue in the body, and it interacts with the enteric nervous system to regulate gut function and maintain intestinal homeostasis. The gut microbiota also plays a critical role in the immune system's development and function. Dysbiosis, or an imbalance in the gut microbiota, can lead to immune dysfunction and inflammation, which have been linked to various neurological disorders, including anxiety, depression, and dementia. Thus, the immune system's close relationship with the gut-brain axis highlights the importance of maintaining a healthy gut microbiota to promote both physical and mental health.
How are IBS and the gut brain axis connected?
One condition that is closely linked to the gut-brain axis is IBS. It is not apparent if within IBS patients whether it is “chicken or the egg”, if the altered mental status brings on the IBS symptoms or the IBS symptoms influence changes in mental status. In some, it appears that a psychological condition was already present, making the person prone to gastrointestinal issues due to faulty messaging in the gut-brain axis. In others, the GI issues were there earlier on and due to the stress and overwhelm that results from not being able to control symptoms, this leads to worsened mental health.
Now how can we improve our IBS symptoms via the gut-brain axis?
Mindful Eating
Mindful eating involves paying attention to the sensations, thoughts, and emotions that arise during eating. This approach can help reduce stress and anxiety around food, improve digestion, and reduce IBS symptoms.
When we eat mindfully we help assist our mind’s awareness of meal and therefore helping our brain to use the gut-brain axis to signal digestion to begin.This awareness helps to promote the secretion of digestive enzymes, allowing us to more thoroughly break down fermentable foods.
Mindful eating leads to more effective digestion by promoting slower eating and more thorough chewing, as well as assisting in our ability to sense fullness. Digestion begins in the mouth using salivary enzymes to start the break down of food. Finishing a meal when we are properly full, instead of overloading our system, can prevent exacerbated fermentation and osmotic pressure in our intestines, which leads to the stretching of our intestinal wall and signaling to pain receptors (A.K.A. IBS symptoms).
Mindful eating helps to reduce stress and anxiety around food, which exacerbates symptoms and can lead to a “self-fulfilling prophecy”. You think something will affect you, therefore it does.
Lastly, mindful eating can promote better food choices by encouraging individuals to pay attention to their hunger, fullness, and digestive cues, and overall how food impacts their bodies. This can help to improve diet quality in a non restrictive way, while helping individuals to identify trigger foods that worsen their IBS symptoms and make changes accordingly
Meditation
Studies have shown that there is direct beneficial impact of practicing meditation on IBS symptoms. In one study participants meditated twice a day for 15 minutes for six weeks and had significant improvements in gas, bloating, and diarrhea. A follow up study after one year of continued meditation practice showed even more improvements in bloating and pain.
Meditation may help improve IBS symptoms through the gut-brain axis by reducing stress and promoting relaxation. Stress and anxiety are known to trigger IBS symptoms, and meditation has been shown to be an effective way to reduce stress and anxiety. Through activating the parasympathetic nervous system (rest and digest), this primes us for better digestion.
Meditation can also improve gut motility, reduce inflammation, and improve the balance of the gut microbiota. Studies have shown that inflammation in the body is often associated with IBS symptoms. Additionally, improvements in the balance of the gut microbiota can lead to improved gut health and reduced symptoms.
Eating to improve our microbiome.
A healthy microbiome produces beneficial byproducts, such as short chain fatty acids, and influences the production of neurotransmitters, such as serotonin. Short chain fatty acids produced in the gut help lower inflammation, improve the integrity of our GI lining, and help to modulate the immune system. All of these actions have direct and indirect affects on our brain and mental health. Although the neurotransmitters created in the GI tract are not the same that are located in the brain, they have major influence on the regulation of our brain neurochemistry through the gut-brain axis. And so, it is proposed that by improving our gut health, we can therefore modulate or help to improve our mental health (and vice versa). Listed below are ways that we can impact our microbiome.
Eating fibrous foods. This means eating more legumes, grains, beans, nuts, seeds, and berries. Yes, vegetables have fiber, but typically not near what a kidney bean or a dense, whole grain bread may have.
Eating a variety of foods. Eat various types of foods and within those types, eat different colors of those. For instance, we want to eat more fruit, vegetables, whole grains, beans, nuts, and seeds, but within the fruit food group we alternate types (e.g. bananas, oranges, blueberries, and/or strawberries). Rotating the types of foods we eat allows us to get the differing types of phytochemicals (active compounds in plant foods associated with their color) from each, which may help to feed beneficial bacteria in the microbiome.
Eating fermented foods. Instead of reaching for a random (expensive) probiotic, that may-or-may-not help, grab a fermented food instead. Good options include greek yogurt, kefir, kombucha, sauerkraut, kimchi, and tempeh.
Consume prebiotic foods. Prebiotic foods are those with compounds known to feed the beneficial bacteria in our microbiome. The tricky part here is that many prebiotic foods are also high in FODMAPs, so knowing your triggers prior to including more prebiotic foods in your diet may be helpful. Examples of good prebiotic foods are garlic, onions, leeks, asparagus, artichokes, bananas, and oats.
Breathing Exercises
Breathing exercises can activate the parasympathetic nervous system, via our vagus nerve, which is responsible for the body's rest and relaxation response. When the parasympathetic nervous system is activated, it can help to reduce stress and anxiety, which can have a positive impact on the gut-brain axis.
Additionally, breathing exercises can increase oxygenation and blood flow to the gut, which can support healthy digestion and nutrient absorption. Improved digestion and nutrient absorption can lead to a healthier gut microbiome, which can in turn support mental health and cognitive function
Therapy
Gut-directed hypnotherapy (GDH) and GI focused cognitive behavioral therapy (CBT-GI) are therapy techniques proven to reduce IBS symptom severity and improve quality of life.
During gut-directed hypnotherapy, the therapist guides the patient into a state of deep relaxation and suggests visualizations and positive affirmations the gastrointestinal tract and symptoms. The therapist may also teach the patient self-hypnosis techniques to use on their own. By changing the patient's thoughts and attitudes towards their gut symptoms, GDH can help improve the gut-brain axis and alleviate symptoms.
CBT-GI helps those with IBS manage their symptoms through a combination of cognitive and behavioral strategies. The therapist works with the patient to identify and change negative thoughts and beliefs about their condition and to develop strategies for coping with symptoms when they arise. For example, a patient with IBS may believe that their symptoms are uncontrollable and that they will never feel better, which can lead to feelings of hopelessness and anxiety. Through CBT, the patient can learn to reframe these negative thoughts and develop more positive and realistic ways of thinking.
In Conclusion…
In conclusion, the gut-brain axis is a complex and important connection between the GI tract and the central nervous system that plays a crucial role in overall health and well-being. By addressing mental health and stress levels, individuals with IBS can improve their gut health and alleviate symptoms, and vice versa. Incorporating practices such as mindful eating, meditation, and gut-directed hypnotherapy can help to reduce stress and anxiety, promote relaxation, and improve gut function. Similarly, a healthy diet rich in prebiotic and probiotic foods, as well as avoiding trigger foods, can support a healthy gut microbiome and reduce IBS symptoms. By taking a holistic approach to health that includes both mental and physical well-being, individuals with IBS can take steps towards a healthier and happier life.
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