The gut is the organ that hosts the largest concentration of immune cells in your entire body. The enteric nervous system (ENS), which is the nervous system of the gastrointestinal tract, is known as the “second brain”. This is because it controls a variety of gastrointestinal functions, communicates continuously with the central nervous system (brain and spinal cord), but could also function independently of them. It also shows promising evidence as a key link between modern global disease epidemics which include obesity, mental health and IBS. This signaling between the brain and intestine is known as the gut-brain axis.
In the gut (which is part of the ENS), there are billions of microorganisms which are referred to as the gut flora or gut microbiome. This community in the gut is unique to every individual, like a fingerprint, and begins to colonize the gut at birth. The diversity and composition of the gut microbiome changes throughout the lifetime as a result of different factors like diet, hormones, antibiotics, emotional state, or gut disorders. In fact, a gastrointestinal infection disrupts the gut microbiota which contributes to post-infectious IBS.
Having a healthy balanced medium in the gut can help better absorb nutrients from food and prevent harmful bacteria from colonizing the gut. It also helps teach immune cells how to identify invaders. This community of cells has been referred to as the “peacekeeper” in regulating the brain-controlled function and behavior.
Rethinking the Stress and IBS Relationship
Initially, it was thought that anxiety, stress and depression contributed to gastrointestinal conditions like IBS, but there has now been evidence that indicates that it may also be the other way round. IBS, which is a major chronic disorder of the gut, is associated with an imbalance of bacteria in the gut. This imbalance in the gut can send messages and signals to the brain that trigger mood changes. These findings may explain why individuals with IBS and functional bowel problems (like constipation, diarrhea, bloating, abdominal pain) develop anxiety or depression.
Better Treatment with Integrative Medicine
Because of the brain-gut axis, IBS and other digestive disorders can be treated via an integrative approach that focuses on both gastrointestinal and behavioral medicine. Here are 4 things to keep in mind which can help mold our gut bacteria to give us the best health we can, help minimize discomfort, and manage persisting symptoms.
Diet significantly impacts the composition of the gut microbiome. Reducing the dietary intake of fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) in people with IBS has been recently shown to change the gut microbiota and consequently improve IBS symptoms and quality of life. Common examples of FODMAP foods are wheat, milk, onions, and honey. Instead, including fiber (focusing on fiber-rich plants, like spinach) and probiotics could positively impact the composition of your gut flora.
Exercise can help enrich and promote gut bacteria diversity. It can be used as a treatment to maintain the balance or rebalance the gut bacteria, thus improving overall health status
Limit antibiotics to only when you really need it or as directed by your physician as they can reduce the diversity of your microbiome
Reducing stress can help maintain a balanced gut. There are 3 medically-reviewed psychotherapy approaches that can help:
Cognitive behavioral therapy (CBT)
As we begin to better understand the gut brain communication, mind-body therapies like CBT have been tested in multiple trials and have consistently demonstrated significant effects on IBS symptoms and quality of life. CBT, a form of psychotherapy, refers to short-term, skills-based approach that involves specific strategies which focuses on modifying behaviors and influencing mood. This approach can influence the brain gut axis and lead to symptom improvement.
Progressive Muscle Relaxation (PMR)
Practice of PMR enhances mindfulness by increasing awareness of muscle sensations. When you learn to recognize when and which muscles are tense, you can release the tension before it starts to build up. Such series of exercises can help reduce anxiety and stress. It may take a few weeks of practice to achieve a complete sense of relaxation. It is effective for gastrointestinal disorders when it is combined with CBT.
Meditation comes in different forms and means different things to individuals who practice. Goodpath has some examples which can be explored here. Regardless of the varieties and ways to practice meditation, the key is to find the path that promotes feelings of peacefulness and relaxation. Meditation is a great mind body tool that can help balance the nervous system, which can help improve mood, reduce gastrointestinal symptoms and decrease anxiety.
Get Started on a More Balanced Gut
The amount of ongoing research on the gut-brain axis and the role it plays in human health is having a huge impact in the world of medicine. It seems evident that an integrative approach can help enhance the bidirectional communication between our two brains.
Focusing on diet, exercise and behavioral medicine treatments can ultimately lead to fewer medical visits for IBS. To get help on how to manage IBS, get a personalized program that incorporates these components, get started here: