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IBS and the gut-brain axis

To truly manage IBS, you need to fix the way your brain and your gut talk to each other.

When talking about irritable bowel syndrome and IBS symptoms (abdominal pain, bloating, diarrhea, constipation), the discussion is not complete without considering the gut-brain axis. Especially since IBS experts are now calling the syndrome a disorder of gut-brain interaction. It’s a fascinating subject that reminds you how everything in the body affects everything – in good and in bad. This applies also to managing IBS symptoms: it’s not enough to focus on one aspect of gut health, like your diet, but also sleep, circadian rhythms, exercise, stress, and even thoughts have to be assessed as all of these affect the gut-brain axis.

cartoon brain and blue wax intestines connected with arrows

What is the gut-brain axis 

Often called the gut-brain-microbiota axis, the gut-brain axis is the communication channel between the gut and the brain, the two-directional phone line between the two.

Your gut and your brain are talking to each other all the time! The main office (the brain) wants to know what the branch office is doing (the gut) and give orders if need be. They relay information back and forth about gut processes, hunger, satiety, stress, and feelings, just to name a few. 

Problems in this information exchange are linked to irritable bowel syndrome and other “functional” gut problems, immune function, sleep problems, mood disorders, neurodegenerative diseases, and even obesity.

How are your gut and your brain connected?

It’s not simple. Many processes are involved:

  • Central nervous system (brain and spinal cord): both the sympathetic (stress response) and the parasympathetic (rest response) branches of the autonomic nervous system are involved, especially the vagus nerve
  • Enteric nervous system (gut’s own nervous system)
  • Endocrine pathways (hormones): such as HPA-axis with cortisol (stress hormone), gut hormones like ghrelin (hunger hormone) and leptin (regulates appetite)
  • Immune system of the gut: cytokines (inflammation controlling molecules)
  • Microbiota (gut microbes) and the molecules they produce, like short chain fatty acids and neurotransmitters
red phone on gray background

To simplify, what you need to know is that 

  • The enteric nervous system takes care of digestion, but the brain can override its functioning in stressful situations. 
  • The vagus nerve is the main information pathway between the brain and the gut, and there is evidence to show that it’s not working well in people with IBS. 
  • Gut microbes are highly important, and how you take care of them makes an impact on the gut-brain axis level also. 

What disrupts the gut-brain axis

It’s not completely clear how this happens, but it seems stress plays a big role, as does the health of the gut microbiota. Your gut microbes are affected by your lifestyle and your diet, both in helpful and harmful ways. It is thought that dysbiosis of the gut microbiota (negative changes in your gut microbes) can cause problems in the gut-brain axis, but it is not clear whether dysbiosis happens first, or whether the disruption of the gut-brain axis causes the dysbiosis. 

IBS can become triggered by a gut infection, which could support the idea that your gut microbe balance becomes disrupted first, but an infection also causes inflammation which the immune system controls. Gut infection is also a source of stress, and a sensitive brain may overreact to infection signals coming from the gut, starting a feedback loop that causes IBS. So, it’s not clear.

The brain then is responsible for assessing whether we are in danger or not, but your lifestyle and your diet can also affect your stress sensitivity, or how readily a stress response is triggered in the body. A typical Western diet and an irregular lifestyle with sleep deprivation could make you more sensitive to stress.

woman overwhelmed by stress

Stress sensitivity

People who have had lots of stress in their lives, whether in childhood or in adulthood, become more sensitive to stress, and are at a higher risk for developing IBS. Studies show that over time their brains have adapted to stress in an unhelpful way, which explains this increased sensitivity, and probably also why not everyone with stress has IBS.

Additionally, people with IBS tend to have these similar structural brain changes and increased stress sensitivity also, and a history of highly stressful life periods. For example, I had a client whose gut symptoms began after a serious natural disaster hit her country. This all suggests that chronic stress wreaks havoc on the gut-brain axis and promotes chronic gut issues, like IBS.

What’s more, it’s relatively common that anxiety and depression happen together with IBS, both probably feeding the other. What came first, however, is not clear. 

Looking after the gut-brain axis

Everyone can benefit from taking good care of the gut-brain axis, but this is especially important for people with IBS and other functional digestive disorders. It seems that gut symptoms are like the tip of an iceberg – your gut-brain axis may have been disrupted for a while before gut symptoms surface!

How to nurture your gut-brain axis:

  • Feed your good gut bacteria with a balanced diet rich in fiber
  • Support digestive processes by eating regularly, avoiding overeating, drinking enough fluids, limiting alcohol consumption
  • Stimulate vagus nerve and calm the nervous system with stress releasing activities 
  • Activate brain areas that lower stress sensitivity: breathing exercises, meditation
  • Work on your mindset to reduce catastrophizing, expecting problems etc.
  • Pay less attention to your gut symptoms
  • Nurture body’s processes: keep regular daily rhythms with sleep, meal patterns and exercise, do your best to sleep well
  • Perhaps specific supplements, like probiotics can help

It’s a lot! But not impossible to do. 

professional woman staying calm under work pressure and demands

Strong gut-brain axis plan

The first step is to map out honestly how you are doing in these different areas listed above. 

The second step is to make a plan: what needs to change and in what order. Consider what might be easier to start with, or what might make the biggest impact. 

But you don’t have to figure this out on your own. Nurturing a sturdy gut-brain axis and relieving IBS symptoms in the process is what I do. If you are not sure, let’s chat. You will have the opportunity to tell an expert about your situation, and I will go over your best next steps without you having to commit to a program. I want to make sure you and I are a good match before you invest anything in working together. Book you free consultation here.

I hope you enjoyed learning about the all-important gut-brain axis! If you are feeling overwhelmed by this, just remember that even small adjustments to diet, lifestyle, thought patterns and stress sensitivity can make a big difference. Check out all of my free resources (scroll down my home page) – they provide lots of tips to get going with.

Thank you for reading!

Love,

Anna-Kaisa 

Picture of Anna-Kaisa Manolova

PS. Book your free 30-minute consultation here.

PPS. Feeling bloated? Get your copy of the free “5 Easy Ways to Beat the Bloat” guide here.

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  2. Mayer EA, Nance K, Chen S. The Gut-Brain Axis. Annu Rev Med. 2022 Jan 27;73:439-453. doi: 10.1146/annurev-med-042320-014032. Epub 2021 Oct 20. PMID: 34669431.
  3. Mayer EA, Labus JS, Tillisch K, Cole SW, Baldi P. Towards a systems view of IBS. Nat Rev Gastroenterol Hepatol. 2015 Oct;12(10):592-605. doi: 10.1038/nrgastro.2015.121. Epub 2015 Aug 25. PMID: 26303675; PMCID: PMC5001844.
  4. Karakan T, Ozkul C, Küpeli Akkol E, Bilici S, Sobarzo-Sánchez E, Capasso R. Gut-Brain-Microbiota Axis: Antibiotics and Functional Gastrointestinal Disorders. Nutrients. 2021 Jan 27;13(2):389. doi: 10.3390/nu13020389. PMID: 33513791; PMCID: PMC7910879.
  5. Sun LJ, Li JN, Nie YZ. Gut hormones in microbiota-gut-brain cross-talk. Chin Med J (Engl). 2020 Apr 5;133(7):826-833. doi: 10.1097/CM9.0000000000000706. PMID: 32132364; PMCID: PMC7147657.

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