Gut Brain Connection
The gut and the brain develop from the same part of the human embryo. So it is not surprising that the intestinal tract has such a rich nerve supply that it is sometimes referred to as “the little brain.”
The gut shares many of the same kinds of nerve endings and chemical transmitters as the brain. The two also remain linked through a collection of nerve cells. These nerves are partly responsible for controlling anxiety and fear, which explains why these emotions can sometimes be associated with bowel function.
Are You a Gut Responder?
Imagine an anxiety provoking situation (such as taking a test, speaking in public, or disagreeing with the boss). Everybody experiences both an emotional and a physical response to this kind of situation. This is the nervous system’s way of gearing up to meet a challenge.
Emotional feelings can include fear, anxiety, stress, apprehension, or doubt. The physical sensations may include muscle tension, sweating, palpitations, breathlessness, or abdominal cramps. Every person differs in which emotions or sensations they experience and also in whether they are more aware of what is happening in their mind or their body. For some people, their target organ is the gut. This may be partly hereditary.
Certain individuals are more symptom sensitive than others; it is as if an amplifier were turned up so they are more tuned in to their bodies. Why this is so remains unclear. People vary in how much they communicate distress verbally or through body language. This may be partly learned.
Whatever the reason, anybody who is either a gut responder or symptom sensitive or both is at risk for experiencing irritable bowel symptoms under stressful circumstances.
What does irritable mean in IBS?
In irritable bowel syndrome (IBS), irritable means that the nerve endings in the bowel wall, which control muscle function and affect sensation of the gut, are unusually sensitive. Even normal conditions that can stimulate the bowel in anyone may lead to a greater response for persons with IBS. This results in the nerves and muscles of the bowel becoming more active and producing symptoms.
Irritable Bowel: Cause, Consequence, or Coincidence?
Because the bowel and the brain are so closely linked, it is often hard to separate cause from effect. Life’s daily hassles, as well as more prolonged predicaments (a difficult job, a tense relationship), may provoke an irritable bowel. But, it is equally true that the symptoms this produces such as diarrhea, urgency, or pain, are stressful themselves. This creates a situation in which it may be impossible to separate cause from effect.
Plus, digestive and emotional disorders are both common. IBS, depression, panic, and anxiety each, by themselves, occur in at least 1 in 10 people. It is hardly surprising that emotional symptoms and bowel dysfunction often occur together in the same person – regardless of cause and effect.
If a person does suffer from an episode of depression, panic, or anxiety and happens to be a gut responder, they will almost certainly experience a worsening of bowel symptoms while their emotional disorder persists.
Everyday Living and Irritable Bowel
Living with IBS is not easy. Unpredictable, painful, and frequent bowel movements or constipated stools can disrupt everyday living and create embarrassment. Loss of control, loss of dignity, altered body image, reduced physical activity, and dietary restrictions may all be problems to contend with. These can interfere with work or school and social functions both in obvious and subtle ways – including leisure and sexual activities.
Any or all of these considerable adjustment issues may create fatigue, depression, anxiety, or sleep disturbance. People who deal with tiredness by drinking coffee or soda, or with anxiety by consuming junk food, alcohol, or by smoking create still further insults to their already sensitive bowel.
You and Your Doctor
Another difference among people is the degree to which they worry about bodily sensations and their tendency to seek help from doctors. A person feeling more vulnerable may seek reassurance in repeated visits to doctors and requests for multiple tests or medications. IBS symptoms may contribute to this because they are often chronic and intermittent, and their cause is uncertain. A doctor who understands your condition and one in whom you have confidence is obviously important.
Hints on How to Cope
- Learn to recognize your own emotional and bodily responses to stress. Close your eyes and imagine a stressful situation. Are you symptom sensitive, or a gut responder?
- Keep a daily diary for a month or two to help identify situations that provoke your stress response.
- If possible, try to avoid situations that provoke your stress response.
- Learn new coping skills that lessen your vulnerability to stressful situations.
- Train yourself to reduce gut responses through relaxation, breathing exercises, or mediation techniques.
- Find a caring physician.
- If you believe you have an emotional disorder (such as depression or anxiety) that may be making your symptoms worse, ask for help. Because of their shared chemistry, medications that calm the mind often soothe the bowel.
- If you need to learn more about developing new coping techniques or a better understanding of your own gut-brain connections, ask your doctor to suggest a mental health professional who can help you. This preferably is one who knows about IBS and who has a working relationship with your physician.
Adapted from IFFGD Publication #108 by: Barry Blackwell, MD, University of Wisconsin Medical School, Milwaukee, WI.