IBS and the Mind/Body Connection
Written by: BBolen Ph.D
Irritable Bowel Syndrome (IBS) patients were done a disservice when, contrary to long-held Eastern traditions, Western medicine started treating the mind and body as two separate entities. Because IBS does not show up on diagnostic testing, patients were led to believe that the problem was purely psychological, thus compounding their stress level and leading to further despair. Only recently did IBS researchers begin to focus on the many interconnections between brain and body in their efforts to understand what causes IBS. As a result, it can now be said definitively that your IBS is not all in your head.
A quick review of high school biology will help you understand the IBS mind/body connection. The nervous system is complicated, with many different pathways. One such pathway is the autonomic nervous system (ANS), which is responsible for the inner organ function. Digestive systems each have their own branch of the ANS, called the enteric nervous system (ENS), which handles the movement of gut muscles as well as secretion of fluid. With this in mind, it is easy to see that dysfunction in the ENS would result in diarrhea (movement too fast, too much fluid) or constipation (movement too slow, too little fluid).
One specific area of inquiry into ENS dysfunction is the role of serotonin, a neurotransmitter (a substance that allows for communication from one nerve cell to the next). Serotonin appears to affect gut movement, fluid secretion, and sensitivity to pain, and is also thought to play a role in mood, including anxiety and depression, and therefore may be the reason behind the association between IBS and these mood disorders. Medications such as Zelnorm® and Lotronex® were designed to target serotonin to reduce IBS symptoms, but, unfortunately, these medications proved to be problematic. The hope is that newer, safer medications are being developed that target serotonin and other neurotransmitters that may be involved in IBS symptomatology.
In addition to dysfunction within the ENS, emerging research shows that IBS may be caused by problems in the pathways that connect the gut to the brain. Nowhere is this brain/gut connection more apparent than in response to stress. Understanding how innate stress response works can help you to take the necessary steps to curtail this reaction and actively calm your body.
The Stress Response
A body’s fundamental survival skill is its fight-or-flight stress response. This response consists of rapid changes that occur within the body when any threat is encountered. All of these bodily reactions were designed to help either successfully fight or flee from any hungry beasts our ancestors encountered when venturing forth from their caves. Thus, in response to a perceived threat, the heart starts to beat more rapidly, blood is sent to extremities, and muscles become tense. As all of the body’s energy is directed toward fighting or fleeing, the digestive system becomes less important, resulting in disruption of the normal digestion process.
Bodies have not yet adapted to the unique challenges of modern life. Like an alarm system that fries because it is set off too frequently, stress-related health conditions such as IBS have become all too common. It is too simplistic to say that stress causes IBS, but it certainly can be a contributing factor, either in directly exacerbating symptoms or in creating an internal environment in which other factors such as food intolerance or bacteria may prosper. Fortunately, stress is something you can actually work at controlling.
Promoting Mind/Body Healing
The most important tool you can have in your IBS kit is to learn how to actively calm your body. There are a variety of ways to do this—calming visualization, diaphragmatic breathing, progressive muscle relaxation, yoga, and meditation are all good ways of counteracting stress, and all are worth trying. Actively calming the body sends the message to the brain that no threat exists and therefore encourages the body’s systems to return to normal functioning.
Psychotherapy is another option for directly addressing the mind/body connection in IBS. Two forms of therapy—hypnotherapy and cognitive-behavioral therapy (CBT)—have research backing for their effectiveness in reducing IBS symptoms. Gut-directed hypnotherapy involves the induction of a deep state of focused attention in which suggestions for improved digestive functioning are made. CBT for IBS involves teaching the individual how to modify unhealthy ways of thinking and behaving that may be contributing to the maintenance of IBS symptoms.
The complex nature of IBS often requires a comprehensive approach, including medication, over-the-counter remedies, vitamin supplements, and nutritional changes. With your new knowledge about the mind/body connection, you can be empowered to take steps to directly counteract the effects of stress on your body. This self-care will serve you well as you work toward returning your body to a state of good health.