The brain has a direct effect on our digestive health. An individual’s gastrointestinal upset can be the cause or the result of anxiety, stress, or depression. There are three key parts of the brain and nervous system that play a role in IBS symptoms:
- Psychosocial Stressors: Epidemiologic studies have demonstrated that approximately 60% of IBS symptoms are triggered with stress. As the brain has an increased sensitivity to perceived stressors, it responds with gastrointestinal consequences.
- Visceral Hypersensitivity: Functions of visceral organs (i.e. gastrointestinal distensions and contractions), in non-pathological conditions has normally no pain. Visceral hypersensitivity is referred to enhanced or altered perception of mechanical triggers applied to the bowel which seems as pain and discomfort. It is generated from disturbance in the peripheral sensory pathway and/or central nervous system.
- Psychiatric Comorbidities: Several studies have shown that a significant amount of patients with psychiatric comorbidities, such as anxiety, and, to a lesser degree, depression, have IBS. There is a high prevalence of IBS in psychiatric patients who seek treatment, with a prevalence of 19% in schizophrenia, 29% in major depression, and 46% in panic disorder among other disorders.
Based on these observations, the psychologically based approaches can greatly improve in digestive symptoms more than only conventional medical treatment. There are important management strategies such as yoga, meditation, exercise, massage, hypnotherapy, acupuncture, and low-dose nerve pain/antidepressant medication to target the gut, not the brain.
References:
- Mayer E. A. (2018). The Role of Gut-Brain Interactions in Influencing Symptoms of Irritable Bowel Syndrome. Gastroenterology & hepatology, 14(1), 44–46.
- Farzaei, M. H., Bahramsoltani, R., Abdollahi, M., & Rahimi, R. (2016). The Role of Visceral Hypersensitivity in Irritable Bowel Syndrome: Pharmacological Targets and Novel Treatments. Journal of neurogastroenterology and motility, 22(4), 558–574. https://doi.org/10.5056/jnm16001
- Kanazawa, M., Hongo, M. and Fukudo, S. (2011), Visceral hypersensitivity in irritable bowel syndrome. Journal of Gastroenterology and Hepatology, 26: 119-121. doi:10.1111/j.1440-1746.2011.06640.x
Author Anna Chung Patient Care Coordinator