IBS is incredibly common in the US – somewhere between 10-20% of people suffer from it. But it’s incredibly more common in people with mood and anxiety disorders such as generalized anxiety disorder, schizophrenia, major depression, and panic disorder.
Let’s be clear: IBS is not always IBS. Sometimes there are other issues going on that medical professionals can miss, especially since IBS is often a “diagnosis of exclusion” (meaning, “we’ve ruled out everything else we can think of, so it must be IBS”). It’s always important to see a provider with a specialty in gut disorders to make sure that you get the correct diagnosis.
But let’s assume that the diagnosis is correct. What is going on in the gut that makes things so wonky in the brain? Or what’s going on in the brain that makes things so wonky in the gut?
Since the connection between the gut and the brain goes both ways (primarily via the vagus nerve, hormones, and the immune system), problems with either one can affect the other. And that means that there is a long list of factors that can impact the gut-brain axis and trigger mood disturbances, anxiety disorders, and IBS.
Dietary changes are often needed to calm an “irritated” gut, improve the composition and health of the gut microbiome, heal an intestinal barrier that has become too permeable (or “leaky”), provide adequate vitamins and minerals and amino acids to produce neurotransmitters necessary for mood stability, and more. Dietary changes sometimes include increasing fiber intake, eating more probiotic foods, eating a greater variety of foods, or, on the other hand, restricting certain foods that are common triggers (and then re-introducing them in a planned and careful way).
Lifestyle changes are often needed to calm an over-worked or over-stressed mind. We all have stress, and stress is not inherently bad or harmful, but often can be when we are dealing with it in an unhealthy way or when the stress is chronic and when we aren’t good at resting and relaxing in a healing way. CBT (cognitive behavioral therapy) has been helpful for many people with IBS, which is testament to the importance of managing this disorder from both a gut and a brain perspective. Yoga, stretching, and other forms of gentle movement are also helpful for some people.
Probiotic supplements, fiber supplements, and herbal supplements such as natural anti-microbials, demulcents, digestive bitters, and peppermint can be helpful for some people, but I would always recommend getting advice from a trained professional such as a gastroenterologist or dietitian before starting such supplements, as they need to be carefully selected and tailored to your needs.
Managing disorders of the gut-brain axis, like IBS, can be very challenging. You don’t have to go it alone. If you’re interested in working with a gut health dietitian, schedule a virtual telehealth nutritionist appointment with me or send me a message today.
Erica Golden, RDN, LD, IFNCP
Registered Dietitian Nutritionist