For those living with irritable bowel syndrome (IBS), a flare-up of symptoms such as abdominal pain and bloating can, in turn, lead to feelings of stress and anxiety. Recently, more research suggests that gut bacteria are also a key player in mood and mental health because of its connection to the brain. Here, leading gastroenterologist Dr Aathavan Loganayagam explains more…
What are the symptoms of IBS?
Irritable bowel syndrome can bring many unwanted symptoms for the one in seven that live with the condition in the UK. This might include symptoms such as:
- Abdominal bloating
How might symptoms of IBS affect someone’s mental wellbeing and daily living?
The physical symptoms of IBS can bring anxiety and a significantly decreased quality of life. Those living with IBS report increased absenteeism from work, more days spent in bed, their relationships are affected, as well as activities such as dining out.
What is the possible link between IBS, gut and mental health?
Nowadays, we increasingly see that there is a link between the gut and the brain. People often speak about the gut being a ‘second brain’ where they are referring to what is known as the gut-brain axis. This refers to the bi-directional flow of information that occurs between the brain and the gut, meaning that signals from the brain can have an impact on the gut and vice versa.
This means that individuals’ symptoms may increase their stress or anxiety, or stressful situations may exacerbate their symptoms. It, therefore, makes sense that in the IBS population, psychological disorders such as anxiety and depression are more common.
How can someone improve their symptoms of IBS for a better quality of life?
When treating a patient with stress or anxiety, as well as IBS, we know that ¾ of those who go on a low FODMAP diet can control their symptoms. This also improves their stress levels and quality of life.
Alongside the low FODMAP diet, there is increasing evidence for gut-directed hypnotherapy to improve IBS symptoms. One of our studies looked at the low FODMAP diet, gut-directed hypnotherapy, and a combination of both on its effects on symptoms as well as psychological indices.
All forms of treatment were beneficial, however, the combination of diet and hypnotherapy led to greater improvements in the psychological areas. Here, we have a case for the use of both forms of treatment for some individuals with IBS.
What is the microbiome and how does it fit into all of this?
The microbiota are the microorganisms – ‘gut bacteria’ and fungi – that live in the digestive tract. Research is still trying to define what makes a ‘healthy microbiome’, but we are, however, seeing more evidence supporting that the microbiome in people with IBS is different to otherwise healthy individuals.
Similarly, gut dysfunction and ‘dysbiosis’ can be seen in animal models of stress, anxiety and depression. Again, we have a situation where it is like the ‘chicken or the egg’ between gut and brain. Researchers are working hard to explain where the microbiome fits into all of this. Research and technology are evolving at such a rapid pace, that we may have some answers to these rather interesting and challenging concepts sooner, rather than later!
Book an appointment today with Dr Loganayagam via his Top Doctor’s profile here. Can’t make the appointment in person? Dr Loganayagam is available for a video call using our e-Consultation tool, which can also be found on his profile.