Whilst I’m definitely not saying it’s all in your head, there are some simple, effective things that will help you better manage the crossway talk between your digestive system and your mind. That is exactly what I’m going to be covering in this episode of the Inside Knowledge.
You’ll learn about
- how the gut brain axis works,
- why your thoughts matter more than you think in IBS,
- and you’ll also hear about how to support digestion through non-food related activities.
Check out previous episodes
You might have noticed that the first episodes of the Inside Knowledge have all focused on things that you can do with relatively low effort. So you don’t actually have to spend any money. You don’t have to make massive changes to your diet.
They’re things that you can do with a small amount of energy. People I work with generally feel quite tired and quite low in energy. Because they’re struggling with their IBS, so that’s why I’ve not made it massively complicated so far.
If you haven’t yet listened to episode two and three, go back and listen to those because it’s all about when you eat and also how you eat. And there’s some tips in there about just changing the way that you approach meal times, which can make a big difference.
What is the vegus nerve?
Now, today, I’m really gonna be focusing in on the connection between your gut and your brain. This is predominantly through the vagus nerve, which I’ll explain a bit more about. But also I wanna talk about little things that you can do that make a big difference that I’ve noticed with my clients.
So you don’t have to change everything all at once, but some of these things might help you get control of your IBS.
If we’re thinking about the gut brain connection we are talking about the vagus nerve. This is a superhighway of information between your brain and your gut.
It starts at the root of your brain, at the back of your head, and it goes all the way through the majority of your torso. Connecting to all of your digestive functions, but also your lungs and your heart.
So it’s touching your stomach, your intestines, your liver, your kidneys, and sending messages back up to the brain.
Your different nervous systems
It’s part of our parasympathetic nervous system, and that is really a kind of rest and digest mode.
We’ve also got a sympathetic nervous system, which is more about putting us into that fight or flight response. Which is a kind of high alert, high cortisol energy stress state.
Your vagus nerve is part of the parasympathetic nervous system. The other nervous system that you might not remember from your biology lessons at school is the enteric nervous system.
Now this is just a nervous system that’s really focused on the digestion. It’s kind of a separate digestive system and it controls blood flow to the gut, mucus secretions, and the hormone release that happens within digestion.
And it happens without the brain telling it what to do, whereas the parasympathetic and the sympathetic nervous system are connected to the brain.
They are receiving messages from the brain, but also most importantly, sending a lot of messages back up.
What does the vegus nerve do?
If you think about this vagus nerve, it’s like a 10 lane motorway. So you can imagine about 10 lanes going between the brain and the gut.
Around 80% or 90% of this is upwards from the body to the brain, and actually only 10% of the traffic is coming down from the brain to the digestive system.
This helps your brain understand what is going on with your nutrient absorption, bacteria overgrowth, and the crosstalk between your bacteria and immune reactions in the gut. But also your energy balance, like whether you are hungry or full, whether you’ve got enough blood sugars. All of these really important messages are sent back up to the brain.
If you’ve got IBS, you’ve probably realized that this pathway, this crosstalk between the brain and the gut, does not always work effectively!
And also it may be the reason why we have increased visceral hypersensitivity. Which means that you get increased levels of pain sensitivity, and just
IBS is sometimes considered to be a condition of disorder between the gut and the brain. And the connection between the two that’s broken or not firing as it should.
Your vagus nerve has a strong effect on any downward movement in the gut.
The vegus nerve affects motility
So this includes peristalsis. That’s the movement of the food from your stomach through your intestines. It can be sped up and it can be too fast, or it can be too slow.
If you’ve got a slow gut transit time, you might end up with constipation. Your stool dries out the longer it’s been in your large intestine.
Or it could be moving through you too quickly, in which case you are not having enough time to absorb nutrients. You’re not having enough time for the food to break down.
If small intestine digestion hasn’t happened as effectively as it should, it means there’s more there for the gut bacteria in the large intestine to really start fermenting and then that can lead to gas.
So too fast or too slow? Either way, not great.
The gut brain connection affects digestion
The vagus nerve is also involved in the release of bile from your gallbladder, which helps us digest our fats. Bile is antimicrobial, but it can also stimulate gut motility. If you’re not releasing enough of it it could also be affecting the speed of your gut transit time.
Also the vagus nerve is involved in the production of juices from your saliva in your mouth, right down to your stomach acid and all the digestive enzymes along the small intestine.
So it’s really part of how our body reacts to food and how we digest food.
Could the vegus nerve stimulation affect gut motility?
A really interesting study it was on rats, not on people, but the rats were treated with anti-diarrhoea medicine. So it was as if they were constipated.
And then they found that the rats had more bowel movements when their vagus nerve were stimulated. And rats who didn’t have their vagus nerve stimulated, stayed constipated. Rats were fitted with this little contraption, which buzzed and made their vagus nerves stimulate through their ear, actually into their digestive tract.
What happened is that they were actually getting over the symptoms of constipation. It was as if the constipation wasn’t such a big problem for them.
Although they’re just rats I think it just shows that stimulating the vagus nerve could potentially help with a sluggish bowel.
And if you think in the alternate way, if it’s working overtime, we want to soothe it and calm it down. Maybe it could help reduce the amount of bowel movements that you are having.
How to support the gut brain connection
So now I want to talk a bit about the things that you can do to help your vagus nerve.
The first thing that you can do wherever you are is to try some breathing exercises. When we breathe out in a long, slow, deep exhalation, this is switching on the parasympathetic nervous system. That’s our relaxation mode. It can be really helpful just to practice calm, slow, deep breathing at a time when you don’t feel anxious and you don’t have loads of symptoms.
So getting it into your routine to practice breathing out. And practice using your full breath can be very, very helpful in controlling and supporting the vagus nerve.
Example breathing exercises
There’s lots of different breathing exercises that you can try:
- Using your hand – A couple of them include going up and down each of your fingers, breathing in and breathing out. So you just take one hand and with your other index finger, trace up your thumb breathing in slowly. Then trace down your thumb as you breathe out. And then again, up your index finger breathing in, and down the other side, breathing out. Just doing that really slowly and just trying to control it. And actually having something physical to concentrate on in terms of your fingers can also be helpful for a lot of people.
- Box breathing – you are imagining going up the side to up the left hand side for four. Then hold your breath for four, then breathing out for four. And then hold your breath for four, and then breathing in for four. So you are imagining going up and down the sides of a square. Now that’s sometimes called box breathing.
- Diaphragmatic breathing – The other thing is just to really make sure when you’re doing this breathing that you are engaging your diaphragm. So this is a like a wall of muscle that goes underneath your lungs, kind of underneath the lot, and it goes across your whole body. And it just really can expand and contract as we breathe. But the majority of time we are breathing, we don’t actually use it to its full effect.
Diaphragmatic breathing for IBS
So as we breathe out and relax, it should come down. And as we are breathing in and expanding our body, we want to try and expand our stomach rather than our lungs. When we do a lot of chest breathing, that’s just really using the top half of our lungs. That can mean you get quite shallow breathing and not the full amount of oxygen into your lungs.
So you can try this by just lying down on the floor and diaphragmatic breathing. You’re gonna try and put one hand on your chest and one hand on your stomach. And as you’re breathing in, try not to increase the air into your chest.
Try to expand your stomach. So as you’re lying on the floor, you can feel your stomach rising and then your chest will rise at the end.
This is just really helping to bring the diaphragm down a little and expand the full extent of your lungs.
The good thing about this as well is that it really helps to almost massage your intestines from the inside. It just helps to push things along and it can be really helpful whilst you are experiencing flares to make sure that you’re breathing in such a way.
Gut Directed Hypnotherapy for IBS
Another thing kind of similar to breathing that helps to reduce the vagus nerve stimulation is meditation. Slowing down your breathing, but also this is really engaging your brain in it.
It’s not about necessarily clearing your mind, but just being present in the moment. It’s an ongoing kind of practice.
It’s not just something you do once and then you’re done. But it can really help to create brain space and resilience to stress. And this is something, yeah, I said it’s a practice. It needs to be done more than once, ideally every day.
There are loads of apps you can use, which are helpful. Things like Headspace and Calm you might have seen.
The Nerva app
There is actually a very specific IBS app called Nerva.
And this app has been developed specifically for people who have IBS, and it uses gut directed hypnotherapy. So it’s not quite meditation as such, but it’s really using imagery and the gut brain connection to try to calm your brain. But also, what I like about it, is it has a lot of information in there about digestion that can help teach you about better digestion.
And I’ve found a lot of people who I work with get some relief from that just by changing their mindset to the symptoms that they’re having. Again, it doesn’t mean it’s all in the mind, but it just because the gut brain connection is so powerful. If there’s anything you can do through changing the way you think about your symptoms, it might be worth a try. It is paid-for, but there is a free trial so you could try it.
Laughing for IBS
So are there sort of similar things that change our breathing and help to shake things up a bit. Help to reduce our stress levels more, just more generally, but also specifically around the vagus nerve.
Include laughing and also exercise because they help to like reset your breathing.
It encourages deep breaths, but it also relaxes us, it gets rid of some of our stress hormones.
And then the same way with exercise, like movement helps to disperse some of that high cortisol level and can help you encourage deeper breathing and just turn off some of that stress hormone production. So that is also something that helps to like reset your breathing patterns and forces you to take deep breaths.
Can sound help the vegus nerve?
Now the other thing about the vagus nerve that can be helpful is to try to stimulate it using sound and using the muscles in your throat. Two examples that I’ve got for you with that is gargling.
So you can try this with a small sip of water and just. Throw it to the back of your throat and then gargle with the water a couple of times a day for a couple of weeks, and try and see if this has any effect. Now you wanna do it with enough noise that you can really feel yourself kind of gagging and it stimulates the muscle at the back of the throat.
Or the other thing you can try is humming and singing. It’s really good because it also creates a bit of a vibration in your chest, and that can also just help to stimulate the vagus nerve. Can be singing in the car or in the shower if you don’t feel confident making a big, loud noise. But singing in a group is also really powerful, so if you have the option to join a choir or just to sing with others, it can be really, really good for mental health.
Catastrophising IBS symptoms
Last section that I want to start on now is just about how you think about your symptoms. How your thought processes can affect your digestive symptoms, like bloating and pain. And how it can really be linked up in mood disorders as well, such as anxiety or low mood. Sometimes we call it catastrophizing, where you believe the worst outcome is definitely going to happen.
It’s almost like that very pessimistic thinking of, “yeah, it’s all terrible. I’m never gonna be able to eat out”. “I’m never gonna be able to eat normally.”
And often I have to say this is based on real life negative experiences. You’ve had terrible experiences of having to dash to the toilet whilst you’re out for a walk and have a poo behind a bush.
Or you’ve been sitting on the toilet for 20 minutes and really struggling and getting a lot of haemorrhoids and pain.
These are really negative symptoms that don’t go away easily. When they’ve happened to you, you don’t want to forget about them. Because your body’s trying to keep you safe. Your body’s trying to tell you that the worst is possible because often it has been possible.
So when we think about catastrophizing though, it’s not actually just over exaggerating. It’s kind of based on these true facts.
Why catastrophising can harm IBS
Problem is with always thinking the worst is that you may, in order to protect yourself from these negative outcomes like bloating, pain, diarrhoea, et cetera. In order to do that, you could avoid some of the things that could actually make you better.
You may be avoiding doing strenuous exercise because when you once went for a run. You had loads of gas and were really farting noisily to everyone you were with. Or maybe when you tried to eat some fibre, you got a stomach ache.
So actually you don’t wanna do that again. While you can see it makes sense in some ways or logical sense that you could start catastrophizing about your symptoms.
We also know that people who are typical catastrophizers can suffer worse with their IBS.
What I mean by that, there was a really good study, of people who catastrophized their IBS had worse psychosocial and functional outcomes.
In addition to the psychological distress that you may experience, people who tended to catastrophize had a worse experience of that.
What we need to do is to try and work out how to reduce those thoughts. Try to control the way you think about your symptoms.
Staying in the present
One of the things that might help is just to notice physical sensations as they are.
Instead of trying to extrapolate the feeling of a burbling of gas inside your tummy, or a slight sensation of heartburn, to “oh my God, this is it.” Or “It’s the beginning of another flare, it’s happening again.”
Just to stop. And just notice where you are right now instead of thinking about what could happen in the future. So a little bit like I talked about in the previous episodes around mindfulness and just like being in the moment and not too, and in a way being not too mindful.
And not just focusing on your stomach, but also thinking about other parts of your body.
Like just focusing on how your fingers might feel or your head rather than just thinking about your digestion.
CBT for the gut brain connection
Techniques that can be really helpful for that is cognitive behavioural therapy. There are people who are trained to do this with you. In a six week course can really help you reprogramme your thoughts about your health and your symptoms and that can be quite powerful.
Back to what I covered at the beginning of just around how our thought processes are so linked up with our digestion through this gut brain connection. If there’s anything we can do, just to reprogram our thoughts a little bit. So that it doesn’t send this cascade of high alert danger signals down to the body that can be helpful.
We wanna try and modulate everything we can to try to minimize your gut symptoms. Some of it’s gonna be around food, but obviously some of it is also around your thought processes. If you can try to do anything you can to reduce anxiety to make your body feel safe and comfortable, then that is going to help as well.
I don’t want anyone to think that I’m saying it’s all in your head. I really know it’s not. And from lots of experience working with all kinds of different clients with IBS, I know how debilitating it can be. And how it can just leave you feeling quite hopeless at some points.
I hope that this episode’s given you a few things to think about in terms of understanding more about how the gut brain connection works.
It won’t necessarily change anything overnight, but just maybe this awareness of the connection between the two. And thinking about what you can do and what you could slightly try to change to support your overall health.
A new way to tackle IBS-C
If you are looking to work on your digestion and you want some help, I’m going to be running a new group programme.
I currently work with people just one to one over three months. But I’m gonna be doing a group version of this course starting in September, 2023.
And it’s going to be a rolling enrollment, so you don’t need to start at a certain time.
But from September onwards, I’ll be opening up the doors of the group gut reset, and I’m gonna start with a focus on constipation because I find people will have a similar presentation and it’s just easier to group people together for this kind of IBS. You’ll get all the things that you get in my one-to-one, but also some group work.
So do let me know if you want to be considered for that programme and you can sign up to join the waiting list. See the course – https://www.goodnessme-nutrition.com/group-course-ibsc/
That’s all for this week. I hope you have enjoyed it, and I will see you next week.