The Brain Gut Connection Part 2: Stress Your Gut Less

Thanks for joining me for part two of the brain gut connection! In this segment we will review part one, and show how the brain gut connection is not only linked to stress, but changes in the gut microbes as well. This change in bacteria can add to symptoms for those with IBD by widening the gap of miscommunication between the gut and brain. Let’s review part one, and then jump right into how these changes and stress adversely affect people with Crohn’s or Colitis. 

Last week we went over how stress is triggered in the body and all the different systems stress involves. This includes, but is not limited to; the adrenal glands, your lymphatic system, brain, hypothalamus, pituitary gland, and immune system. These firings of chemicals and hormones also cause a mucosal immune response, which is why people with IBD often have irregular mucosal linings in their intestines. In addition to this, about 35,000 bacterial species react to these chemicals too. This is known to affect the protective good bacterial layer in the intestines, making more room for bad bacteria to grow ultimately leading to symptoms or active disease. 

So how exactly does this series of stress induced reactions affect inflammation in people with IBD? Evidence suggests that stress whether induced by diet, environment, or neuroendocrine pathways, will adversely affect the gut brain axis as well as the biome of bacteria. This complex impact to the immune system is still being studied as it is not fully understood. However, we do know that depending on the stress and the hormones that are released, will either suppress or enhance immune functions. 

Many studies on short-term stress show significant changes in numbers and composition of blood leukocytes, as well as increasing pro-inflammatory monocytes called interleukin. Other types of short-term stress, school and work related, were associated with an increased production of tumor necrosis factor alpha as well as interferon-gamma. These then upregulate anti-inflammatory cytokines while blocking pro anti-inflammatories. On the flip side, long-term stress has been shown to raise cortisol levels, which affects immune suppression as well as an increase in C-reactive proteins that release proinflammatory effects. This shows that the gut and its microbial biome serve as the organs and microorganisms mediating these immune responses from stress. These findings give us some insight to IBD as well as IBS, and bring hope for future treatments. 

There are a few other factors to mention specifically for IBD patients and inflammation. For Crohn’s in particular, Escherichia coli can replicate in cells which release large amounts of TNFa. This has been shown to contribute to inflammation for those with Crohn’s. It is important to note also that psychological stress, anxiety, and depression lead to low-grade chronic inflammation of the gut as well. If you have IBD and one of the above conditions listed, it is imperative that you speak to a healthcare professional to help get them under control. It will not only help your mind, but your gut as well, since these conditions will trigger more inflammation especially in IBD patients.    

Since stress is such an important factor for those with IBD, let’s take a look at ways to manage stress and the effects on our bodies. Several studies have been conducted on relaxing techniques. This includes meditation, ‘relaxation training’, guided imagery, and CBT or cognitive behavioral therapy. These methods have been shown to decrease pain and fatigue in IBD patients. It was also shown that IBD patients practicing behavioral self-management showed a 57% decrease in relapse at one year. I don’t know about you, but I think this is pretty incredible! There have also been studies done on combining relaxing therapies with guided images. Here, the therapists replace stressful thoughts and images with mind-relaxing ones. This technique and the use of multi-convergent therapy, which combines CBT and mindfulness practices, were shown to decrease anxiety and improve symptoms as well as quality of life in IBD patients. 

We have known for years that stress increases inflammation and triggers the inflammatory response. Only now are we really diving into specific reasons for these reactions, and being able to relate them to symptoms and active disease in IBD. With new studies on how to manage stress and symptoms in IBD we are coming ever closer to new knowledge that could lead to drug advancement and care. 

Throughout this two-part series I have gone over quite a bit of information, however we have only scratched the surface of this topic. The interactions of the gut and brain are fluid and do affect our gut microbes in a complex way. In IBD we often see miscommunications in this exchange, resulting in symptoms and even active disease. Now, with more research being done on stress and the relationship of IBD we see new viable treatment options in managing stress like CBT, meditation, mindfulness, and guided imagery. With these advancements, real positive change is being seen in IBD patients. I encourage you to do some research of your own, and see if any of these therapies could benefit you!

Want to check out the original article with the results from these findings? Click HERE!

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