Tips for Managing the Brain-Gut Connection

Have you ever noticed that your stomach can feel fine the entire morning you are home but the second you get in your car for your daily commute to work it starts to ache and cramp? Or perhaps you feel your stomach churn just at the thought of going to your son's soccer game, knowing there is no bathroom available?

There is a reason that thinking about feeling sick or worrying about having to use a bathroom actually makes us have to use the bathroom more urgently, and that is the connection between our gut and our brain, also known as the brain-gut axis.

The physiology of the brain-gut connection

The brain-gut axis demonstrates how pain transfers from our gut and is experienced in our brain by following along the dorsal horn of the spinal cord, through neurons going to the midbrain and limbic structures, and then to the cortex. Fortunately, our brain has the ability to block the pain signal from the dorsal horn (thus reducing symptoms) through distraction.

Many chronic GI symptoms stem from a dysfunction of this gut-brain pathway, either through an increased signal from the GI tract, central hypersensitivity, or the inability of the brain to turn off the ascending signal from the dorsal horn. Understanding this is a key part in better managing GI symptoms, especially during times of distress.

Fortunately, there are a few exercises that you can do to help your brain "block" the signal of pain from your gut to the dorsal horn.

Tips for calming the brain-gut connection with Crohn's and colitis

Distract yourself

This may seem trivial, but simply distracting yourself from constantly thinking about your stomach pain can help reduce it.  Should your stomach begin hurting during a long car ride, for example, play your favorite song on Spotify and allow the good feelings to distract you from the fact that a rest stop isn't for another 20 miles.

We also may get a "nervous stomach" right before a major event such as public speaking. Do your best to distract yourself from the task at hand that is making you jittery and notice how a calming effect sweeps through your gut and mind.

Do diaphragmatic breathing

Diaphragmatic breathing (or DB) has helped many patients calm down their central nervous system and reduce the sense of urgency throughout the day. Licensed GI psychologists have been using this technique for a while, helping patients cope with chronic GI pain. There are actually several videos on YouTube that demonstrate both the benefits and techniques of DB to ensure you are doing it correctly, allowing yourself the gift of calming down from head to toe and easing stomach issues when you need it most. 

I have found that practicing DB when caught in uncomfortable situations (long ride before a rest stop, stuck in traffic while urgently having to use the bathroom, sitting in the window seat of an airplane and not wanting to climb over two sleeping passengers to get to the restroom, etc.) has helped me tremendously in calming down my GI tract and avoid having accidents.

Practice meditation

Meditating can be beneficial to one's physical and mental health in many ways. When relating to GI symptoms specifically, meditating helps calm down the central nervous system by making us focus on our breath rather than the pain we are experiencing. 

It can also be used to imagine being pain-free, relaxing on a beach with the waves crashing around you, which helps to "block" the pain signal ascending the spinal cord to the brain.  Meditation apps such as Calm or Headspace are great ways to start meditating for those new to the practice as they offer meditation prompts and practices that can be done daily or on an as-needed basis.

Managing stress and anxiety with Crohn's and colitis

It is clearly no secret that there is a connection between our gut and our brain that causes the vicious cycle of being "sick and stressed" when living with IBD. The above tips can help manage these symptoms and better control the pain signals being fired back and forth between the brain and gut. Hopefully, these can help you in time of need when urgency strikes and a bathroom is not easily accessible.