Gut feelings: How counselling and mindfulness can help gut pain, intolerances and bloating
By Jad Patrick
Have you ever noticed butterflies in your stomach before giving a speech or doing something nerve-wracking? Or felt reflux or the need to gulp heavily?
These are obvious example of how the brain and stress can affect the gut, as it responds to stimuli from the brain and nervous system.
Ongoing gut problems can be difficult to live with. Symptoms of bloating, gut pain, changes in stool habit (diarrhoea and constipation) are not just uncomfortable but for some people can really interfere with their day to day lives. Many of my patients carefully plan their day around access to clean public toilets, and become fearful of eating out. Some of this of course needs to be treated on the physical level – managing intolerances, addressing gut flora imbalances and using herbs, nutrients or medications to deal with uncomfortable spasms and pain.
But one factor often overlooked is the impact of psychological stress on the gut. The gut has its own nervous system and the brain and the gut nervous system ‘talk’ to each other throughout the day. If things aren’t going right in the gut, we can experience mental health symptoms such as anxiety and depression.
Likewise, if the brain is stressed out, this sends messages to the gut too, causing many of the classic symptoms of Irritable Bowel Syndrome (IBS) such as bloating, pain, distension, and changes in stool habit such as urgency, diarrhoea and constipation.
THE RESEARCH
Researchers in one study actually measured the level of a substance called LPS in the bloodstream of volunteers before and after they did a speech in front of strangers. LPS is a by-product of bacteria in the gut (I like to call it bacteria pooh!).
LPS shouldn’t be in the bloodstream and when it’s there it can cause inflammation and lead to symptoms of depression and anxiety. So if we see any LPS in the bloodstream, we know that the gut is ‘leaking’ bacterial pooh into the circulation. It might sound gross but that’s what practitioners mean by leaky gut, or intestinal permeability.
What the study found was that after the speech, participants who reported feeling the most nervous or stressed had the highest levels of LPS in their bloodstream. Stress was literally causing bacterial pooh to cross into the blood.
In fact, psychological stress has been linked to virtually all the symptoms associated with IBS including:
- Disordered gut movement (dysmotility)
- Leaky gut (intestinal permeability)
- Gut pain (visceral hypersensitivity)
- Not breaking down nutrients properly (enzyme secretion)
- Imbalance of gut flora (dysbiosis)
- Gut flora in the wrong part of the gut (Small Intestinal Bacterial Overgrowth – SIBO)
So it’s incredibly essential with any gut disorder that we address the mental reasons, as well as the physical reasons, why our guts might be struggling!
HOW COUNSELLING AND MINDFULNESS CAN HELP
Put simply, counselling is a conversation designed to help you explore your life in a non-judgemental way. I like to help clients to connect with their true values and find what really makes their life meaningful. Additionally, I like to offer simple, practical tools they can use to reduce symptoms of anxiety and stress in their lives. I work a lot with mindfulness.
Mindfulness involves paying deliberate attention to present-moment experience with an attitude of curiosity and acceptance. It’s a way of paying attention to stimuli we receive from the outside world, from inside our bodies, and in response to our thoughts and feelings. Mindfulness has established benefits for reducing stress, anxiety, depression and improving attention, focus and feelings of wellbeing. Importantly, it can also help with gut problems, including many of the symptoms of IBS.
Pain is a common feature of gut problems; sometimes with no obvious physical causes. A recent study found that sometimes the body sustains an injury, which heals and yet the pain response continues – almost like a memory of the pain that repeats on a loop. For instance, when we have a known food intolerance, the brain can start to generalise and interpret more and more foods as ‘threatening’ and release pain signals. The participants in this study were taught mindfulness skills to influence the way they relate to their pain. What they found was that over the course of time the participants’ pain reduced significantly and the effects were actually observed in changes in the nerves and brain! So mindfulness can literally re-wire our brain and nerves. How cool is that?
WHAT YOU CAN DO
An example of what I might do in a session with a client with gut pain is to mindfully notice the pain by breaking it down into its component parts (similar to what happened in the above experiment). I ask the client to notice these aspects of the pain
- Its location (describe on your body where you notice it most)
- Its temperature (does it feel hot, cold, or neutral)
- Its density (is the feeling tight and constricted or loose and expansive)
- Its weight (is it a heavy feeling or a light feeling)
- Its movement (does the feeling shift around, stay in one place, or change over time as you observe it)
Attending to the pain in this was way not only changes the way the client thinks about the pain, but also activates different brain regions and nerves in response to the pain. Over time this can help make the pain either (a) far more manageable or (b) disappear.
Of course, there is a lot more to it than just a simple exercise such as described above, and typically it may take a few sessions to really get the hang of it. But the benefits can be huge.
So as you can see, whilst it’s important to address the physical causes of gut problems, it’s just as important to address how stress and our own nervous system can help with healing too, and mindfulness and counselling can be just the thing to help!
