The Surprising Connection Between Digestion and Mental Health

Recently, after years of on-again, off-again constipation, bloating and acid reflux, I finally received a diagnosis for my elusive digestive problems: Irritable Bowel Syndrome (IBS). When I found out, it was like everything I’d always known suddenly fell into place. After all, I’ve had anxiety and intestinal flareups all my life – but I never thought to connect the two until I got my diagnosis.

One in five adults in the United States has IBS, making it almost as common as anxiety. However, many people don’t think to connect their digestive symptoms to the stress and anxiety they experience on a daily basis. Since I discovered the connection between the two, I’ve been doing everything I can to learn how improving my digestive health can help improve my mental health. From books to journal articles to magazine columns, I will read anything if it has those two magical words – “gut” and “brain” – in the title.

I’ve also recently started the low FODMAP diet to heal my body from my IBS. In the process, I’ve strangely noticed that my anxiety doesn’t seem as bad as it used to be. Considering that most of our serotonin is produced in our gut, this makes total and complete sense from a scientific perspective. Yet as an aspiring mental health professional, I find it completely shocking that I went so long without anyone drawing a connection between my gastrointestinal symptoms and my anxiety.

Part of the issue was, admittedly, my reluctance to seek help; after all, constipation and bloating are hardly glamorous issues. It used to be that I’d rather talk about NASCAR than discuss my bowel habits (which, coming from me, is really saying something!). But I had also never heard of IBS until I was in college, even though I’d had these symptoms for far longer.

This paragraph might be TMI for some, but I remember once, in high school, during the stress of the school play, I suffered from such bad constipation that I had to take laxatives (and a day off school) to recover. After that, I was drinking Milk of Magnesia at least once a month to relieve the pain.

When I got older and developed orthorexic behavior, it was all I could do not to obsess over the constant bloating in my lower abdomen. No matter how many minutes I planked or what I cut out of my diet, I could never achieve those perfectly flat abs like I saw on all the Instagram stars and YouTube icons I idolized so much.

As a sophomore in high school, I was so bloated that I cried trying on my prom dress and, feeling how tight it was, convinced myself that I was “too fat” to go at all. This led to a downward spiral of orthorexia, bulimia and anxiety, which – knowing what I know now – obviously exacerbated the problem. (Eventually, I exchanged the dress for a different size and went, you would never know from the pictures just how damaged my body image, or my gut, truly was.)

For so long, I convinced myself there was something wrong with me or the way my body was built. Then, I spent several long years recovering from my poor body image, anxiety and depression, and realized the problem wasn’t in my weight, but in my gut.

Developing intolerances to lactose and gluten was the last straw: I finally sought help from my doctor, who told me I – like 1 in 5 Americans – most likely had IBS. Suddenly, it all made sense why I always looked three months pregnant in photos, or why my bowel habits were so irregular, fluctuating from nonexistent one week to gas and diarrhea the next. Soon, I also learned that there was a connection between IBS, stress and anxiety, which validated what I had always known: anxiety is a physical disorder, just as much as a mental one.

If this sounds like you or someone you know – or if you’re simply interested in improving your overall gut health – I highly encourage you to read on for tips and tricks on healing your gut for mental health! (As always, I am not a doctor, and you should consult with your GP before making any drastic changes to your health regime.) Below, I’ll share some of the wisdom I’ve learned throughout my journey with IBS, the diet that works for me and some tips and tricks I’ve been meaning to try for giving your gut a much-needed boost.

Gut Health for Dummies

A well-functioning digestive system is one of the cornerstones of good overall health. Because it’s where most of the body’s serotonin is produced, it especially has strong ties to our mental health – a phenomenon doctors and medical researchers like to call the “gut-brain axis.”

But which organs are we talking about when we say the word “gut?” More importantly, how can we tell whether our gut health is good or bad? (While you’d think it would be obvious, many signs of poor gut health are much subtler than pain or erratic bowel movements!) Well, for the purposes of this article, I will use the term “gut” to refer both to your GI tract and to the diverse microbiome that calls it home.

The GI tract is the system of organs that runs from your esophagus down to your anus – in other words, the path your food travels through as it is being broken down by your body. This starts with the esophagus, followed by the stomach, small intestine, large intestine and rectum (your “bowels”). Your anus is the point of exit for any excess waste that hasn’t been used by the end of this process. (See below for a detailed diagram of the GI tract.)

digestion

Within this “gut” of ours, each of us carries as many as 2 kg of friendly bacteria – or what we like to call your “gut microbiome.” We each have a unique breakdown of species populating our gut, which results in small differences between individuals; for example, food intolerances like mine are strongly linked to a lack of “helper” bacteria that break down lactose or gluten.

The composition of your gut is affected by your genetics, as well as environmental factors like whether you were delivered vaginally, whether you were breastfed and whether you played outside often as a child. All these experiences expose us to different kinds of friendly bacteria, which continue to populate our gut and affect our bodies as we grow up.

Unfortunately, it’s difficult to change your microbiome – but you can do it both by creating a positive environment for healthy bacteria to thrive in and by reintroducing positive flora to your gut. In mild cases of gut dysbiosis (a fancy term for “imbalance”), this might mean taking a probiotic or upping your intake of fermented foods; in serious cases, such as IBD or chronic infection, treatment could even include a fecal matter transplant, which transfers bacteria from a healthy person’s gut to your own.

When people speak of “healing” your gut, this is generally what they mean. Not only do you want to minimize the inflammatory conditions in your gut, making it easier for healthy bacteria to thrive there, but you also want to introduce bacteria to your body and give it the opportunity to grow. So, feel free to pass this wisdom on to the moms in your life: a little dirt can actually be a good thing – at least as far as your gut is concerned!

So You Think You Have IBS…

“Yes!” you scream at your computer, knowing full well that I can’t really hear you. “That sounds just like me. I must have IBS, too!” Now, you’re probably wondering “So, what next?” Well, after making an appointment with your doctor to confirm the diagnosis (and rule out any more serious gastrointestinal conditions, such as Crohn’s, ulcerative colitis or celiac disease), there are a couple of steps you can take to help yourself heal faster.

The Low FODMAP Diet

The number one dietary change recommended for IBS patients is cutting out something called “FODMAPs.” FODMAP stands for “Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols” – but if you’ve been on this diet before, you know it pretty much stands for “I can’t eat anything that isn’t sold for $10 at Whole Foods.”

I say this because on the low FODMAP diet, you can only have a limited number of fruits and vegetables, gluten-free grain products, lactose-free dairy products and most kinds of meat and fish. Eating gluten-free isn’t exactly great for one’s wallet – but then again, you can’t really put a price on the bliss you feel from not having to spend half your life in-and-out of bathroom stalls anymore.

Below, I’ve copied the chart I use to know which foods I can and can’t have on the low FODMAP diet. While you’re getting used to the diet, I highly recommend you print it out and post it on your fridge (or somewhere else in your kitchen) for easy reference!

fodmaps

Source: Monash FODMAP

 

On the go, the app called “The Low Fodmap Diet for IBS” only costs $0.99, and provides a simple searchable database of foods and their FODMAP contents, complete with a rating of Low, Medium or High FODMAP next to each food.

Finally, there are tons of bloggers who have posted delicious low FODMAP recipes on Pinterest – I especially love Fun Without FODMAPs – which makes Pinterest an amazing resource to bookmark for meal planning for IBS.

If you’re new to the low FODMAP diet, DO NOT PANIC! Though it looks restrictive at first, there are still so many delicious foods you can eat sans FODMAPs – not to mention that it really, truly does help reset your digestive system, banish bloat and get you “regular” again (if you know what I mean).

Still don’t believe me? Here are some typical snacks and meals I will eat in a day on the low FODMAP diet. (I think I eat pretty normally still!)

Breakfast

  • Two eggs, fried in grassfed butter, with salt and pepper
  • Udi’s gluten-free white bread, toasted, with grassfed butter (and sometimes a low FODMAP strawberry jam)
  • Lactose-free yogurt – I love the one by Green Valley Creamery!
  • Cheerios (which are now 100% gluten-free! Woohoo!) with Lactaid milk and sliced strawberries or raspberries

Lunch/Dinner

  • Turkey and lettuce on Udi’s gluten-free white bread with a side of grapes
  • Quinoa with tomatoes, bell peppers, cucumbers and feta cheese, drizzled with a little bit of EVOO
  • Brown rice spaghetti with grassfed butter and parmesan cheese
  • Amy’s gluten-free macaroni and cheese (with two lactase pills to aid my digestion)
  • Bob’s Red Mill gluten-free pizza crust with sliced tomatoes, fresh mozzarella and fresh basil

Snacks

  • Dunkin’ caramel iced coffee with cream only
  • Gluten-free cookies (Trader Joe’s has delicious ones!) with a glass of vanilla almond milk (or coffee!)
  • Bob’s Red Mill oatmeal with Justin’s almond butter and sliced strawberries or raspberries
  • Gluten-free crackers (I like Back to Nature or Crunchmaster) with brie or cheddar
  • Lactose-free yogurt with sliced strawberries or raspberries
  • Annie’s gluten-free “bunny grahams” in cocoa and vanilla
  • Banana with Justin’s almond butter packet
  • Fun Without FODMAPs’s low-FODMAP chocolate chip pumpkin bread
  • Bobo’s oatmeal bars

Tips for Overall Gut Health

Besides changing your diet to reflect your diagnosis, there are many other steps you can take to improve your gut health that aren’t related to what you eat. Believe it or not, many of the habits we take part in every day have consequences for our overall gut health. Here are some small adjustments you can make to start a more gut-friendly routine for your body!

  • Take a probiotic. Experts recommend taking 10 billion CFUs of a probiotic containing Lactobacillus and/or Bifidobacterium. (If you have lactose or gluten-intolerance like I do, Bifidobacterium deficiency may be to blame!) A high number of CFUs (“Colony-Forming Units”) is key, since many bacteria will die before you take them. My roommate stores hers in the fridge – no clue if this helps or not, but I’m on board with it. I recommend up4’s Adult Probiotic Supplement, which contains both strains and is more affordable than many probiotics on the market.
  • Dry brush. I love dry-brushing for stimulating circulation and digestion. Using a dry brush, brush your skin upwards with firm motions toward your heart. This gets your blood pumping and all those toxins moving down and out, stimulating healthy digestion!
  • Drink bone broth. Collagen, the protein found in bone broth that makes it so darn good for you, has gotten a lot of buzz lately. Drinking this warm beverage will not only keep you toasty on chilly winter days, but also help soothe and heal your intestines from the inside-out.
  • Chug more water. If you suffer from constipation-type IBS like I do, you’ll probably hear lots of people say “Eat more fiber!” However, eating more fiber doesn’t help unless you’re also drinking the appropriate amount of water. On the other hand, if you’re dehydrated, your stools will have less bulk, be harder to pass and may even lead to painful, bleeding anal fissures (which, I know from experience, can cause quite the health scare!).
  • Test your microbiome. The SmartGut test by uBiome is covered by most insurances, and will tell you what bacterial species your gut is most abundant in – and lacking. Its findings have implications for food intolerances like lactose and gluten, and can also identify species linked to Crohn’s disease, ulcerative colitis, IBS and more.

 

 

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