Mindfulness and the Brain-Gut Connection

Mindfulness meditations are exercises that encourage participants to experience situations in life without judgment and without becoming attached to physical or emotional feelings, desires, memories or expectations. Mindfulness practices are meant to bring awareness to what is occurring in life. Such practices are being more widely employed as alternative therapies in many health care settings and mindfulness has been significantly associated with reduction in pain- and stress- predominant disorders, particularly the mindfulness-based stress reduction program (Gaylord et al., 2012).

Mindfulness-based stress reduction (MBSR) is a mindfulness practice and educational program that includes yoga, lifestyle education and various meditations and breathing exercises. Programs are normally offered in 8-week segments with one meeting per week and a one-day intensive.  MBSR offers skills that can be used to alleviate anxiety, cope with pain, depression and stress disorders (Musiala et al., 2011). According to the University of Massachusetts Center for Mindfulness, MBSR participants become involved for a variety of reasons including general stress, chronic pain and illness, anxiety, gastrointestinal distress, problems with sleep, fatigue, headaches and high blood pressure. The program was developed in 1979 to assist those struggling with chronic stress and illness by integrating mindfulness into their everyday lives in order to adapt to living with their condition (Gross et al., 2010). Evidence suggests that the MBSR program may be especially helpful as therapy for immune-related conditions including cancer and HIV, diabetes, insomnia and irritable bowel syndrome (IBS). Support for use of MBSR in IBS pathogenesis is discussed below.

Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder characterized by recurrent abdominal pain for a cumulative twelve weeks in the previous year in conjunction with two of the following related symptoms: pain relieved with elimination, change in stool frequency and change in the appearance of the stool (Nelms, Sucher & Long, 2007). Studies suggest that IBS affects anywhere from 10-20% of the populations of developed nations, and can manifest as IBS with constipation, IBS with diarrhea or IBS with alternating constipation and diarrhea (Camilleri, 2012). The etiology of functional bowel disorders is largely unknown and may vary from patient to patient. Research suggests that many peripheral factors may influence the pathogenesis of IBS including abnormal smooth muscle in the gut, increased sensitivity of the gut lining and enteric nervous system and stimulation or hypersensitivity of the central nervous system (Camilleri, 2012). These mechanisms may result from or result in abnormal transit time, compromised evacuation, imbalanced gut flora, increased mucosal permeability, increased presence of intestinal irritants, food sensitivities and intolerances, genetic susceptibility and an excess of bile acids (Camilleri, 2012).

Evidence supports the link between IBS and psychiatric disorders including depression, mood and anxiety disorders (Mykletun et al., 2010). Population studies show a strong correlation between symptoms of anxiety and depression and functional disorders (Mykletun et al., 2010). In one study, 50.5% of participants with self-reported lifetime pathogenesis of IBS also suffered from lifetime mood or anxiety disorders and nearly all psychiatric conditions have been correlated with increases in IBS, with the exception of bipolar disorder (Mykletun et al., 2010). While IBS is not primarily a psychosomatic disorder, symptoms can be aggravated by stress, anxiety, depression or emotional trauma (Nelms et al., 2007). IBS-related psychiatric conditions such as anxiety and mood disorder are likely in up to 60% of those seeking treatment in gastroenterology outpatient clinics and up to 27.5% of the population as found in a population-based epidemiological study (Quigly & Craig, 2012; Mykletun et al., 2010).

The brain-gut interaction in IBS is prominent, and there is more and more evidence for long-term management of functional disorders with mindfulness practices, particularly disorders such as IBS with underlying psychological symptoms. Neuroscience inquiries have found that mindfulness meditation alters neural circuits that may be involved in sensitivity to internal stimuli, neurovisceral awareness, attention, and self-regulation (Gaylord et al., 2012). There is sufficient evidence to suggest that mindfulness meditation in IBS patients may address sensitivity to pain resulting from underlying anxiety about the condition and inattention to gastrointestinal sensations, alleviating much pain and suffering in this population (Gaylord et al., 2012).

Join my upcoming workshop, “Love your food, Love your body” to learn mindful eating techniques to support optimal health and wellbeing.

October 22nd, 2016 at Peace.Strength.Yoga in Chattanooga, TN.

 References:

Camilleri, M. (2012). Peripheral Mechanisms in Irritable Bowel Syndrome. New England Journal of Medicine, 367(17).

Gaylord, S., Whitehead, W., […], and Mann, J.D. (2012). Mindfulness for irritable bowel syndrome: protocol development for a controlled clinical trial. BMC Complimentary and Alternative Medicine. doi:  10.12659/MSM.883269

Gross, C., Kreitzer, M.J.,  Reilly-Spong, M., Wall, M., Winbush, N.Y., Patterson, R., Mahowald, M., and Cramer-Bornemann, M. (2011). Mindfulness-based stress reduction vs. pharmacotherapy for primary chronic insomnia: A pilot randomized controlled clinical trial. Explore (NY), 7(2). doi:  10.1016/j.explore.2010.12.003

Musiala, F., Büssingb, A., Heusserb, P., Choic, K., and Ostermannb, T. (2011). Mindfulness-based stress reduction for integrative cancer care: A summary of evidence. Forsch Komplementmed, 18. doi: 10.1159/000330714

Mykletun, A., Jacka, F., Williams, L., Pasco, J., Henry, M., Nicholson, G.C., Kotowicz, M.A., and Berk, M. (2010). Prevalence of mood and anxiety disorder in self reported irritable bowel syndrome (IBS): An epidemiological population based study of women. BMC Gastroenterology, 10:88.

Nelms, M., Sucher, K., Long, S. (2007). Nutrition Therapy and Pathophysiology. Thompson, Brooks/Cole: United States.

Quigly, E.M.M., Craig, O.F. (2012). Irritable bowel syndrome; update on pathophysiology and management. Turkish Journal of Gastroenterology, 23(Quigly & Craig, 2012) 313-322. doi: 10.4318/tjg.2012.0551

Szczepanska-Sadowska, E., Cudnoch-Jedrzejewska, A., Ufnal, M., Zera, T. (2010). Brain and cardiovascular diseases: Common neurogenic background of cardiovascular, metabolic and inflammatory diseases. Journal of Physiology and Pharmacology, 61(5), 509-521.

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