Do You Trust Your Gut?
If you or someone you love is plagued by chronic digestive distress, you know what it’s like to be held captive by your gut. You may feel increasingly frustrated and don’t know what to do next. You’ve probably seen several competent physicians who have given their best efforts to thoroughly diagnose and treat your condition. You may have tried many different medications to treat the symptoms, only to find that they brought temporary relief at best. You have lived in fear of your unpredictable “problem” that forces you to find excuses for canceling events.
We approach the treatment of gut issues from the premise that the mind and body are all part of an integrated system. Our own clinical experience and the research data show that the mind-body relationship is interactive in both directions. If we don’t look at health from a 360-degree perspective, we miss some of the most important cues and clues to our wellness.
Both the latest neuroscience of the gut and the ancient wisdom of Asian medicine and martial arts are in agreement: The gut is the focal point of human energy and the seat of the emotions. Indeed, scientists are increasingly referring to the gut as the “second brain.” Although your gut might appear to be the cause of all your problems, it is actually the center of hope for relief from your symptoms.
A philosophical separation
Western philosophy and science—starting with Plato and Aristotle—have seen the mind and rational thought as part of some higher reality, whereas the body and emotions are of lesser importance. Classical philosophers taught that reason must control the emotions and that the mind must rise above bodily concerns. Centuries later, the French philosopher Rene Descartes formalized the split by declaring the mind and body to be two metaphysically different kinds of realities. This led to centuries of scientific exploration of the body with little regard to the mind. Although few scientists believe in such dualities anymore, the study of the mind still lags far behind the study of the body. The reason for this is simple: It’s much easier to study the body. You can see it, measure it, touch it, and x-ray it. You can do none of those things with a mind.
The problem is that our minds are inherently subjective, but science is only looking for objective truth that can be measured. Behaviorism—the theory that all behavior is based on conditioning—became the dominant movement in psychology in the 20th century by removing the mind as an object of study, focusing only on behavior.
This started to change by the 1970s when pioneering scientists integrated the study of psychology, neurology, and immunology—termed psychoneuroimmunology—to create the new science of mind-body interactions. It is still a very new and developing field, and we are among the first wave of health professionals to apply this new knowledge to solve chronic gastric distress. The results we’ve had are astounding.
Here is a story that may be familiar to you. (It certainly is to us: We have heard variations of it from hundreds of patients.) The following is the story of “Maria,” who is a composite of many people we have treated:
Maria, a married mother of three teenagers, works full-time in a busy office downtown. One day she began to feel pains in her abdomen, followed by a severe bout of diarrhea. She figured it would go away, like it always had before.
But it didn’t go away. It got worse. The diarrhea started alternating with periods of constipation. She couldn’t predict what she would experience next. She began missing meetings at work because she was in the restroom. Some days she would call in sick “just in case.”
When she realized she was distancing herself from her family and friends, she went to see her primary care physician. Maria’s doctor examined her and ran all the appropriate diagnostic tests but couldn’t find anything physically wrong. Maria was also assessed for depression, anxiety, posttraumatic stress disorder, and excessive stress. Maria’s doctor recommended fiber and gave her a referral to see a gastroenterologist (GI specialist). The GI specialist gave Maria a colonoscopy and several other tests to rule out serious physical pathology. “The results are all negative,” the specialist said. “You don’t have something serious like cancer or inflammatory bowel disease. Your symptoms are due to irritable bowel syndrome.”
The GI specialist then discussed lifestyle changes and stress reduction, and reviewed the range of prescription drugs that might be helpful. The specialist also suggested that Maria might benefit from seeing a psychologist to address some of the stresses affecting her symptoms. Maria was concerned about the drug recommendations because of her previous sensitivity to medications. And the suggestion to see a psychologist pressed the wrong button in her. Now Maria was really scared. “They think I’m crazy,” she said to herself. “They think it’s all in my head.”
Though Maria went to see a psychologist after all, the psychologist could not solve her problem either. Maria made the rounds, seeing different doctors and getting prescriptions that treated her symptoms, but she felt no hope for successful treatment. “I’ve been scoped from both ends, nobody can do anything for me, and I still have this pain and gastric distress,” she said. “So what now?”
Maria wasn’t the only one feeling frustrated and helpless. Health professionals who see patients like Maria often feel frustrated by their limited ability to positively affect problems like hers. This can be true even for GI specialists, the physicians with the most training in gastrointestinal diseases. They are the ones we go to for evaluation of serious, sometimes life-threatening, diseases like gastrointestinal cancer and inflammatory bowel disease. Though they have technologies for diagnosis of organic or structural diseases, even they get frustrated by the severe suffering experienced by those who have the unexplained symptoms known as functional bowel disease. In spite of the diligent and caring work of GI specialists, Maria and millions of others can’t find relief for their chronic digestive distress.
Instead of talking about the body and mind as two separate entities, we talk about the body/mind. Each person is a unified system and should be approached as such. This shift in perspective was possible due to the technical advances in imaging that allowed scientists to measure the brain’s functional activity in living people. The most surprising insight to come from these inquiries is that our brain does not distinguish between what is physical and what is psychological—it creates the same neurohormonal responses either way. This new perspective allows a completely different way of looking at the problem of gastric distress. More important, it makes it possible to find new solutions.
The Western approach to disease and illness uses a lot of violent metaphors that suggest healthcare is a huge battle. Doctors fight disease, they wage war on cancer, and patients struggle valiantly to conquer the disease. The medical arsenal includes lasers, radiation, chemicals, and pills. One of the primary goals is to kill pain.
The Western “us versus them” strategy works well for a lot of illnesses, such as when you need an antibiotic to kill bacteria or chemotherapy to kill cancer cells. But this approach falls short for many gut sufferers. You probably believe that your gut is a problem to be attacked, because that is how you have been taught to think about illness. We have a totally different approach. We don’t want you to fight your gut—we want you to trust it.
The key to solving your gut distress is realizing that your gut is not your enemy—on the contrary, it is the center of your body/mind system. It is your core. Your chronic gut problems are signs that your system is out of balance. To restore that balance and become centered, you must learn to listen to what your gut is telling you.
Just as heat sensations tell you to take your hand off the stove and the bad smell of spoiled milk tells you not to drink it, the various symptoms of gut distress are messages that need to be deciphered and acted upon. Instead of killing the pain with a pill, we want you to observe the pain and try to understand the signals it contains.
Think about it. If you killed the pain in your hand when it was on the stove, it would become severely burned. If you killed the ability to smell, you could get sick (or worse) from eating spoiled food. So why try to kill the pain and discomfort in your gut? It doesn’t make the problem go away—it only allows you to forget about it. Your body is trying to tell you something, and the best thing to do is to listen to it.
Think of all the pills and remedies you have taken over the years. They haven’t brought lasting relief. They may have even created other health problems. It’s time to quit fighting and start listening. Your gut is not your enemy. Your gut is part of you. You don’t need pills, you need skills to help you observe and respond effectively.
It may feel like your gut is holding you hostage and is trying to sabotage your life, yet no matter how hard you fight, you don’t seem to win. That is because the gut is a vital messenger to heed and trust, rather than an enemy to be feared. We focus on those functional relationships between the brain and the gut—including the neural and hormonal interactions—as well as the interactions with each patient’s inner (ecology) and outer environmental factors such as stress and diet.
Because we know that everything is connected, we must pay attention to all aspects of a person’s life to pinpoint possible areas where the system isn’t functioning properly. We now know that symptoms are messages from the body to rely on, rather than to ignore or medicate.
Gregory A. Plotnikoff, MD, MTS, FACP, is a board-certified internist and pediatrician. Mark B. Weisberg, PhD, ABPP is a clinical health psychologist. Together they are the authors of the new book, Trust Your Gut. You can find it online at trustyourgut.com.
The Probiotic/Prebiotic Quick Fix
Having a healthy gut can be easy … as long as you learn to trust it and eat right. Luckily, probiotics and prebiotics are able to help your gut find normalcy. But what are they?
You can get probiotics and prebiotics as dietary supplements or in food. Probiotics contain high amounts of the good kind of bacteria, which help to restore the intestinal microbial balance. Restoring that balance through probiotics can relieve all manner of GI-related ailments, including irritable bowel syndrome, acid reflux, diarrhea, gallbladder/gallstones, and more.
Prebiotics contain a plethora of nutrients that are considered food for the bacteria in our digestive system. This is not a food for the human body directly (it’s actually indigestible) but rather food that the probiotic bacteria eats. Another major difference between the two is that prebiotics are not affected in any way by heat, cold, or time. Probiotics are extremely sensitive, and too much exposure to heat or cold—or too much time—will either kill the bacteria altogether or significantly lower the amount of it within the supplement.
Together, they create a “synbiotic effect” (named for probiotics and prebiotics working in synergy) that gives your body extra benefits. Many people achieve this synbiotic effect with the use of supplements, but there are foods that contain both of these important digestive tract ingredients that aren’t in a supplement form.
Food sources that contain probiotics are:
Yogurt with live cultures
Some soft cheeses
Food sources that contain prebiotics are:
By Amy Vergin