Recurrent heartburn could be a sign of GERD

It’s not unusual to feel “sick to your stomach” with grief or anger. Or to think of a decision fraught with worry and anxiety as “gut wrenching.” That’s because your gut responds to emotional signals from your brain — and vice versa. It’s known as the mind-gut connection. And it may affect your mental and physical health.

What’s Your Gut?

Your gut includes the organs involved in digesting food and processing waste. These organs are all part of your gut:

  • Esophagus
  • Gallbladder
  • Liver
  • Pancreas
  • Stomach
  • Small and large intestines

The organisms that live in your gut make up what’s known as the gut microbiome. Your gut contains tens of trillions of microorganisms, including bacteria, viruses, and fungi.

You’re born with most of your gut bacteria. But your gut microbiome makeup and bacterial levels can change over time. Various factors can alter the gut microbiome, including dietary choices, illness, antibiotic use, and whether you were breastfed.

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How Does the Mind Affect Your Gut?

Mental health problems are strongly associated with gastrointestinal symptoms such as heartburn, indigestion, bloating, pain, constipation, diarrhea, and acid reflux. People with irritable bowel syndrome (IBS) — which affects your large intestine, or colon — frequently suffer from anxiety and depression.

Since your colon is partly controlled by your nervous system, it responds to stress. So anxiety and depression can worsen IBS symptoms. In turn, not coping with symptoms of IBS, such as pain, bloating, and diarrhea, can worsen anxiety and depression.

How Does Your Gut Affect Your Mind?

Your brain and your gut communicate physically and chemically.

The vagus nerve is the physical connection between your brain and gastrointestinal tract. It oversees numerous bodily functions, including digestion, mood, heart rate, and immune response. Having healthy gut bacteria may improve mood and anxiety by stimulating the vagus nerve.

Hormones and neurotransmitters are the chemicals that send messages between the gut and the brain. The makeup of your gut microbiome can affect those chemical messages.

In recent years, researchers have found that the microbiome may play a role in autism, depression, dementia, schizophrenia, Alzheimer’s disease, and Parkinson’s disease. Most of the evidence is from experiments in mice. With more research, it may become possible to alter the microbiome to treat psychiatric and neurological disorders.

One way to do that may be through changes in your diet. Dietary changes to alter your gut microbiome may help to treat hyperactivity and neurodevelopmental conditions, such as autism, according to the National Center for Complementary and Integrative Health.

Maintaining a Healthy Mind-Gut Connection

Taking care of your gut health starts with eating a balanced and nutritious diet. You’ll also need to eat a mix of foods containing prebiotics and probiotics.

Prebiotics, which are found in high-fiber foods, feed and help grow the good bacteria of your gut microbiome. Foods high in prebiotics include whole grains, such as barley, oats, quinoa, rye and wheat. Prebiotic fruits and vegetables include apples, asparagus, under-ripe bananas, berries, carrots, garlic, jicama, mangoes, onions, and tomatoes. For the most prebiotic benefit, eat these foods raw or lightly steamed.

Probiotics are live microorganisms that supply good bacteria to your gut. Fermented foods are high in probiotics. These include yogurt with live or active cultures, kefir, kimchi, kombucha, and sauerkraut.

Preserving your gut health also means avoiding unnecessary antibiotics, which kill both bad and good bacteria. Keep in mind that antibiotics only work to fight bacterial infections, such as strep throat. They don’t work against viral infections, such as the flu. Don’t take an antibiotic unless directed by your doctor.

Getting Help

Gastrointestinal disorders can cause real mental health distress, such as anxiety and depression. Left untreated, both the underlying disorders and related mental health issues can worsen. The UPMC Digestive Health Care takes an integrated, holistic approach to treating gastrointestinal diseases.

The center treats not only the physical symptoms of digestive disorders, but also the mental and emotional impact. Treatment may include antidepressants as well as cognitive behavioral therapy and relaxation techniques to help reduce anxiety and stress.

If you have a gastrointestinal disorder and think you are also experiencing mental distress, contact the UPMC Digestive Health Care at 1-866-442-7876 (4GASTRO) to request an appointment with one of our gastroenterologists.

National Center for Complementary and Integrative Health. 4 Fast Facts About the Gut-Brain Connection. Centers for Disease Control and Prevention. Link.

Fitness 4Body4Mind: The Gut-Brain Connection. Mental Health America. Link

Irritable Bowel Syndrome. Anxiety and Depression Association of America. Link

Carl Zimmer. Germs in Your Gut Are Talking to Your Brain. Scientists Want to KNow What They're Saying. Jan. 28, 2019. New York Times. Link

Sigrid Breit et al. Vagus Nerve as Modulator of the Brain-Gut Axis in Psychiatric and Inflammatory Disorders. March 13, 2018, Frontiers in Psychiatry. Link

About Digestive Disorders

UPMC Digestive Health Care cares for a wide range of gastrointestinal (GI) conditions and diseases, from diagnosis to treatment. Whether your digestive condition is common or complicated, our experts can help. Upon referral from your physician, we coordinate your testing and treatment. If you have a complicated condition, we can refer you to one of UPMC’s digestive health centers of excellence. Find a GI doctor near you.