Disorders of the Gut Brain Interaction (DGBI) encompass a wide range of chronic digestive conditions characterized by recurring gastrointestinal symptoms without discernible physical abnormalities. A central component of all disorders of DGBI is the dysfunction and or communication problems between the central nervous system (i.e., the brain) and the enteric nervous system (i.e., the neuronal network that helps to control and manage gastrointestinal function). Irritable bowel syndrome (IBS) and functional dyspepsia (FD) are two of the most common DGBIs which are known to significantly affect the quality of life for those living with it. The cause of DGBIs remains unclear, but it is increasingly apparent that psychological factors play a crucial role in both the onset and management of these disorders. Below are common symptoms that people experience with these two DGBI.

Irritable Bowel Syndrome (IBS):

• Abdominal Pain: Recurring stomach pain or discomfort, the pain can vary in intensity and is usually relieved after a bowel movement.
• Bloating: Abdominal bloating, which can contribute to feelings of discomfort and fullness.
• Abdominal Distention: The visible enlargement or swelling of the abdomen due to the accumulation of gas, air, or fluid in the digestive system.
• Altered Bowel Habits: IBS can cause changes in bowel habits, including diarrhea, constipation, or a combination of both.
• Gas: Increased gas production and flatulence are common.
• Mucus in the Stool: Some individuals may experience mucus in their stool.
• Urgency: IBS can lead to a sudden and strong urge to have a bowel movement, especially in those with diarrhea-predominant IBS.

Functional Dyspepsia:

• Upper Abdominal Pain or Discomfort: Persistent, bothersome pain or discomfort in the upper abdomen, this discomfort typically occurs during or after meals.
• Feeling Full Quickly: Individuals with FD may feel full after consuming only a small amount of food, a sensation known as early satiety.
• Bloating: Excessive bloating, gas, and a sensation of abdominal fullness are common.
• Nausea: Frequent feelings of nausea, sometimes leading to actual vomiting.
• Belching: Excessive belching or burping.
• Regurgitation: Where stomach contents flow back into the throat without vomiting.

Understanding the Brain-Gut Connection

Given the central role of the interaction between the brain and the gut in relation to DGBI, understanding the psycho-social factors that may facilitate and maintain gastrointestinal symptoms is essential. Stress, anxiety, and emotional distress can act as triggers, whilst the constant discomfort and unpredictability of IBS symptoms can lead to anxiety, depression, and chronic stress. Paradoxically, these psychological issues can further intensify the physical symptoms, creating a vicious cycle.

Psychological Treatment for DGBI’s

To date there have been numerous large research trials which have provided evidence for the benefit relating to psychological interventions for the treatment of a range of DGBI, these include: Cognitive Behavioural Therapy, Hypnosis and Mindfulness / Relaxation.

Cognitive-Behavioural Therapy (CBT): CBT is a prominent psychological treatment for DGBIs. It focuses on equipping patients with the tools to identify and modify negative thought patterns and behaviours that contribute to their symptoms. By teaching effective coping strategies, CBT helps individuals manage stress and anxiety, which in turn reduces the frequency and severity of their symptoms.

Hypnotherapy: Gut-directed hypnotherapy has shown remarkable promise in alleviating DGBI symptoms. It centres on enhancing the mind-gut connection, enabling patients to gain better control over their gut functions and reducing their perception of pain.

Mindfulness and Relaxation Techniques: Mindfulness practices, like meditation, deep breathing, and progressive muscle relaxation, offers client’s valuable tools to manage their symptoms. These techniques promote relaxation, alleviate stress, and foster a heightened mind-body connection.

If you or someone you know is grappling with a DGBI like IBS, seeking psychological treatment offers a promising path, breaking the cycle of symptoms and emotional distress, and paving the way for a healthier, happier life.