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Psychogastroenterology & the Gut-Brain Connection
I am particularly interested in the powerful connection between the brain and the gut—the gut-brain axis. We now understand that gastrointestinal symptoms are influenced by between these two systems, and that behavioral interventions can help improve this communication and reduce symptoms. I have pursued specialized training in behavioral treatments for Disorders of the Gut-Brain Interaction (DGBI), conditions such as Irritable Bowel Syndrome (IBS) and Gastroesophageal Reflux Disease (GERD). Gut-brain is typically a focused, short-term treatment that uses evidence-based approaches to help people better manage and reduce gastrointestinal symptoms. See some common questions I receive below!
What is psychogastroenterology?
Psychogastroenterology is a specialized area of behavioral health focused on
the connection between the brain, nervous system, and gastrointestinal
system. It recognizes that digestive symptoms are influenced by a complex
interaction of biological, psychological, and behavioral factors.
What are Disorders of Gut-Brain Interaction (DGBI)?
Disorders of Gut-Brain Interaction (DGBI) are gastrointestinal conditions involving changes in the way the gut and brain communicate. Symptoms are real and can occur even when routine medical testing does not identify structural damage or disease. Because the gut and brain are closely connected, factors such as stress, attention, emotions, expectations, and the nervous system can influence how gastrointestinal sensations are experienced.
How can psychological treatment help my GI issues?
Psychological treatment does not mean your GI symptoms are "all in your head." Rather, it recognizes that the brain and gut are constantly communicating and that this communication can influence the intensity and persistence of symptoms. Behavioral treatment can help people understand the gut-brain connection, reduce fear and anxiety surrounding symptoms, change patterns of hypervigilance and avoidance, and develop skills for responding differently to uncomfortable sensations.
What does gut-brain therapy involve?
Gut-brain therapy is typically a focused, short-term treatment tailored to a person's symptoms and goals. Treatment may include education about the gut-brain connection, behavioral strategies, mindfulness, relaxation and breathing techniques, attention training, behavioral changes, and approaches for reducing fear and hypervigilance toward bodily sensations.
The goal is not simply to "think positively" or make symptoms disappear through willpower. Instead, treatment focuses on changing the ways we respond to gastrointestinal sensations and reducing factors that can keep the brain and gut caught in a cycle of distress.
What happens when persistent GI symptoms become a source of anxiety?
For some people, gastrointestinal symptoms become more than an uncomfortable physical experience. They can begin to create worry about what the symptoms mean, when they will happen next, or whether they will interfere with work, school, travel, eating, or social activities.This can create a self-reinforcing cycle: a physical sensation leads to worry, worry increases attention to the body, increased attention makes the sensation feel more noticeable, and the resulting anxiety can further affect the gastrointestinal system. Treatment can help break this cycle by addressing both the thoughts and behaviors surrounding symptoms and the body's response to stress and perceived threat.
My approach to gut-brain therapy
I draw from my training in Cognitive Behavioral Therapy (CBT), Acceptance and Commitment Therapy (ACT), mindfulness, and behavioral medicine, along with specialized training in interventions for Disorders of Gut-Brain Interaction (DGBIs). Treatment is individualized based on each person's symptoms, concerns, and goals.
For some people, this may mean learning how to respond differently to uncomfortable sensations. For others, the focus may be reducing hypervigilance, challenging catastrophic interpretations, decreasing avoidance, or becoming less caught up in monitoring the body. Mindfulness, breathing, relaxation, and other nervous-system regulation strategies may also be incorporated when appropriate.My goal is to help people develop a more flexible and less fearful relationship with their bodies while getting back to the activities and experiences that matter to them.
Behavioral treatment is generally most effective as part of a comprehensive approach to gastrointestinal health and does not replace appropriate medical evaluation or treatment.
Learn more about the gut-brain interaction in my blog post on the subject!
