How Can a Psychologist Help Me with My Gastrointestinal Problems?

Most of us have experienced what it feels like when our gut reacts to a strong emotion or stressful situation. But do you really know what’s going on down there? Many people simply chalk it up to “stress impacts my gut,” but the reality is much more complex.

Our gut is often called our “second brain” because it contains a system of nerves that’s constantly communicating with the brain. This system, known as the enteric nervous system, spans everything from our esophagus down to our rectum. It’s connected to the central nervous system through a specialized nerve called the vagus nerve, often referred to as the body’s “gut-brain connector.” Together, these systems form what we call the gut-brain axis.

Stress plays a major role in disrupting the gut-brain connection. When your brain sends out an “alarm signal,” it can throw off gut functioning, causing short-term gastrointestinal symptoms like bloating, acid reflux, urgent bowel movements, or even constipation. But this system is bi-directional, meaning gastrointestinal distress can also send signals up to the brain, leading to anxiety and mood issues.

For some people, this becomes a longer-term problem. Miscommunication between the gut and brain can create a vicious cycle: gastrointestinal symptoms lead to emotional and cognitive changes, which then worsen the physical symptoms, and so on. This is a nervous system issue that might not always show up during standard gastrointestinal assessments. These conditions are often referred to as Disorders of the Gut-Brain Interaction and can significantly interfere with day-to-day life. Symptoms may include abnormal gut sensations, problems with gut motility, abdominal pain, bloating, nausea, diarrhea, constipation, and indigestion. Overall, having a gut-brain issue can also increase your risk of developing anxiety and depression.

Thankfully, the way we understand these disorders is shifting—and with that shift, psychological interventions have been developed that can effectively treat symptoms and improve quality of life. Psychologists who specialize in this area are often called gastro-psychologists. These treatments are skills-based, concrete, focused, and short-term (typically lasting between 4 and 12 sessions). Gastro-psychologists often collaborate with other members of your healthcare team, such as your gastroenterologist and dietitian, to coordinate care.

These treatments aim to reduce nervous system reactivity by helping you change how you respond to symptoms and manage the thoughts that can trigger them or make them worse. One major intervention for Disorders of the Gut-Brain Interaction is Cognitive Behavioral Therapy (CBT), which helps you identify and shift unhelpful thoughts related to your symptoms while teaching effective coping skills to reduce stress and emotional reactivity. Mindfulness-based therapies can also help by increasing awareness of how you respond, internally and externally, to symptoms. These strategies can reduce the hypervigilance many people experience and that constant sense of symptoms always being “in the back of your mind,” which can impact decisions around eating, socializing, or even taking a vacation. Gut-directed hypnotherapy is another powerful tool that can help reduce physiological arousal.

Some of the issues a gastro-psychologist can help with include:

• Irritable Bowel Syndrome (IBS)

• Acid reflux and Gastroesophageal Reflux Disease (GERD)

• Functional dyspepsia

• Functional constipation

• Abdominal pain and bloating

• Belching disorders

Finally, for individuals with chronic gastrointestinal conditions like Crohn’s disease, Ulcerative Colitis, Cyclic Vomiting Syndrome, or POTS, working with a gastro-psychologist can help keep stress levels low, which has been shown to reduce inflammation and disease flare-ups, and support adjustment to the day-to-day challenges these illnesses can bring.

If you're interested in learning more about gut-brain treatment or would like to schedule an intake session, please contact me here!