The Most Prevalent Gut Disorder Actually A Gut-Brain Disorder

Irritable Bowel Syndrome with Constipation (IBS-C) isn’t just a case of occasional gut issues —it’s a condition that takes over your life, often in frustrating and unpredictable ways. For those navigating its challenges, IBS-C can throw a wrench into routines, take a toll on emotional well-being, and leave you feeling like your body is working against you. With symptoms like abdominal pain, bloating, and those all-too-familiar hard, infrequent stools, it’s clear that IBS-C is more than just “a stomach issue.”

But here’s the thing: understanding what’s happening in your body is the first step toward managing it. In this article, we’ll unpack the fascinating connection between your gut and brain—yes, they’re constantly chatting—and how this relationship influences your IBS symptoms. We’ll also take a closer look at how stress, anxiety, and even the microscopic world of your gut microbiota can make things worse.

Understanding the Gut-Brain Axis in IBS

An excerpt from my book The Gut Revolution: The most prevalent gut disorder is actually a gut–brain disorder and provides more proof of the strong connection between the gut and the brain. Your gut and brain are in constant conversation, thanks to the gut-brain axis—a network linking your gut, brain, and gut microbes to each other. This system regulates gut functions like motility and sensation. IBS is an intestinal motility disorder that can cause either diarrhea (IBS-D), constipation (IBS-C), or a mix of both (IBS-M). In IBS-C, disruptions can lead to sluggish gut movement and heightened sensitivity, causing symptoms like abdominal pain and constipation. An imbalance in gut microbes, or dysbiosis, can make things worse by affecting neurotransmitters and immune responses, further confusing the signals between your gut and brain.

Both stress and early childhood trauma increase susceptibility to developing it and many sufferers report worsening of their symptoms during periods of stress. When the body is under stress, the vagus nerve sends signals to the brain, which the brain interprets as a reason to get ready for battle. So, instead of a “rest and digest” situation that prevails when we aren’t stressed, the body reacts with a “fight or flight” response. This fight or flight leads to a miscommunication between the gut and the brain. In some individuals, it triggers diarrhea, while in some, it triggers constipation or a combination of both. Studies have illustrated that gut dysbiosis can trigger this miscommunication, most likely due to an effect on the production of the neurotransmitters serotonin and GABA.

Role of Neurotransmitters Produced by Gut Microbes

Your gut microbes do more than aid digestion—they produce key neurotransmitters like serotonin, dopamine, and GABA. These chemicals regulate everything from gut movement and sensation, to regulation of mood. For example, serotonin helps control intestinal movement and sensitivity, while GABA plays a role in managing pain and stress.

In IBS, this system can go off track. Disrupted neurotransmitter production may lead to abnormal gut motility, heightened sensitivity, and even mood changes. It’s a two-way street: the gut impacts the brain, and emotional symptoms often stem from these same pathways.

Influence of the Vagus Nerve and Central Nervous System on Gut Function

The vagus nerve acts as the main communication highway between your brain and gut, overseeing key digestive functions like stomach acid production, movement, and immune responses. When vagal signaling falters, these processes can break down, leading to symptoms like bloating or constipation.

But there’s more to the story—stress signals from the central nervous system (CNS) can activate the hypothalamic-pituitary-adrenal (HPA) axis, further disrupting gut function. This stress-gut connection often worsens IBS symptoms, making management even more challenging. Anxiety and depression often make things worse, causing hypersensitivity and shifting the balance of gut microbes.

This creates a frustrating loop—IBS symptoms worsen mental health, and poor mental health, in turn, exacerbates GI distress. Breaking this cycle is key to finding relief.

https://www.med.umich.edu/pdf/digestive/Gut-Brain-Axis-and-IBS.pdf?utm

https://www.nature.com/articles/s41380-023-01972-w?utm

https://pmc.ncbi.nlm.nih.gov/articles/PMC5337130/?utm

Natural Approaches to Management:

1.Lifestyle Modifications

Diet: The low-FODMAP diet is widely recognized as one of the most effective ways to manage IBS symptoms. FODMAPS are short-chain carbohydrates found in foods like apples, onions, and certain dairy products—In some individuals, they are poorly absorbed in the gut, leading to fermentation that can cause gas, bloating, and abdominal discomfort. While I am not a fan of the low FODMAP diet as a permanent fixture, it is a good temporary diet (4 weeks or less) that identifies trigger foods and helps heal the gut lining. By cutting back on high FODMAP foods for a short while, many people with IBS find significant relief from these symptoms. Hydration is an important component of dietary changes because dehydration can trigger constipation symptoms.

Exercise: Staying active is a game-changer for gut health. Regular physical activity helps keep things moving by boosting intestinal motility—the process that pushes food through your digestive system. Moderate exercises like walking, swimming, or yoga can gently stimulate your gut, easing constipation and reducing bloating. Plus, exercise has the added bonus of lowering stress hormones like cortisol, which often make IBS symptoms worse. Even something as simple as a brisk walk can make a noticeable difference, with studies showing it can significantly reduce symptom severity and improve overall quality of life for those suffering with IBS.

https://pmc.ncbi.nlm.nih.gov/articles/PMC9243367/?utm

2.Stress management

: As noted earlier, stress is a well-known culprit behind IBS flare-ups, largely because of its influence on the gut-brain axis. Techniques like mindfulness meditation, yoga, and cognitive behavioral therapy (CBT) have proven to be powerful tools for managing stress-related symptoms. Mindfulness encourages staying present and calming the nervous system, while CBT helps reframe thought patterns that heighten anxiety about IBS. Simple practices like diaphragmatic breathing or progressive muscle relaxation can also work wonders by activating the parasympathetic nervous system, easing tension, and reducing the gut’s sensitivity to discomfort.

https://www.webmd.com/ibs/stress-anxiety-ibs?utm

3.Visceral Massage

: A hands-on therapy aimed at the abdominal organs. By encouraging peristalsis (those wave-like muscle contractions that keep things moving) and boosting blood flow, it can help improve gut motility, reduce bloating, and calm visceral hypersensitivity. Certain techniques even target specific areas, like the ileocecal valve—the gateway between the small and large intestines—to help relieve constipation and discomfort. While studies suggest this type of manipulation can offer noticeable relief from abdominal pain and distension, its benefits for constipation may be more short-lived.

https://www.nhpcanada.org/NHPC-Blog/Trust-your-Gut-Visceral-Manipulation-for-Digestive-Disorders?utm

4. Fiber Supplements

: Fiber supplementation—especially with inulin—plays a key role in managing IBS symptoms. Fiber works by increasing bulk in stool which encourages more regular bowel movements. Inulin stands out because it ferments slowly, meaning it’s less likely to trigger gas or bloating compared to other fibers. It also feeds beneficial strains of gut bacteria which also helps with dysbiosis.

Some inulin rich foods include asparagus, artichokes and chicory root. Inulin supplements can also be added. Be sure to stay hydrated when on a fiber supplement.

5. Magnesium

: Magnesium is a key player when it comes to relaxing intestinal muscles and improving gut motility by pulling water into the colon. This makes it especially helpful for those dealing with IBS-C (the constipation-predominant type). Supplements like magnesium citrate or magnesium glycinate are often used to encourage bowel movements and ease straining. But there’s a catch—taking too much can lead to diarrhea or cramping, so sticking to the right dose under a doctor’s guidance is crucial. Make sure to always check with your doctor before you start magnesium because it should be taken with caution in anyone with impaired kidney function.

Medications for IBS-C

Many people find relief with Prescription Medications:

Linaclotide (Linzess/Constella): Effective in increasing fluid secretion into the GI tract to ease in stool passage.

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Prucalopride (Motegrity/Resotran/Resolor): A prokinetic agent that enhances colonic motility and can also help with constipation.

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Tenapanor (Ibsrela): Reduces sodium absorption to improve stool consistency.

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Plecanatide (Trulance): Stimulates intestinal fluid secretion.

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Lubiprostone (Amitiza): Activates chloride channels to soften stools.

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Conclusion

Since no two cases of IBS are exactly alike, experimenting with different options and working with a healthcare professional to create a personalized plan is essential for lasting comfort and a better quality of life. With the right strategies and support, you can take back control of your gut health and enjoy a life where symptoms don’t call the shots.

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