Irritable Bowel Syndrome (IBS) has traditionally been difficult-to-define. Usually composed of a cluster of complaints-bloating, abdominal cramping, gas, diarrhea and constipation-that come and go. But new research points to several triggers of the problem (not just a single cause) and an article in the New England Journal of Medicine stated a review of data found that IBS symptoms are definitely not "all in the head."

Psychological factors may play a role in IBS, but so do others including: genetics, eating certain foods, gut flora, and/or a bout of gastroenteritis. Recent studies have also pointed to small intestinal bacterial overgrowth (SIBO) and inflammation of the mucosa in the gut's lining-home to the enteric nervous system-as possible causes of IBS.

The Mind/Gut Connection
While IBS may have other causes beyond psychosomatic factors, your gut truly does have a mind of its own. Often referred to as the "second brain," the enteric nervous system is complex and able to manage every aspect of digestion while communicating  with the brain in your head. Signals travel from the enteric nervous system (in the gut's lining) to the central nervous system in the brain. "The communication goes both ways," says Steven Lamm, MD, author of No Guts, No Glory. "If the gut is really uncomfortable it sends a signal to the brain; and if your brain is uncomfortable it sends a signal to your gut," he explains. 

Because of this two-way communication, Lamm says you'll see psychological manifestations in the brain (anxiety, depression) along with the physiological symptoms in the body (abdominal cramping, bloating, constipation, etc.). Anyone who has experienced butterflies in her stomach before a stressful event knows what this means.

Just because experts can't find the pathology of IBS doesn't mean the problem is not real, stresses Lamm. "There is no doubt that patients with IBS have greater sensitivity to pain and greater changes in gut motility."

What the experts do know is that lifestyle and diet make a huge difference. "Currently, what we're looking at-more than anything else-is manipulating the diet," says Lamm.

Here are six strategies:

  • Use your brain to detect possible food sensitivities. Many people with IBS seem to have sensitivity to either gluten, dairy or hard-to-digest carbohydrates (sugars such as fructose, lactose, and sugar alcohols like sorbitol), says Lamm. In fact, he says, patients find symptoms may significantly be reduced once they've eliminated their problem foods.
  • Eat frequently. Don't go hours and hours without eating.
  • Eat slowly.
  • Ask your doctor about probiotics and digestive enzymes which facilitate the chemical breakdown of food into smaller, more absorbable components. Lamm says they may help relieve bloating and constipation.
  • Incorporate daily physical activity to keep your colon stimulated.
  • Manage stress. Find coping mechanisms-learn how to meditate, extricate yourself from toxic environments, and get restorative sleep, which really settles the gut-and the mind. Some studies have shown that cognitive behavior therapy can be used to change how the brain perceives what is happening in the gut.

Steven Lamm, MD, reviewed this article.


Steven Lamm, MD, "House Doctor" on ABC's The View and author of No Guts, No Glory (Basic Health Publications, 2012)

Mayo Clinic (2012, November 13). Irritable bowel syndrome definitely isn't 'all in the head'. ScienceDaily. Retrieved January 2, 2013, from