Comment by objclxt | Hacker News Reader

Comment by objclxt | Hacker News Reader

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I certainly never really considered just how intertwined the gut and the brain are until I was diagnosed with IBS (or perhaps a better name, the "we have no clue what's wrong with your digestive system, but it's not physical" syndrome).

About 18 months ago a number of things conspired against me: I was having a very stressful and uncertain time at work/home, and I went on a strong course of antibiotics for an infection which wiped out my gut (a known side effect). For about six months I had serious digestive problems, both bloating, gas, diarrhea, nausea, abdominal pain - real, visible, symptoms...but despite a barrage of tests, nothing at all medically wrong. I had dozens of blood tests, an ultrasound, a gastroscopy, and a colonoscopy with biopsies - nothing. At the same time, I went through a serious depression and malaise that nearly always coincided with my digestive problems.

A year an a half later, I have a lot more respect for how the gut is tied in to general mental health. I'm not totally back to normal, but I'm a lot better than I was, thanks to meditation, watching my diet (my gut is a lot more sensitive to what I put in now - previously, I would eat any old junk), and generally making that connection between my mood and my stomach.

This. It's so weird when you conclude your mind is having a direct and undeniable influence on your physical wellbeing.

In my case, I can't eat certain foods (I'm still trying to work out which, but it includes chocolate) when I'm stressed. I get severe cramps, bloating, pain and even hot flushes (intense sweating). It happened to me on a train once and people thought I was OD-ing.

And stressed doesn't mean "close to the edge". Just a bit of nerves about something, definitely not enough to keep me up at night, will do the trick.

When the evidence suggested chocolate made me really unwell, but only if I was a bit stressed, it was really hard to accept because it just sounds so weird and implausible.

It's not really surprising, as we already know that the gut is influenced by stress. The main pathways are the vagus nerve and the HPA axis, which control gastric emptying and colonic movement. Stress will either shut down your vagus nerve resulting in reduced stomach emptying, or it will activate the HPA axis and cause diarrhea (or both).

I get IBS myself, so I find it a little strange that some people don't. My guess is that my nervous system is simply more liable to over-activate than most people's. This is useful in that it gives me copious amounts of mental energy and ability to crank out amazing code very quickly and do stuff that most people (present company excepted) wouldn't be able to do, like design and build a compiler/VM for my own programming language, or build an HTML5 web conferencing system by myself. The downside is that I am prone to IBS and burnout.

While there is ample evidence of the brain influencing the gut, there isn't really much evidence of the gut influencing the brain. It seems unlikely that 'butterflies in the stomach' is caused by the gut influencing the brain, rather than the other way around. The afferent vagus nerves do signal to the brain when there is a gut infection, and that can certainly cause anxiety and depression. However most people with anxiety/depression/IBS don't have any active infection, and there is more evidence that it is the brain influencing the gut rather than the other way around. One possibility is that people with these conditions are genetically programmed to release more serotonin, and that happens both in the brain and the gut.

I have IBS and a history of panic disorder. A couple weeks ago, after five years of no attacks I had a relapse after taking a probiotic. I'm almost back to normal (heart palpitations and slight uneasiness whenever I eat) but man, that experience shook me.

I never had any IBS symptoms as a result of panic disorder but I can say from experience that finding a good evidence based* therapist can change your life. I've gone from panic attacks sending me running home and downing Xanax to them being a general annoyance lasting 5 minutes tops. And given my trajectory I have every reason to believe that soon, with a possible rare exception, I won't have any at all.

Related: https://news.ycombinator.com/item?id=7790727

* This is key. A therapist who works off their intuition ("why do you think you freaked out?") is a waste of money.

Similar. 30 years never a (serious) symptom. Relationship / work problems and bam! - severe Crohn's disease resulting in a bowel resection. But also lost the relationship and the job. It's taken 15 years and I've had to change my lifestyle (no more late nights and the things you do during late nights) but I feel better than ever and no longer have day to day gut problems.

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