Is this simply a physical problem? I doubt it.
When I say, ‘my stomach is in a knot’, it usually means I am dealing with strong, difficult emotions, experienced as tension in the abdomen. After 15 years of consistent meditation practice and many silent retreats, I can now detect even subtle emotions as body sensation: fear has been a companion, and anxiety, its offspring (which I define as amorphous fear), has been hitching a ride every day and night since the beginning of February. It is now mid-June.
What is the relationship between my emotions and digestion? While I can’t say for certain, I do know two things: 1. I’ve had digestive problems for many years. They seemed to start after I took a long course of antibiotics in my mid-20s in an attempt to eradicate acne, and 2. I do not doubt that there is a correlation between the severity of my digestive problems and anxiety: burping can become worse when I am stressed.
The physical diagnosis? My naturopathic doctor, Melissa Fougere diagnosed me with small intestine bacterial overgrowth (SIBO). SIBO is a ‘new diagnosis’, one with which many medical doctors are unfamiliar, although there are many references to it in well-respected medical journals, which a quick pubmed search will reveal.
Meanwhile, my allopathic medical doctor suggested that I had been hoaxed by my naturopathic doctor when I took a breath test to diagnose SIBO and that I was wasting my money on the treatment protocol. His solution? A prescription of a ‘proton pump inhibitor’ to ‘take away’ my heartburn.[i] His lack of curiosity about the causes of heartburn and bloating is discouraging to me. All he could say about my diet is to avoid cucumbers and high-fat foods (because my gallbladder seems to be acting up). He is otherwise simply uninterested in exploring the possible causes of my symptoms.
What is SIBO?
Mark Pimentel is an associate professor of medicine at Cedars-Sinai Medical Center in Los Angeles. His medical training includes a fellowship in gastroenterology at the UCLA Affiliated Training Program.
In an interview with health researcher Chris Kresser, Pimentel defines SIBO thus:
“It’s an over-colonization of specific bacteria, usually the colon bacteria, into the small intestine, where they don’t belong…And when all this bacteria builds up in the small bowel, then you get this bloating, gas and distention, and a lot of changes in bowel function.”
A 2010 article from the World Journal of Gastroenterology, says, “SIBO is defined as an increase in the number and/or alteration in the type of bacteria in the upper gastrointestinal tract.” The authors state that the causes of SIBO are complex and may be multifactorial.[ii]
What is the relationship between digestion, emotions and the brain? Oh my, where to begin?
First, anyone dealing with grief is likely to be in a state of mental confusion. Since dad’s illness and death, it’s been difficult to concentrate on my freelance writing assignments; I missed appointments that were in in my calendar and simply forgot to note other commitments. I had to psyche myself up to get my work done and there was no mental energy for anything else, even talking with friends on the phone.
When my SIBO was finally diagnosed (early April) and I began treatment with a two-week course of the antibiotics Rifaximin and metronidazole, my gut began to feel better and my brain wasn’t much worse. But once the medication stopped and I began using certain botanical antimicrobials herbs like concentrated oregano and garlic, oh my….my body felt sick and my brain function was abysmal. This was likely due to bacterial die off in the gut. I wouldn’t have said I was depressed (having had clinical depression in the past I had some handle on that experience) but my symptoms were very like that. I went through about four weeks of no mental vitality at all.
One sign that things are improving, after two months of treatment, including a special diet, is that I have mental clarity and motivation to write this article. My digestion still has a way to go….I still have bloating and some belching, but there is improvement. SIBO can be very difficult to treat and about half of those who are treated successfully later relapse. The dietary restrictions aren’t too bad, given that I have been mostly grain free and gluten free for several years now.
My complex life challenges these last six months have driven home the truth that nothing and no one is just one thing. We’re all complex psycho-social-physical-spiritual beings, and healing is most likely multifactorial. Removing some of the stress in my life by resigning as power-of-attorney for Sue, has been a big step in the right direction. And now that both my parents have passed, I have less responsibility for loved ones in need, which sometimes feels like a new kind of freedom, while also reminding me of my loss.
Being the curious person I am, I continue to look at the research around the microbiome, brain and emotions. If you wish to learn more about the relationship between your digestive system and brain, it’s an exciting time to be alive. Let me share a couple of recent research tidbits with you. But first, for an excellent short article on SIBO I recommend, SIBO—What causes it and why it’s so hard to treat, by Amy Nett M.D..
Next, check out Microbes Can Play Games with the Mind, by Laura Sanders, as published in Science News. Here is a tantalizing excerpt:
“By tinkering with the gut’s bacterial residents, scientists have changed the behavior of lab animals and small numbers of people. Microbial meddling has turned anxious mice bold and shy mice social. Rats inoculated with bacteria from depressed people develop signs of depression themselves. And small studies of people suggest that eating specific kinds of bacteria may change brain activity and ease anxiety. Because gut bacteria can make the very chemicals that brain cells use to communicate, the idea makes a certain amount of sense.”
You may want to have a look at this abstract about research from the journal Nutrition, showing that probiotics significantly reduced depression in a randomized, double-blind, placebo-controlled study. Or instead read this article about the same research from Psychology Today.
Finally, I just started to read Ten Percent Human: How your body’s microbes hold the key to health and happiness, by Alanna Collen. I am amazed to learn that while our human genome has fewer than 21,000 genes: “Together, the microbes living on the human body contain 4.4 million genes – this is the microbiome: the collective genomes of the microbiota. These genes collaborate in running our bodies alongside our 21,000 human genes.”
Collen had her own digestive issues after years of antibiotics and was looking for healing. She sent a stool sample to a lab to discover what the microbe composition of her faeces was. This was quite revealing. After significantly altering her diet and in particular, increasing dietary fibre, she did a second analysis, and was pleased with the change in the increased diversity and especially the known, helpful microbes.
BBBL will be publishing a review of Ten Percent Human shortly, written by my colleague, ace-researcher and new contributor Kris James.
Do you have knowledge or experience to share with us on this, admittedly very broad, topic? If so, please comment, or get in touch.
 I didn’t take the samples the doctor gave me and subsequently found this excellent article by Chris Kressor on proton pump inhibitors, with many excellent research references: http://chriskresser.com/the-dangers-of-proton-pump-inhibitors/?mc_cid=d719e909a9&mc_eid=776fa477da.
[ii] "Aetiology of SIBO is usually complex, associated with disorders of protective antibacterial mechanisms (e.g. achlorhydria, pancreatic exocrine insufficiency, immunodeficiency syndromes), anatomical abnormalities (e.g. small intestinal obstruction, diverticula, fistulae, surgical blind loop, previous ileo-caecal resections) and/or motility disorders (e.g. scleroderma, autonomic neuropathy in diabetes mellitus, post-radiation enteropathy, small intestinal pseudo-obstruction). In some patients more than one factor may be involved. Symptoms related to SIBO are bloating, diarrhoea, malabsorption, weight loss and malnutrition."