Irritable Bowel Syndrome is really a label for “I’ve got bloating and discomfort” — and very often, the root of it sits in the nervous system, not just the gut. Here’s the foundations-and-roof-tiles way I think about treating it.
Why IBS Is a Non-Diagnosis
Irritable Bowel Syndrome (IBS) is a very nondescript label for “I’ve got bloating and discomfort.” For some people, it may present as constipation; for others it may present as looser bowel movements. Some people find that they fluctuate between the two.
The Brain-Gut Axis
There are all sorts of reasons why we can have irritable bowel symptoms. It can be because of the brain-gut axis — the relationship between the microbiome and the nervous system1. We know that there is a relationship, and if you disrupt one, it is going to affect the other. Therefore, the challenge is which one do we treat, because sometimes we might need to look at both.
If the roof tiles have fallen off because the foundations are unstable, and you put the roof tiles back on without addressing the foundations, they are probably going to fall off again.
If you just address the foundations, but the roof tiles have already fallen off, you might now need to put them back on as well.
In that analogy we are asking, “What if the nervous system was part of the origin of the problem?” How might the nervous system affect the gut? Well, in this case, the autonomic nervous system is like the Yin and Yang — or in Western medicine, we would call it homeostasis: the sympathetic and parasympathetic balance. In essence, what we are looking at is the balance that is constantly changing within the system.
How the Sympathetic/Parasympathetic Balance Controls the Bowel
If we have a fear, fight, flight, or stress response, we will tend toward mobilizing our system to get away or protect ourselves — either in a deep shutdown or in some active state, like a functional freeze-type state.
Sympathetic and parasympathetic systems govern the peristaltic movement within the bowel. Peristalsis is a snake-like movement that moves things through the bowel, which is under the control of the sympathetic and parasympathetic balance. If the balance gets thrown out by the body messaging — “Don’t worry about digesting food right now, we need to run away from this tiger” — then we divert the body’s energies. We shut down the bowel, and we divert the circulation and the energy to other parts of the body: the heart, the lungs, the legs, the muscles, and so on, to run away or fight. Our body reacts to do whatever we need to do.
That chronic “stuck-on” state is fine short term, but in a chronic state, that is going to have an impact on the gut, because you are not supplying it with the right neurological tonal messages. If you are taking away and diverting some of the blood from there because you want it to do something else, then long-term that is likely to affect the gut’s function. This is true for any organ. This same explanation could apply to almost all organs in the body, but it presents very heavily in the gut, for various reasons.
How I Approach Treatment
So what am I going to do about it? Well, I’m not going to give you an endoscope or a colonoscopy, and I’m not going to do anything that a general surgeon might do. Importantly, those investigations may be necessary for some individuals, but from my perspective, I help people on a daily basis to start to look at their nervous system. We look at the imbalance and restore that normal homeostasis within their systems, and restore normal organ function. If we change what is going on in the messages from the nervous system and hormonal system going down to the gut, we will start to restore normal function and balance.
Of course, we might need to consider the gut microbiome, and it is important to consult with clinical professionals on that, because we might need to consider looking at diet. If the diet has been particularly poor, there is a lot of evidence that adding a greater diversity of natural products into the diet might form part of the solution2.
However, restoration of the normal homeostasis and balance through the nervous system is my way of addressing the issues of irritable bowel syndrome.
References
- Hillestad EMR, van der Meeren A, Nagaraja BH, et al. “Gut bless you: The microbiota-gut-brain axis in irritable bowel syndrome.” World Journal of Gastroenterology. 2022;28(4):412-431. https://pmc.ncbi.nlm.nih.gov/articles/PMC8790555/
- Fu J, Zheng Y, Gao Y, Xu W. “Dietary Fiber Intake and Gut Microbiota in Human Health.” Microorganisms. 2022;10(12):2507. https://pmc.ncbi.nlm.nih.gov/articles/PMC9787832/
Rodger Duckworth is a physiotherapist specialising in trauma-informed care for complex chronic pain, autoimmune, and mind-body health conditions, treating the whole person — nervous system, immune system, and psychology together — rather than isolated symptoms.
