Categories
Family health General

Fatigue and FGIDs

Almost 2/3 of patients with inflammatory bowel disease (IBD), who initiate biologic therapy (infliximab, adalimumab, vedolizumab, or ustekinumab) continue to experience persistent fatigue up to 1 year later. 

Ongoing inflammation was thought to be the main cause of IBD related fatigue, however research now suggests that gut dysbiosis and a less diverse microbiome may be the prevailing factor. 

According to the lead study author, Nynke Z. Borren, MD, “We think that gut dysbiosis might be involved in inducing fatigue,” Dr. Borren said. “In the beginning, we thought that it might be due to ongoing inflammation, but our research has shown that we find a less diverse gut microbiome in those patients with fatigue compared to patients without fatigue while they were in remission. There is something in the gut that influences the central nervous system. We are still exploring this.”

Acupuncture has demonstrated effectiveness in the regulation of gut dysbiosis, intestinal barrier function, visceral hypersensitivity, gut motor dysfunction, depression/anxiety, and pain, and low vagal tone, all of which are factors that can significantly impact quality of life in patients with inflammatory bowel disease.

Persistent fatigue plagues many IBD patients

“Fatigue is one of the most heard complaints in the clinic,” lead study author Nynke Z. Borren, MD, said in an interview at the annual Digestive Disease Week. ® “In the past few years there has been more interest because we know there is a communication system between the gut and the brain.

Acupuncture in Inflammatory Bowel Disease.

Inflamm Bowel Dis. 2019 Jun 18;25(7):1129-1139. doi: 10.1093/ibd/izy371.

Wishing you wellness,

Mary Clark

Categories
General

How Does Stress Affect the Gut?

Feeling stressed, anxious, angry or sad while eating will have a short and long-term effect on the functions of the gastrointestinal tract. 

Research continues to report that exposure to stress results in alterations of the bidirectional microbiota-gut-brain axis interactions (“brain-gut axis”). 
⠀⠀⠀⠀⠀⠀⠀⠀⠀
“The major effects of stress on gut physiology include: 

1) alterations in gastrointestinal motility; 2) increase in visceral perception; 
3) changes in gastrointestinal secretion; 4) increase in intestinal permeability; 
5) negative effects on regenerative capacity of gastrointestinal mucosa and mucosal blood flow; and 
6) negative effects on intestinal microbiota.”
⠀⠀⠀⠀⠀⠀⠀⠀⠀
Although functional GI disorders (FGIDs) are not considered to be psychological diseases, the research continues to support to notion that the brain plays an important role.  
⠀⠀⠀⠀⠀⠀⠀⠀⠀
Dr. Emeran Mayer, MD recommends that: “we can each take care with what, when, and how we eat to promote healthy diversity in our gut microbiome. We can seek to maintain a positive emotional state as much as possible by relaxing and enjoy mealtimes. There are many simple forms of stress reduction that can be employed such as regular exercise, abdominal breathing, or progressive muscle relaxation.”
⠀⠀⠀⠀⠀⠀⠀⠀⠀
In clinical practice, I not only focus on what an individual is eating but will delve into when and how they eat. There is a significant difference between eating mindfully and slowly, and what l refer to as “inhaling” food. I encourage all of my patients to step away from their televisions, multiple screens and distractions, and eat in silence. Even if it begins with 5-10 minutes at a time, it is progress. 

https://iffgd.org/?fbclid=IwAR1cWYXEM6EdpbZ1Y5D0K8obYJyr7pVIS2WNl3-graOVEgumlPVDkQYUMHQ

https://onlinelibrary.wiley.com/doi/pdf/10.1111/cns.12490?fbclid=IwAR1zZTUrXcYuftgh3yHPhIYBgWmHLmqnfpKeAHl9nL8bVibfH2HMGVIxS3o&

Wishing you wellness,

Mary Clark