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OSTEOPATHIC RESEARCH

Functional Gastrointestinal Disorders (FGIDs)

GUT-BRAIN AXIS

This research looked at the effects of osteopathic treatment on FGIDs and the gut-brain axis. The gut-brain axis is the direct structural hardwiring between the brain and gut where information from emotional and cognitive centers of the brain communicates to the peripheral gastrointestinal tract functioning and vice versa. The gut also communicates with the brain and the rest of the body via hormones, neurotransmitters, inflammatory mediators and products of digestion.

EMOTIONS AND STRESS

Emotions such as fear, anger, anxiety, painful stimuli as well as physical and psychological stress can delay or increase gastric emptying and intestinal transit which can lead to gut pain. On the other hand, there is growing evidence that enhanced motility, ongoing visceral inflammation, and injury can increase ascending visceral pathways and affect brain areas, which may lead to greater pain and altered mental functioning including anxiety and depression.

IMPAIRED PAIN REGULATION

This impaired pain regulation between psychosocial distress and painful symptoms is due to impaired function of various brain networks and the failure of the brain’s pain control system to up-regulate or down-regulate incoming neural signals affecting symptom perception and pain threshold. It is possible to enable pain control by cognitive or emotional factors such as focused attention, hypnosis, psychological treatment and certain antidepressants.

MICROBIOME

Central nervous system modulation of the gastrointestinal tract via the autonomic nervous system, the HPA axis, and stress can influence gut microbiota as well as dietary changes, immune function, and the use of medications, in particular antibiotics, can trigger a more harmful population of microbes, that can modify the stress hormone, noradrenaline, intensifying its damaging effect on the microbiome and the gut. Research is also beginning to recognize how disturbances in the gut microbial world can influence our brain.

The science now says that changing your diet is not enough. You need to modify your lifestyle as well. Therefore, a balanced life style, stress reduction, regular exercise, mindfulness and a healthy diet, can all help create a healthy ecosystems and help prevent chronic inflammation.

BIOPSYCHOSOCIAL MODEL

FGIDs have been defined as disorders of gut-brain interaction and are best represented with a biopsychosocial model. This model provides a framework for understanding the complex interaction of environmental (e.g. cultural beliefs and behaviors, adverse life events), psychological (e.g. stress, anxiety and depression) and biological factors (e.g. hereditary and genetic patterns) that may lead to the clinical expression of FGIDs; and can only be treated satisfactorily when all these factors are considered and addressed.

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