Neuroscience & Neurology

Irritable Bowel Syndrome Linked to Abnormal Brain Activity

January 14, 2008 | By Lindsey Kay, MD | Bookmark and Share | 5 Comments

Neuroscience and Neurology Category Irritable bowel syndrome (IBS) affects 10 to 15 percent of the U.S. population, predominately women, and can produce severe abdominal pain, bloating, and changes in bowel habits. No physical abnormalities can be identified on examination, and patients are often left with suboptimal symptomatic treatments and the idea that the pain is “all in your head.”

Well, maybe it is.

A new study used magnetic resonance imaging (MRI) to detect differences in brain activity in IBS patients compared to healthy ones. When predictable, mild abdominal pain was stimulated in healthy women, MRI showed decreased activity in the insula, amygdala and brainstem, areas associated with emotion and pain. IBS patients did not show decreased activity in these areas, suggesting they are hard-wired to respond more strongly to pain than others.

The idea that the errors in the perception of pain are the underlying cause of IBS has been around a long time, but this is one of the first studies to demonstrated altered brain activity in the disease. Researchers hope that this information may lead to medications targeted at the brain centers or peripheral nerves responsible for the abnormal signaling.

Patients with IBS often feel left out in the cold. Current treatments for the symptoms of IBS only work temporarily and only in some patients. Many studies have demonstrated a link between anxiety, depression and IBS. Perhaps the link lies in an incorrect, hyperactive perception of pain and danger resulting in increased sensitivity to both emotional and physical pain.

I myself have a long history of abdominal pain that fails to respond to most treatments. I’ve undergone a battery of medical tests, all with no definitive results. IBS is a diagnosis of exclusion, given when all other ausative factors are eliminated as possibilities, so I know that my pain could easily be diagnosed as IBS. And yes, the pain is more frequent and more severe when I am anxious and stressed out, as it is for many women. But that doesn’t mean the pain isn’t real, and that doesn’t mean there isn’t a real organic cause. Even if I don’t have a tumor, or an ulcer, or something else in my belly causing me pain, maybe I just have I hyperactive amygdala, and maybe future researchers will learn how we can retrain or medicate the parts of our brain that are responsible for emotional responses to pain.

Reference

Berman S, Naliboff B et al. Reduced Brainstem Inhibition during Anticipated Pelvic Visceral Pain Correlates with Enhanced Brain Response to the Visceral Stimulus in Women with Irritable Bowel Syndrome. J. Neurosci. 2008 28: 349-359.

Tags: anxiety, brain, depression, diagnosis, emotion, MRI, pain, research, stress, studies, women

5 Comments

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dar
January 15, 2008 | Permalink

T’aint in Yoor head…the medical deities Always say that for alot of diseases they can’y beat into submission with Drugs.
Alternative medicine has achieved spectacular victories:but it requires a patient change his lifestyle;not an easy way out for sure. Diet,supplements are the key.
Everyone,please check out Rbt Cohen’s website:
http://www.notmilk.com/
and Andrew Saul’s
http://doctoryourself.com/colitis.html

Pam Hampton
January 16, 2008 | Permalink

While I, a woman have SBS(short bowel syndrome)(only 12 inches of small intestine after a bowel resection). I live with the same symptoms as a person with IBS. In reading this article, I have to wonder if this is happening to my husband who is extremely Bi-Polar. He has been suffering from IBS for as long as he can remember. With the mood swings from depression to homicideal episodes. When his anziety (manic) is high, his IBS just rages. He’s mentally so down on himself at these times, the depression time is when it hits the hardest.
Thanks for the interesting article, we need to discuss this with his primary Dr as well as his phychiatrist. In connecting with the two, we may have the answer to all the tests that have came up negitave so far.

William Norton
February 07, 2008 | Permalink

I appreciate your writing on this topic, which is important to many with pain and IBS. But your use of the pejorative phrase “it’s all in your head” - however well meaning in the context of the story - followed immediately by “Well, maybe it is” tends to reinforce the misconception shared by many that IBS is not a ‘real’ disorder but is, instead, as IBS suffers continue to hear over and over again, ‘all in your head.’ It would have been accurate and just as catchy to say, “Well, its not - but it is, at least in part, in your brain.”

Jan Patenaude, RD, CLT
February 13, 2008 | Permalink

Working with IBS patients has been my specialty are for the past 6 years. I must say, it’s in the gut, not in the head for most true IBS patients. I’ve been using a blood test called a Mediator Release Test to help identify trigger foods and chemicals. (Do you know ANYBODY with IBS that hasn’t identified that diet plays a role?)

Then, based on blood-test results, an individualized diet is set up. I’ve seen amazing results.

The president of the company I work with was an IBS cripple prior to finding out his triggers - that’s why he went to work for the company. He figured others shouldn’t have to suffer for 35 years, as he had, when there are better answers than trial and error. (He’s happy to share his story with anybody willing to listen. Does he still have IBS? Yes - Are symptoms controlled now - yes also.)

I’ve seen many lives restored, anxiety reduced, headaches relieved, etc. etc. As an RD since 1982, it’s the most exciting and rewarding work I’ve done since starting in the nutrition field.
There is so much research to show that it’s not “all in your head” - but there is certainly a relationship between mediators that can cross the blood-brain barrier and symptoms, so, yes, some of it is “in the head.”

Always happy to talk, privately if needed, with anybody. Would love to spread the word about the most effective diet therapy I’ve ever worked with!