insights

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The gut-brain axis describes the two-way communication between the gastrointestinal (GI) tract and the brain and involves many organ systems, including the hormone, immune, and nervous systems.^1,2 The communication signals along this axis help maintain normal GI function and can originate in the gut, the brain, or both.³

A diverse range of friendly microorganisms reside in the gut, known as the gut microbiome, and neurological and mood disorders, including anxiety and depression, often involve gut and gut microbiome–related symptoms.^4-6 In addition, GI disorders with an imbalanced gut microbiome, in which the balance of healthy bacteria is disrupted, may also have brain and mental health–related symptoms,^7,8 and in turn, psychological stress may impact microbiome balance and GI function.^3,9

In the following video, functional medicine expert David Rakel, MD, talks about the connection between stress and GI function:

Stress & An Upset Gut

Stressful life events may alter GI function and may significantly change the gut microbiome’s structure and activity, leading to an imbalance known as gut dysbiosis.^10,11 In turn, gut microbiota may influence stress-related responses in the body.^1,11 Research studies suggest a close interaction between the gut microbiome and the body’s neurologic and hormonal responses to stress.¹¹ For example, the following neurotransmitters are active in the brain as well as the gut, influencing the movement of food through the digestive tract, nutrient absorption, the immune system, and the gut microbiome:¹²

• Serotonin
• Norepinephrine
• Epinephrine
• Dopamine

In addition, stress-related conditions such as anxiety and depression have been shown to have a close relationship with the gut microbiome.¹ Studies suggest that:

• Anxiety and depressive disorders may be characterized by a higher abundance of inflammatory microbiota and less beneficial bacteria in the gut.⁵
• Negative emotions and stressful life events have also been associated with other GI disorders such as colitis, Crohn’s disease, and dyspepsia.¹³

Functional Medicine Approach

Functional medicine uses personalized treatment strategies to address root causes of chronic conditions, and stress is but one modifiable lifestyle factor that may be addressed in an intervention. Managing external stress-related factors while optimizing gut health may jointly address some chronic health conditions. Overall, transforming the body’s response to stress may lead to more positive health outcomes, and some techniques have the potential power to bolster immune function,¹⁴ strengthening overall resilience.

Research studies have evaluated the effectiveness of stress management for GI disorders such as inflammatory bowel disease (IBD), a chronic intestinal inflammatory condition associated with dysfunctional interactions between the gut and the brain.^15,16 Many of these studies have suggested that stress management techniques such as mindfulness meditation have beneficial effects on inflammation, stress levels, anxiety status, and quality of life.^15,16

Within the functional medicine framework, practitioners partner with patients to develop personalized treatment plans that best fit each patient’s current conditions and concerns. Click on the banner below to find a functional medicine practitioner near you to learn more about lifestyle-based interventions that help address life stress and support gut health.

Related Articles

Understanding the Psychoemotional Roots of Immune Disease

Intestinal Permeability & Associated Diseases

The Importance of Digestion & Nutrition in Chronic Disease

References

1. Lach G, Schellekens H, Dinan TG, Cryan JF. Anxiety, depression, and the microbiome: a role for gut peptides. 2018;15(1):36-59. doi:10.1007/s13311-017-0585-0
2. Cryan JF, O’Riordan KJ, Cowan CSM, et al. The microbiota-gut-brain axis. Physiol Rev. 2019;99(4):1877?2013. doi:1152/physrev.00018.2018
3. Margolis KG, Cryan JF, Mayer EA. The microbiota-gut-brain axis: from motility to mood. Gastroenterology. 2021;160(5):1486-1501. doi:1053/j.gastro.2020.10.066
4. Simpson CA, Diaz-Arteche C, Eliby D, Schwartz OS, Simmons JG, Cowan CSM. The gut microbiota in anxiety and depression – a systematic review. Clin Psychol Rev. 2021;83:101943. doi:1016/j.cpr.2020.101943
5. Qu L, Li Y, Liu F, et al. Microbiota-gut-brain axis dysregulation in Alzheimer’s disease: multi-pathway effects and therapeutic potential. Aging Dis. 2024;15(3):1108-1131. doi:14336/ad.2023.0823-2
6. Montalbán-Rodríguez A, Abalo R, López-Gómez L. From the gut to the brain: the role of enteric glial cells and their involvement in the pathogenesis of Parkinson’s disease. Int J Mol Sci. 2024;25(2):1294. doi:3390/ijms25021294
7. Fairbrass KM, Lovatt J, Barberio B, Yuan Y, Gracie DJ, Ford AC. Bidirectional brain-gut axis effects influence mood and prognosis in IBD: a systematic review and meta-analysis. Gut. 2022;71(9):1773-1780. doi:1136/gutjnl-2021-325985
8. Kraimi N, Ross T, Pujo J, De Palma G. The gut microbiome in disorders of gut-brain interaction. Gut Microbes. 2024;16(1):2360233. doi:1080/19490976.2024.2360233
9. Schneider KM, Blank N, Alvarez Y, et al. The enteric nervous system relays psychological stress to intestinal inflammation. Cell. 2023;186(13):2823-2838.e20. doi:1016/j.cell.2023.05.001
10.  Oligschlaeger Y, Yadati T, Houben T, Condello Oliván CM, Shiri-Sverdlov R. Inflammatory bowel disease: a stressed “gut/feeling.” Cells. 2019;8(7):659. doi:3390/cells8070659
11.  Karl JP, Hatch AM, Arcidiacono SM, et al. Effects of psychological, environmental and physical stressors on the gut microbiota. Front Microbiol. 2018;9:2013. doi:3389/fmicb.2018.02013
12.  Mittal R, Debs LH, Patel AP, et al. Neurotransmitters: the critical modulators regulating gut-brain axis. J Cell Physiol. 2017;232(9):2359?2372. doi:1002/jcp.25518
13.  Panduro A, Rivera-Iñiguez I, Sepulveda-Villegas M, Roman S. Genes, emotions, and gut microbiota: the next frontier for the gastroenterologist. World J Gastroenterol. 2017;23(17):3030-3042. doi:3748/wjg.v23.i17.3030
14.  Schakel L, Veldhuijzen DS, Crompvoets PI, et al. Effectiveness of stress-reducing interventions on the response to challenges to the immune system: a meta-analytic review. Psychother Psychosom. 2019;88(5):274-286. doi:1159/000501645
15.  Qian X, Zhang J. Mindfulness-based interventions on psychological comorbidities in patients with inflammatory bowel disease: a systematic review and meta-analysis. Actas Esp Psiquiatr. 2024;52(4):571-582. doi:62641/aep.v52i4.1559
16.  Naude C, Skvarc D, Knowles S, Russell L, Evans S, Mikocka-Walus A. The effectiveness of mindfulness-based interventions in inflammatory bowel disease: a systematic review & meta-analysis. J Psychosom Res. 2023;169:111232. doi:1016/j.jpsychores.2023.111232