My Anxiety and SIBO: The Gut-Brain Connection

I'm sure by now you've heard of the powerful connection we have in our bodies, the connection between the health of our gut and the health of our brain.  If you haven't heard about this, it may sound really strange and ridiculous.  How can the health of my brain be connected to my stomach?!  Well, it isn't quite that simple, but that's it in a nutshell.

I'm no expert on this, but I am definitely an expert on my personal experience with how very connected these two parts of our body are, and how important it is to have a healthy and well functioning digestive system for a well functioning brain which is in short, the status of our mental health.  I will try to explain this in layman's terms for simplicity's sake, and because, again, I'm not an expert!

It is currently estimated that more than 90% of our serotonin is made in our gut.  Over ninety percent!!  Serotonin is the hormone that, along with dopamine, helps regulate our mood.  If the bacteria living in our digestive system are not able to help produce serotonin due to imbalances or overgrowth, we won't have a stable or good mood.  If there is too much of certain types of bacteria or yeast, or types that makes us sick, we will not only have digestive symptoms, we may feel mentally unwell, experiencing anxiety, panic or depression.

I have lived this first hand.  I had been suffering from anxiety and panic for months before I was diagnosed by my naturopath(and my gastroenterologist) with SIBO, or Small Intestinal Bacterial Overgrowth.  I had an overgrowth of bacteria in my small intestine that should have only been in my colon.  They had somehow migrated north where they didn't belong.  My small intestine was not meant to have that many bacteria, and it was throwing off the healthy balance of microflora that kept my digestion optimal, and my mind and mood stable.  This overgrowth had been going on for months and months!  This kind of overgrowth can also be the start or cause of other diseases and illness manifesting in the body.  For me, it was the cause of my liver not functioning properly(not detoxing well), and it was probably part of why I developed ulcerative proctitis(a form of ulcerative colitis).

You can get SIBO many different ways, and I will probably never know for sure how mine developed.  I can definitely guess, though!  I had taken antibiotics multiple times in the months leading up to my anxiety starting, so I suspect it was from that.  Not much you can do if you get pneumonia twice in one year, along with an infected hornet sting.  Oh well!  Using antibiotics is sometimes necessary if we don't want to die from an infection, and this can lead to an imbalance in our gut microbiome.  Taking probiotics wasn't enough for me to keep SIBO from taking hold eventually.

Once I found out I had SIBO, all I wanted to do was treat it and move on with my life.  If only!  I learned that SIBO is very hard to treat, and often returns with a vengeance.  This was very disheartening!  SIBO is not like a simple infection you take a pill for, and you're cured.  It is very complex and difficult to completely eliminate.  At this point in my healing journey, though, I was very invested in feeling better and I was willing to do whatever it took.

One piece of advice I have for you, if you get diagnosed with SIBO and are deciding on treatment, try to find a functional medicine doctor to help you.  You can just go to a gastroenterologist and get some antibiotics and be on your way, but these often don't work, or they don't work permanently.  There is more to treatment than simply taking pills.  Even my own gastroenterologist said his personal choice in treating my SIBO was to not treat it.  He said it was so difficult to treat, and it would just come back anyway, there was no benefit to me.  It would be better to just stick to the low FODMAP diet and live my life.  I did tell him I was going to seek treatment with my naturopath, who wanted to use supplements and a healing diet, and he was very supportive of my choice.  I'm lucky in that, I think!  Most conventional doctors would poo-poo anything about diet, but I got lucky with my GI doc, and he is still one of my favorite doctors I have ever worked with.  He just "gets" the gut-brain connection!  (If you live in the Puget Sound area, I'd be happy to pass along his info!)

With my naturopath's guidance, I began my treatment.  The plan was to take an herbal supplement, and simultaneously begin reintroducing high FODMAP foods.  The idea was that the herbal would mitigate some of the possible digestive upset from the high FODMAP foods, and I would learn which of those foods I could tolerate, and in what amounts.  You see, the low FODMAP diet is not meant to be your diet forever.  The initial goal is to reduce your symptoms, and then you test foods to see which of them are a problem for you, and which are not.

I experienced slow but steady improvement in my anxiety as time went on.  I didn't notice it as it happened, but looking back at my records I was clearly feeling better!  I had been recording my symptoms for months already at the time I began treatment for my SIBO, so I was able to determine that the trend was going upward.  I still had anxious days and moments, mostly around my moon cycle, but overall I was improving.  Even if I wasn't on my cycle, I still had anxiety at times, usually triggered by something in my life, which as far as I was concerned, was perfectly normal for me, a highly sensitive person.

Going methodically through the different types of FODMAP foods and seeing how my body reacted was very helpful, and important to the variety of my diet.  Restricting foods for long periods is really not healthy long-term, it's much better to test previously problematic foods to see what your body can tolerate once you've avoided them for at least a month.  My naturopath gave me a guide she had created to help with this, with different food choices for each of the types of FODMAPs, so I would know which category of fermentables were the ones causing me digestive upset.  These types are what makes up the name, Fermentable Oligosaccharides Disaccharides Monosaccharides And Polyols.  Oligosaccharides include fructans and galactans, disaccharides include lactose, monosaccharides include fructose, and polyols include sorbitol and mannitol.

For example, to test sorbitol, she recommended eating two fresh apricots.  They are highest in sorbitol, which is a polyol.  I could also try something artificially sweetened, but thankfully there was a whole foods option!

Going through each category like this was super helpful to me, and learning what foods I could tolerate well, and which ones I could not(here's looking at you, asparagus!).  It did take quite a bit of time, but within a month I had a very good idea of what foods I could now rotate into my diet.  I definitely had missed my roasted cauliflower, avocados, and mushrooms, so it made eating meals much more varied and enjoyable.  So that contributed positively to my mental health, too!

I'm now at the point where we have stopped the herbal supplement and I'm now going to work on building up my mucosal lining in my gut, basically the "sealing" part of healing the gut.  I'm still working with my naturopath, and she has been a great support to me through all of this.  I really encourage you to find a functional medicine doctor, or at least a naturopath who really understands how important the microbiome is.  I never would have improved my anxiety and panic as much as I have without her help.  She listened to me, believed me, and had a plan of action right from the beginning.  This relationship has been integral in helping me to heal my body and my mind.  It isn't the only thing that has helped me, but it has been a huge part, and I'm so thankful I decided to begin seeing her.

If you would like more information on the gut-brain connection from one of my favorite experts, Dr. Sarah Ballantyne, check out this link.  

To find a functional medicine doctor near you, check out the Functional Medicine Institute's helpful search option here.

For more information on SIBO, check out this link