The link between your gut and your physical and mental wellbeing

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With popular medical TV shows putting the spotlight on the link between our gut health and physical and mental wellbeing, even usually polite conversation is venturing to previously unmentionable areas: poo, bowels, faecal transplants, farting, bloating, constipation, diarrhoea and cramping.
 
If you haven’t been following the gut debate, here are a few hot topics to kick off conversation at your next dinner party.
 
Gut microbiome: The gut microbiota is comprised of trillions of microorganisms that mostly live in the gastrointestinal (GI) tract, including about 160 different species of bacteria. Gut bugs help you break down undigested food and can offer protection against pathogens. The balance of these organisms plays an important role in your health and wellbeing. Recent studies have linked significant diseases to disturbances of the gut microbiota. Antibiotics, your environment and diet can affect your gut microbiota. Fortunately, you can adapt your diet to support the growth of good gut bugs by eating a nutritious, balanced diet with plenty of fibre. The issue for some people, for example people with Irritable Bowel Syndrome, is that a high fibre diet can cause unpleasant symptoms such as severe bloating and abdominal cramps. That is why seeing a dietician is so important.

Leaky gut: While mainstream medical experts recognise that some people with medical conditions have an increased intestinal permeability in the small intestine, commonly called ‘leaky gut’, there’s disagreement - largely between mainstream medical science and holistic practitioners - about the proven existence of a distinct ‘leaky gut syndrome’. It’s also a point of contention whether leaky gut actually causes harm to the body. When we eat, nutrients are absorbed by the small intestine and transferred to the blood stream as amino acids, fats and sugars. Damage to the lining of the stomach and intestine may mean it becomes ‘leakier’, potentially allowing larger undigested protein particles to pass to the blood stream. Increased gut permeability is common in people with untreated coeliac disease, Crohn’s disease and some other digestive illnesses. Other factors that may increase gut permeability include consumption of alcohol and antibiotics, chemotherapy and non-steroidal anti-inflammatory drugs. Research suggests having increased intestinal permeability maybe associated with digestive disorders, malnutrition and even diabetes. Complementary medicine practitioners, such a naturopaths, also believe leaky gut sets off the immune system, causing a wide list of symptoms including food allergies, mood, migraine, anxiety, diarrhoea and chronic fatigue.

Low FODMAP diet: FODMAPS are carbohydrates such as fructose (honey), fructans and galactans (wheat and onions), lactose (milk), and polyols (apples) that for some reason are poorly absorbed in the small intestine. As they move through the gastrointestinal tract to the large intestine, bacteria digest the FODMAPS producing gas that can cause bloating, wind, reflux, constipation and abdominal pain. Some people are much more badly affected by these symptoms than others. FODMAPS can also draw fluid into the bowel causing diarrhoea. In a low FODMAP diet, foods that trigger symptoms are substituted for ones that don’t. Certain foods may cause problems in high quantities, but you may be able to eat small amounts of them occasionally. Initially, you will be required to eat a plain, restricted diet for two to six weeks under the supervision of a dietician. Then you will slowly reintroduce foods to your diet in a methodical way to see which foods trigger a reaction. This phase must be taken slowly and can take six to eight weeks. After that, you begin a longer-term low FODMAP diet adapted to cater for your trigger foods. Intolerances can change over time, so trigger foods may be re-tested some months later to see if you can reintroduce them to your diet in small quantities. Monash University is a  world leader in FODMAP and IBS research and has developed an app to help people with diagnosed intolerances make low FODMAP food choices.
 
Gut Directed Hypnotherapy and Cognitive Behaviour Therapy: Did you know that the brain and the gut evolve from the same material in the embryo? As an adult, your brain and gut are still connected via your Vagus nerve, and neurotransmitters relay information between the two. Worrying about a gut symptom can cause muscle tension in your abdomen, which actually worsens your symptoms. Noticing the increase in symptoms then leads to more anxiety and even worse gut symptoms. Now evidence-based psychological treatments have been designed to fix your gut symptoms via your brain. Specialised clinics, such as The Gut Centre in Melbourne, use hypnotherapy and Cognitive Behaviour Therapy (CBT) to treat Irritable Bowel Syndrome, Inflammatory Bowel Disease and other gut conditions. According to The Gut Centre, ‘CBT attempts to reduce physical symptoms by assessing the association between physical sensations, thoughts, emotions and physiological responses.’ Gut Directed Hypnotherapy involves four to six weekly sessions of relaxation and listening to the therapist. The Gut Centre says it has been shown in clinical research to reduce the symptoms of IBS in 70 to 80 per cent of cases.
 
Faecal Microbiota Transplantation (FMT): FMT involves transferring poo from a healthy donor (via pill, colonoscopy, endoscopy, sigmoidoscopy or enema) to the gastrointestinal tract of another person in an attempt to cure diseases such as colitis and recurrent Clostridium difficile infection (RCDI). FMT restores gastrointestinal microflora by introducing healthy bacteria. It has been used in trials to treat people with IBD and also neurological conditions such as Multiple Sclerosis and Parkinson’s Disease. FMT is not without risk and research is being done to assess the long-term benefits and potential negative side effects of the treatment.