Digestive problems are one of the most common complaints encountered in my clinical practice. In addition to chronic pain, many of my patients will also report some type of digestive problem–heartburn, stomach pain, bloating, constipation and/or diarrhea, nausea, poor appetite, or various food intolerances. Systemic inflammation, which aggravates chronic pain, often begins in the gastrointestinal system. Maintaining good gastrointestinal health is not only a vital part of overall health and wellbeing, it is also necessary to be able to resolve many chronic pain conditions. What a lot of people don’t realize is that how they eat, not just what they eat, can have a tremendous impact on their digestive system and overall health. So what is the gastrointestinal-brain connection, and what are some simple things you can do to improve your digestion? Here is a brief explanation of one of the ways your gastrointestinal system and brain/mind are connected, followed by my suggestions to aid digestive health.

While good digestive health relies on your body producing enough digestive enzymes and having a healthy population of the good types of bacteria in the intestines, the state of your nervous system (affected by your state of mind) also plays an important roll in your digestive health. The enteric nervous system (ENS) is one of the main divisions of the nervous system, and it is often described as the second brain. It consists of a mesh-like system of nerve fibers that govern the function of the gastrointestinal system. The ENS communicates with the autonomic nervous system (ANS), which regulates the fight-or-flight stress response. When the sympathetic stress response is active, body functions that are essential to immediate survival (those that assist in running from or fighting danger, repairing injury, and defending against invading organisms) are up regulated. Blood pressure increases, respiration increases, the immune system and inflammatory response is fired up, and your body releases glucose stored in the body to give you the energy to run from or fight off danger. At the same time, body functions that are not essential to immediate survival (such as digestion) are down regulated. As a result, the digestive system is suppressed. When the sympathetic stress response is active, and the ENS is suppressed, the digestive system will produce fewer digestive enzymes to break down the food you eat, and the motility of the intestines is impacted, which can lead to constipation and/or diarrhea. This process can also contribute to acid reflux, nausea, headaches, fatigue, and mood changes.

Eating when stressed, or otherwise not in a relaxed state (such as working on your computer trying to get a project completed), not only impacts the overall function of your digestive system, it can also contribute to a weakened immune system and chronic inflammation and pain. So, what should you do to regulate the enteric nervous system and aid digestion?

1. Set aside time to eat without doing other work or activities. That means, no work, email, computer browsing, driving etc. while you eat.

2. Before you eat, take 5-10 slow, deep breaths and relax the tension from your shoulders.

3. Practice mindful eating. This means focus on your food–how it looks, smells, tastes, and feels while you are chewing it.

4. Chew your food well. This not only breaks the food down, it also provides a number of other important benefits.

   a. It causes the release of digestive enzymes. Some of these enzymes are in the saliva, which mixes with the food you are chewing to begin the digestive process before food reaches the stomach and intestines.

   b. By breaking food particles down and triggering the release of hydrochloric acid (which digests proteins and neutralizes harmful bacteria), chewing food properly reduces the risk of bacterial overgrowth in the intestines that can lead to indigestion, bloating, constipation, fatigue, and mood changes.

   c. It relaxes the lower stomach to allow food to pass into the small intestine for further digestion. This speeds up digestion and improves absorption of nutrients.

5. Don’t drink too much water or other beverages before, during, or immediately after meals. Give yourself about 30 minutes either side of the meal. Drinking too much fluid around mealtime dilutes the digestive enzymes in the stomach and slows down digestion. Iced beverages are especially bad, as they also cool down the stomach and the contents of the stomach, which need to be warm to digest food properly.

6. Take your time and don’t rush eating. If you think you don’t have time to eat in a relaxed fashion, it’s really important to manage your day and make the time. Allow time for nourishment, rest and digest, and achieve better health and wellbeing as a result.