The Vagus Nerve: Your Key to Managing IBS

It’s the chemical communication that runs along this gut-brain axis that can make you feel ‘sick with worry’, or have ‘butterflies’ when you’re excited. Sometimes miscommunications can happen along the vagus nerve⸺the wrong messages are sent or the right messages are misinterpreted. For people with IBS, this can lead to gut symptoms such as diarrhea, constipation or pain.

While anxiety and stress can contribute to these messages misfiring, there are strategies you can put in place to change how your gut and mind signal each other along the vagus nerve. Understanding your triggers and actively working towards calming your mind can help you manage your pain and IBS symptoms, promote a better, more positive outlook, and help you break out from your IBS/anxiety loop.

‍_{The gut-brain connection}

Studies have long shown that IBS is not just a gastrointestinal illness. Instead, it's a complex disorder involving the way your brain and gut interact with each other.

To understand the vagus nerve and its vital role in managing IBS symptoms, first, you need to get to know your autonomic nervous system. 

This system regulates all of the body's natural processes that you never consciously think about, like digestion or breathing.

Within your autonomic nervous system, there are three sub-systems:

1. The enteric nervous system 

2. The sympathetic nervous system  

3. The parasympathetic nervous system 

Let's start with the enteric nervous system (ENS).

If a person doesn’t have IBS, it’s likely they’ve never thought much about their gut beyond knowing it’s the place where their body processes food and retrieves nutrients. In reality, your ENS is in charge of the whole area.

Your ENS is a complex mesh of around 500 million neurons and independently manages your digestive function. This is why your ENS is sometimes referred to as your ‘second brain'. 

Your ENS communicates non-stop with your central nervous system (CNS)—your body's processing center—forming what's known as the gut-brain axis. Your ENS and CNS 'talk' to each other via your vagus nerve, a complex highway of nerves that communicates messages between your gut and brain. 

Your ENS and CNS also communicate through hormone secretion, gut bacteria (microbiome), and along what's known as the HPA-axis, which manages our stress response.

_{Understanding your fight or flight response}

The other two sub-systems of the autonomic nervous system are the sympathetic and parasympathetic. These play a key role in your stress response, and can influence your IBS symptoms.

When you're feeling stressed, your brain kicks your sympathetic nervous system into gear. Messages fly along your HPA-axis to your gut, communicating that your body needs more adrenaline and less digestion. Instead of processing food, your body needs to flee or fight. Your body will respond by either slowing digestion (constipation) or speeding it up (diarrhea).

When there's no danger, you're not feeling stressed, and all is quiet along the HPA-axis, this means your vagus nerve has sprung into action and your parasympathetic nervous system is engaged. Your heart rate will slow, you'll feel more relaxed, and your digestion will be stimulated. This is commonly referred to as our 'rest and digest' setting.

While your sympathetic nervous system can help you in times of genuine stress (such as sprinting away from danger), it can be provoked by non-life-threatening stress too. For someone with IBS who may worry about the food they’ve just eaten or ruminate endlessly about flare-ups while they’re away from home, the sympathetic nervous system may be working overtime and the messages being sent along the vagus nerve are telling your gut there’s danger ahead and it should either stop what it’s doing or do it faster.

These IBS-related anxieties that set off your fight or flight response are very common, and you're not alone. For many people, it can feel like your symptoms and stress go hand in hand. And studies have shown that generalized anxiety disorder (GAD) is five times more common for people with IBS.

This type of stress also actively creates oversensitivity in your intestines, leading to pain and discomfort. When your gut experiences this kind of increased sensitivity, it once again sends distress signals to your brain. 

_{Communication misfires} 

As your vagus nerve is kept busy with all of this communication running back and forth between your gut and brain, sometimes messages inevitably get missed or misinterpreted—this is when your IBS symptoms make themselves known.

For some people, these miscommunications in the vagus nerve could have you feeling a little nauseous before a stressful event, like speaking in public. For others, managing these miscommunications is an everyday battle. 

If you have IBS, you're probably experiencing malfunctions along your gut-brain axis regularly. 

This means your vagus nerve might be sending the wrong messages, or the right messages are traveling along, but your body is interpreting them as bad.

While the vagus nerve delivers clear communications for most people and gets the job done without them having any awareness of its function, for people with IBS, these miscommunications are significant contributors to symptoms like gut pain, constipation, or diarrhea.

Gut-directed hypnotherapy and your vagus nerve

Many people with IBS are caught in a loop: anxiety triggers IBS symptoms; IBS symptoms trigger anxiety. And around you go in a self-perpetuating circle. However, one way to help break out from the IBS/anxiety loop is through gut-directed hypnotherapy.

Listening along to a gut-directed hypnotherapy program like Nerva is about more than just closing your eyes for a peaceful 15-minute time-out. Instead, it's an effective way to relax and actively engage your parasympathetic nervous system via the vagus nerve.

Stimulating your vagus nerve in this way could release a neurotransmitter called acetylcholine which, amongst many other things, can lower your heart rate and calm your stress response, giving your body a much-needed break.

The other side effect (the good kind!) of gut-directed hypnotherapy is many people report it leads to general feelings of wellbeing and the ability to sleep better after a session. 

Breathe your way to calm

Diaphragmatic breathing is another strategy you can use to break your stress-symptom cycle by activating your parasympathetic nervous system.

Sometimes known as 'belly breathing,' this technique involves fully engaging your diaphragm (the large muscle at the base of your lungs), stomach, and abdominal muscles as you breathe.

Most of us have fallen into a natural habit of shallow chest breathing. But with diaphragmatic breathing, you fill your lungs with greater efficiency, slow your heart rate, and lower or stabilize your blood pressure simultaneously. 

Diaphragmatic breathing will activate your vagus nerve and engage your parasympathetic nervous system. Additionally, it has been shown to improve gut motility (the speed at which your gut works). 

Diaphragmatic breathing in four steps:

‍Step 1: Lie down comfortably with your legs straightened out in front of you.

‍Step 2: Place one hand on the chest and the other hand on your abdomen above your navel.

‍Step 3: Inhale through your nose, hold for a moment, and then exhale through your mouth. Your mouth should be open for the exhalation (some people like to purse their lips very slightly to feel the air leave their chest and mouth). The aim is for your abdomen to rise while your chest and shoulders stay still. Imagine a balloon is inflating and deflating inside your abdomen. This should be done slowly. Count to five with each inhalation/hold/exhalation.

‍Step 4: Practice 30 breaths at a time (for about five minutes) every day when you notice symptoms. Once you feel competent, you can try doing the exercise sitting and/or standing.

Your goal? Maintain your breathing at this rate for 15 minutes every day. 

Developing this habit makes it physiologically impossible for your SNS to be in total control. 

If you choose to try gut-directed hypnotherapy, you can apply this breathing technique during your daily sessions to ensure the therapeutic suggestions are being absorbed in a relaxed state, teaching your body to be calm and embrace healthy changes.

The cognitive defusion circuit-breaker

Practicing cognitive defusion is another way of breaking out of an IBS/anxiety loop to support your vagus nerve and engage your parasympathetic nervous system.

Stop for a moment and consider how you think about your IBS. 

Many people with IBS tend to treat negative thoughts passing through their minds as hard-and-fast facts, such as 'I'm going to be in pain forever' or 'I just know I'm going to get diarrhea after dinner'. 

This sort of thought loop can keep you in a state of distress and anxiety, putting your sympathetic nervous system on high alert.

The idea behind cognitive defusion is that you will teach yourself to see these kinds of stress-inducing thoughts for what they are—just ideas that come and go—and it's a technique that actively minimizes their influence. 

The most straightforward definition of cognitive defusion is it's the act of looking at our thoughts rather than from them. It becomes a way to grow your moment-by-moment awareness and notice your thoughts without getting too entangled or 'fused' to them. 

Start by changing your language around your IBS. 

Think of the difference between, 'My IBS is never going away, and it's going to ruin my life' and 'I'm noticing anxiety about my IBS'. The latter thought is more defused and, as a result, less anxiety-provoking. Practicing thinking and speaking with defused language effectively keeps your symptom-related anxiety at arm's length. This way, you control your thoughts; your thoughts don't control you. And it's a good way to put your parasympathetic nervous system in command.

There is a whole range of science-backed cognitive defusion techniques you can try, including: 

‍Sing your negative thoughts

• Hearing pessimistic or upsetting thoughts about your IBS symptoms differently will help you detach from them more easily.

‍Make it a movie

• Visualize a negative thought about your IBS symptoms on a giant movie screen, such as 'I know I will have the worst stomach pain all day'. Picture the thought scrolling slowly up the screen like movie credits. You can't hang onto the thought; you just watch it appear down the bottom of the screen and then disappear at the top. 

‍Praise the brain

• Send a shout out of thanks to your mind. Next time an unhelpful thought about your symptoms pops into your head, try saying to yourself, 'Thanks for that, brain'. After all, your brain thinks it's helping.

The Wrap Up

The way your brain and gut 'talk' to each other and communicate via your vagus nerve can significantly impact your IBS symptoms and experiences. Stress and anxiety can lead to communication breakdowns and aggravate your symptoms. By learning to engage your parasympathetic nervous system and improve the signals along your vagus nerve via gut-directed hypnotherapy, diaphragmatic breathing, or cognitive defusion, you can reduce your symptoms and improve your wellbeing.

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