8 August, 2022
What does chronic pain and gut dysfunction like irritable bowel syndrome (IBS) have in common?
Firstly, it’s common for people with chronic pain to have IBS symptoms as well. But why?
Well first we need to explore why both occur.
What is Pain?
When we injury ourselves, we feel pain. It’s a safety feature. It’s our warning system to get us away from the danger. The danger might be a snake bite when bush walking or tearing a muscle on the footy field.
The pain is a great thing!
It brings our attention to the body part to get away from the snake or stop us from playing the game.
Of course that doesn’t mean pain is a lovely sensation to experience. That’s why we seek the expertise of health practitioners to get us out of pain and heal the injury. Better still, your chiropractor or osteopath will also help you prevent future injuries.
So when is pain not so great?
When pain persists. If your body has healed but you’re still in pain, that’s when we get chronic pain.
Chronic pain isn’t due to tissue damage. The torn muscle has healed and the scab a distant memory.
Instead, chronic pain is due to the brain perceiving that there might still be a threat to the body without any injury, damage or actual threat. The brain thinks there’s a threat.
Chronic pain isn’t caused by the muscles, joints, skin or inflammatory chemicals. It’s caused by the brain and nerves becoming overly reactive.
What’s central sensitisation?
When the nervous system (the brain and nerves) are too quick to react or have an over-reaction, this is central sensitisation.
Examples of central sensitisation:
- Irritable Bowel Syndrome (IBS)
- Fibromyalgia
- Migraines
- Chronic pelvic pain
- Chronic pain
- Ongoing jaw pain (temporomandibular dysfunction)
- Chronic fatigue syndrome
What are the symptoms of central sensitisation?
Those with central sensitisation might feel:
- Sensitive to lights, noise and touch
- Sensitive to toxins, allergens and medications
- Sensitive to hot or cold temperatures
- Fatigue
- Numbness
- Tingling
- Feel swollen
- Difficulties with sleep or restless sleep
- Difficulties with concentration
IBS & the Highly Reactive Brain
Irritable Bowel Syndrome (IBS) frequently occurs with diarrhoea / constipation / both, sensitivities to particular foods and ongoing pain without any damage to the guts. Many IBS sufferers also experience chronic pain, painful periods and chronic fatigue.
Gastroscopes show no damage to the gut. Instead the pain nerves in the gut, spinal cord and brain are believed to contribute to this array of symptoms.
The nerves become over-reactive to foods and stress. Eating too much cheese might set off an attack in someone with IBS but not their healthy friends and family.
How to Manage IBS
IBS Diet
Finding which foods trigger can be half the battle. A specialised diet called the FODMAP diet can be helpful for this. The FODMAP diet is complex but it's designed to be short term. It's not something that you should be following forever - despite many people getting caught out doing that. Your FODMAP-trained Accredited Practicing Dietitian can help with this, and it'll likely be covered by Medicare due to the ongoing nature of IBS.
Calming the Hyper-Sensitivity
When there are other non-gut problems, like painful periods, chronic pain or persistent fatigue, it can be suggestive that the spinal cord and brain are overly sensitive. As such, for some people, it can be helpful to reduce this sensitivity.
The vagus nerve, that travels from the brain down to the guts, may become dysfunctional. This can sometimes be referred to as vagal tone.
Reducing Stress
Stress is a common trigger for people with IBS. There will always be stressful events in life - it's inescapable. It's not all doom and gloom. You can reduce how triggered you are to everyday stresses like traffic, presentations and your phone battery dying. You can reduce the degree your body reacts to stress. You can build resilience against stress.
Appointments available in Moonee Ponds or online.
About the Author
Dr Cassie Atkinson-Quinton - Chiropractor, Brain Health Coach & Biofeedback Practitioner
Dr Cassie is a Chiropractor and Brain Health Coach. Having a special interest in treating nerves and brain-based conditions like nerve pain, chronic pain, dizziness, whiplash, migraines and fibromyalgia. She's one of a handful of practitioners to be trained in Neuro-Rehabilitation, Neurofeedback, QEEG Functional Brain Scans and Brain Health Coaching.
She’s had concussions and atypical migraines as well as a vestibular disorder called Labyrinthitis. During this time, she would hold on to tables to avoid falling over. She understands the journey coming from a family of chronic pain and migraine sufferers.
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Chakiath RJ, Siddall PJ, Kellow JE, Hush JM, Jones MP, Marcuzzi A, Wrigley PJ. Descending pain modulation in irritable bowel syndrome (IBS): a systematic review and meta-analysis. Systematic reviews. 2015 Dec;4(1):1-6.
