A friend recently recommended that I view the Amazon documentary, “The Gut is Our Second Brain” (https://www.amazon.com/dp/B01MY5C9VI).

This well done, one-hour film is both fascinating scientifically and visually entertaining. It shows a broad array of clinical and research discoveries related to the gut with cast of international scientists.

In “The Healthy Gut Workbook” several years ago, I lamented in “Ode to the Gut” that, like the late comedian, Rodney Dangerfield, the gut gets no respect. With its often embarrassing rumblings, outgassings, borborygmi, burps, belches, flatulence, vomitus and olfactorily offensive offal, the gut has been relegated to a second-class citizen in the galaxy of our organ systems.

Many primitive organisms are primarily a food tube, their entire nervous system embedded in their gut. As humans, many nerve functions still occur in the gut. Would you be surprised to know that there is as much brain power in our gut as in a dog? The enteric nervous system is in many ways as complex as the central nervous system. They communicate intimately with each other through direct nerve connections and also neurotransmitters in the bloodstream.

Having a “gut feeling” is not just a metaphor, but a reflection of the reality that most of the body’s serotonin is released in the gut. Serotonin is best known in its role in depression mediated via medications like Prozac, which affect its levels in the central nervous system. The vagus nerve wanders from the brain to the gut and provides reciprocal information exchange to both. What happens in our gut can affect our moods, behavior, and physiology. Likewise, brain interventions like hypnosis or relaxation exercises can alter pain perception in irritable bowel syndrome and other gastrointestinal complaints.

It turns out our gut may be a seat of our unconscious. Is gastric psychoanalysis next?

Surprisingly, neurological diseases like Parkinson’s can be detected in gut biopsies, which are much safer and easier to obtain than brain biopsies. Digestive disturbances, like severe constipation or impaired sense of smell may presage Parkinson’s by decades. Lesions typical of Parkinson’s in the brain have been discovered in nerve tissue retrieved from the gut. Perhaps this will give us earlier diagnosis and treatment for those at family risk of Parkinson’s, Alzheimer’s, and autism.

Evolving research in abdominal acupuncture show it to be helpful not only for gastrointestinal problems, but for mood issues, cognitive problems, back pains, and more. Functional MRI studies have brought new understandings to this ancient method of Traditional Chinese Medicine as many parts of the brain are selectively activated in scans during abdominal acupuncture treatments.

Another high impact area of research is the role of gut bacteria whose DNA and sheer numbers exceed our own cellular volume by orders of magnitude. Keeping our gut bacteria/microbiome in balance is a rapidly evolving field. Now, not only integrative medicine doctors, but mainstream gastroenterologists are employing probiotic therapies. A recent study showed that probiotics have a significant benefit in children with recurrent abdominal pain. Other studies show alterations in gut bacteria contribute to obesity and diabetes, but can improve resilience in the face of stress.

Meditating on your navel may not be so far out anymore. The brain-gut axis is emerging as one of the most fascinating and respected areas of medical science.

Dr. Victor S. Sierpina is the WD and Laura Nell Nicholson Family Professor of Integrative Medicine and Professor of Family Medicine at UTMB.

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