Insight Lab
The GI Tract: Your Body's Hidden Powerhouse
Have you ever noticed that feeling of “butterflies in your stomach” when you get nervous? That is because your gut and brain are connected! That is because your gut and brain are connected! The gastrointestinal (GI) tract is so critical to your physical and emotional well-being that it is often referred to as your "second brain." In this guide, you will learn the ways that your gut affects your everyday life. You will gain an appreciation for how healthy habits can mitigate the risk for diseases, cancers, and mental health ailments.
The Gut-Brain Axis
Your GI system is “a series of organs that form a continuous passage from our mouth to the anus. These organs include the mouth, esophagus, stomach, intestines, and anus.”41 The GI system and brain work in tandem to maintain your body’s nervous system. This is called the gut-brain axis. The gut-brain axis is “a bidirectional communication network that links the enteric and central nervous systems”.23 The eccentric nervous system is responsible for GI tract functions, while the central nervous system controls the brain and spinal cord. That is your gut-brain axis working together!
Gut Health and Emotional State
Since communication flows in both directions between the brain and gut, changes in the digestive system can affect your state of mind. The National Institutes of Health (NIH) have found that anxiety, depression, and even autism often coincide with problems in the GI tract. Imbalances in gut bacteria can lead to conditions such as irritable bowel syndrome (IBS), which further exacerbate mental health struggles.41
In patients with depression, the gut’s microbiome is often out of balance – a term known as “dysbiosis”. Dysbiosis is a key contributor to inflammation within the gut. The inflammation causes stress within the body, thereby increasing the likelihood of sufferers experiencing a depressed mood.37, 41
Healthy Eating Habits
Consider some of these foods to keep your gut-brain axis in balance.
- Fish such as salmon and mackerel. These fish are high in omega-3 fats, which boost beneficial bacteria levels in the digestive system.37
- Fermented foods like sauerkraut and yogurt are good for gut and brain alike.37
- Prebiotics, such as those found in fruits, vegetables, and whole grains, can mitigate depression and anxiety by lowering stress in the body.37
- Foods derived from plants, such as green tea, olive oil, coffee, and cocoa. These all contain polyphenols, which are digested by healthy bacteria in your gut.37
- Turkey, eggs, and cheese contain an amino acid called tryptophan. Tryptophan becomes serotonin in the body, which helps regulate your emotional state. About 95% of your body’s serotonin is produced in the gut.37
Key Insights
Your digestive health is key to your overall well-being. Johns Hopkins estimates that “up to 30% to 40% of the population has function bowel problems at some point” in their lives.10 That means that, at any given time, more than a third of us have a “second brain” that is not functioning optimally. To combat this, we need to raise awareness of the effects of an unhealthy gut. Simply eating healthier can go a long way to reducing stress, anxiety, and depression.
Resources
- The Brain-Gut Connection | Johns Hopkins Medicine
- The Gut-Brain Connection - Harvard Health
- The Gut-Brain Axis: Influence of Microbiota on Mood and Mental Health
- The Gut-Brain Connection: How it Works and The Role of Nutrition
- What Are The Most Common Signs And Symptoms Of Gastrointestinal Disorders?
Understanding the Patient Experience with Rare Conditions
There are times in our lives when we feel frustrated and alone. We often reach out for support from people who understand what we are going through. However, for people living with a rare gastrointestinal (GI) disorder, finding people who understand can be challenging at best. With limited treatment options for most of these disorders, life can be downright frustrating. Understanding the patient experience is critical for healthcare providers to deliver the best level of care.
Current Challenges
A disease is considered “rare” when it “affects fewer than 200,000 Americans.” That might sound like a lot of people, but consider that the population of the United States is 345 million people. In this case, 200,000 people represent 0.06% of the country.
The Pennsylvania Health Care Cost Containment Council (PHC4) has identified several ways in which so few patients can create challenges for healthcare providers and researchers:
- It is hard to detect which people ended up in the hospital due to a rare disease based on medical coding alone.25
- “Rare disease research is limited by the lack of available ICD-10-CM codes connected to a rare disease.”25
- Related to the first point, researchers cannot always be sure that they have an accurate picture of sufferers of any given rare disease due to potential misdiagnoses, as well as underestimates or overestimates of hospitalizations.25
- Researchers are sometimes stymied by mandated “data suppression” at low levels of hospitalization to keep patient identities private.25
Reality for Sufferers of Rare Diseases
Rare or not, these disorders cause monumental hardship for individuals and their families. The mental and financial challenges can seem overwhelming in the face of the many challenges to finding cures.
In 2019 alone, nearly $1 trillion was spent on bills, lost economic output, and other expenses such as travel to receive treatment to combat rare diseases.25
Beyond the Numbers
Around 70% of rare disorders are acquired in childhood. Colin LaMura of Fairfield, Conn. was diagnosed with Angelman syndrome at the age of one. Though a treatment for the rare chromosomal mutation might be in sight, advocates worry “how changes to federal medical research funds could affect those efforts.”25, 38
Colin’s mother, Monica, traveled to Washington, D.C., to talk to policymakers and raise awareness of Angelman syndrome through their personal stories.38
LaMura spends large portions of her time working with neurologists, pediatricians, and other medical experts to aid in her son’s development until a cure is discovered.38
The LaMuras are confident an FDA-approved treatment is near, but they stress the need for continued funding and to “continue to believe in science.”38
Advocacy is Critical
You do not have to travel to Washington D.C. to take action on behalf of sufferers of rare diseases. You can advocate for policy changes in your community. If you are a healthcare provider, you can stay current on research and treatments available for rare diseases. Even if you are not a medical expert, you can donate to organizations like the National Organization for Rare Disorders (NORD) or volunteer with an organization that supports people with rare diseases in your community.
Resources:
The Funding Gap: Why Rare Conditions are Left Behind
In Reading 2: Understanding the Patient Experience with Rare Conditions, we touched on the difficulties obtaining reliable information about rare diseases, including GI disorders. Another issue facing researchers is a gap between the funding needed to advance studies and cures and the pool of money actually available to these causes. In the following sections, we explore just how wide the finding gap is and what can be done to close it.
Gene Therapy Funding Falling Behind
Gene therapy is critical in the fight against rare GI disorders. This therapy involves “inserting a modified gene to compensate for a faulty gene or change how a patient’s cells produce proteins”.28
“Advancements in understanding the pathogenesis mechanisms underlying gastrointestinal diseases, encompassing inflammatory bowel disease, gastrointestinal cancer, and gastroesophageal reflux disease, have led to the identification of numerous novel therapeutic targets”. However, this life-saving therapy has recently been shedding investment dollars as investors favor areas like weight loss, which promise higher returns.28, 40
In 2021, makers of gene therapy raked in $8.2 billion in funding. By 2023, that number had fallen to $3.5 billion, and in 2024, it sank to just $1.4 billion. In contrast, funding for drugs targeting obesity has increased threefold since 2023, rising from $630 million to $1.75 billion. Subin Baral of Ernst & Young also points out that investors are scared away by the high prices associated with developing gene therapies.28
Closing the Gap
Without advocacy from practitioners, researchers, and the public, the funding gap will only grow larger. While billions of dollars are still going toward finding treatments for rare GI disorders, it is inadequate as people continue to suffer the debilitating effects of these ailments. We must encourage more investment to find cures by highlighting their importance to the well-being of everyday people.
Rare GI conditions such as inflammatory bowel disease, short bowel syndrome (SBS), and trimethylaminuria (TMAU) affect not only the gut but are also linked to increased risk of diseases like Parkinson’s and Alzheimer’s.13
Delaying or cutting research of these diseases will cost the healthcare system and its patients billions of dollars - not to mention countless lives - over the coming years.
It is important to point out that, in most cases, researchers do not have to start from scratch. Inflammatory bowel disease (IBD), for example, has promising gene therapies already on the horizon.40
“Gene therapy has the potential to profoundly change the prognosis of debilitating and often fatal diseases by offering durable and curative solutions”.40
However, further study is needed to determine which genes are most important to modify and to ensure patient safety when undergoing treatment. As with all areas of research, this requires consistent, reliable investment.
Resources:
Advancing Research and Advocacy
Whether a rare disease affects the GI tract or another part of the body, advancing research for the more than 8000 that afflict nearly 30 million Americans is of utmost importance.24
We will explore some of the most critical aspects of rare disease research and learn the importance of advocacy as it relates to GI disorders.
Advancing Clinical Trials
Clinical trials lie at the heart of research on rare diseases. In order to find therapies and cures for rare GI disorders such as eosinophilic enteropathy, Hirschprung’s disease, and Whipple disease, researchers must take great care to design studies that are thorough and effective.
A study from the Journal of Child Neurology describes some key aspects of researching diseases such as designing trials, measuring outcomes, and understanding “the natural course of disease” and “key milestones in disease progression”.24
As we’ve noted in previous readings, the study reiterates that “in rare disease, the small numbers of patients, geographic dispersion of patients, and small number of interested or adequately trained researchers have all been barriers.”24
In other words, it can be hard to find patients to study, and even harder to find medical professionals interested in studying them.
Efforts to Increase Participation
Patients of rare GI disorders need to advocate for themselves in the race to find treatments and cures for their diseases. One way they can do that is by seeking out clinical trials and supporting research initiatives. This can be done in several ways:
- Ask their healthcare providers to recommend clinical trials or contact information for researchers of rare diseases.
- Engage in policy discussions at local, state, or national levels that demand training opportunities and funding.
On the research side, healthcare providers can do more to encourage researchers to educate themselves on rare GI disorders and become more involved in designing trials that address these diseases. Institutions like the NIH provide “career-training grant opportunities…support, mentorship, and protected time for bench and clinical researchers to develop expertise in many areas relevant to rare disease research.”24
The Fight Continues
Advocating for continued research for rare GI disorders is a challenging but rewarding undertaking. From lack of patients and researchers to poor understanding of most rare diseases, the task can seem overwhelming. However, when we realize that millions of people are depending on us to fight for them, we truly appreciate the importance of the struggle.
Advocacy groups play a vital role in the effort to increase participation by both patients and researchers in finding cures, but the patients and researchers themselves can also be part of the solution to quicker treatment innovations. The more we all pitch in, the more public awareness we will achieve. This will increase the likelihood that research will advance more quickly as time progresses.
Resources