#17 Understanding the gut-brain axis in IBD - with clinical psychologist, Dr Gita Robson

In this episode, we gaze deep into the gut-brain axis with Dr. Gita Robson, a clinical psychologist who specialises in  gastroenterology. Our brains and guts chatter in both directions constantly, and we wanted to understand if this had an implications in how Crohn's and ulcerative colitis patients can better manage their disease.

🔍 What We Cover

• Why the gut might be our “first brain”
• The bidirectional nature of the gut-brain axis
• How inflammation, stress and mood are interconnected
• The vagus nerve’s role in gut-brain communication
• Microbiome diversity and its impact on immunity and mental health
• The influence of lifestyle factors - including pets, sleep and exercise
• Psychological therapies that reduce inflammation and improve IBD outcomes
• Strategies for pain management and building a healthier relationship with discomfort
• The impact of sleep disruption on digestion, mood and inflammation
• How small changes can break the cycle of stress and flare-ups

💡 Key Takeaways

• The gut-brain axis is a two-way street: what happens in your gut affects your brain and your mental state can influence gut function.
• Stress, anxiety, and depression can worsen IBD symptoms and inflammation - but they’re also modifiable.
• Therapies like CBT, ACT and mindfulness-based stress reduction show promise in improving both mood and inflammatory markers.
• Lifestyle factors - including diet, sleep, physical activity, and even pet ownership - shape your microbiome and mental health.
• Pain management isn’t just about distraction - it’s about changing how we relate to pain and reclaiming meaningful activities.
• Sleep disruption can trigger a cascade of stress responses that affect digestion, mood and inflammation.
• Even the smallest change such as a walk, a conversation or a moment of connection can help break the cycle.

📚 Resources Mentioned

• NICE guidelines on first-line treatment for depression
• Research from King’s College London on psychological interventions and inflammatory biomarkers
• Studies on microbiome diversity and depression in IBD
• New York Times article on vagus nerve stimulation

Follow Rachel at @bottomlineibd

Follow Nigel at @crohnoid