Your Gut Didn't Get the Memo
It's not the food.
It's not something you ate three hours ago that finally caught up with you.
It's the meeting. Your gut just doesn't seem to have got the memo that the "danger" in the room is a spreadsheet, not a threat.
Here's the thing: your gut isn't confused. It's doing exactly what it's built to do. The trouble starts a few steps earlier, in your mind, with something so quick and quiet you probably didn't notice it happen: a worry thought.
To see how a passing thought ends up as an urgent trip to the bathroom, it helps to get clear on a couple of terms.
Worry thought — a thought that identifies a risk. It can arise automatically (it just pops into your mind) or be consciously generated (you deliberately bring a future risk scenario to mind). There's no end to the things that may be the subject of a worry thought — your health, job, children, finances, climate change, accidents, the future, or even the feeling of anxiety itself.
Anxiety is the mind-body state you experience when uncertainty or an identified risk — a worry thought — activates your survival response.
Following activation of the survival response, digestion in the stomach is slowed and colonic motility increased, which is exactly the mechanism behind risk triggered urgency and diarrhoea in IBS-D.
That's the gut-brain axis at work. Your gut and your brain are not two separate organs that occasionally affect each other — they are one connected system, in conversation with each other, every second.
Your second brain
Lining your digestive tract is a mesh of over 100 million nerve cells known as the enteric nervous system. It is so extensive, and so capable, that scientists often call it the second brain. It runs the minute-by-minute work of digestion largely on its own, and it is in constant contact with the brain in your head.
The line they talk on
The main connection between the two is the vagus nerve, a long communication line running from the brainstem down through the body to the gut. Here is the part that surprises most people. The traffic is not mostly top down. The large majority of signals travel the other way, from gut to brain. Your gut is reporting upward far more than your head is issuing instructions.
The chemical messengers
The conversation is chemical as well as electrical. Around ninety per cent of the body's serotonin, a messenger closely tied to both mood and gut movement, is made in the gut rather than the brain. The trillions of bacteria in your digestive tract take part too, which is why this is sometimes called the gut-brain-microbiome axis. When chronic stress shifts the balance of those bacteria, it can influence digestion and mood at the same time.
So when a worry thought sets off your survival response, your gut isn't a passive bystander. It's wired, chemically primed, and constantly reporting upward — which is exactly why the trip to the bathroom before that meeting was never really about breakfast.
Anxiety and your gut
When the survival response fires, anxiety and gut distress arise together — two sides of the same state, not one causing the other. But gut distress doesn't stay contained to the gut. It becomes something to worry about — and that new worry thought can trigger the survival response all over again, bringing back the same pair: more anxiety, more gut distress.
None of this is a sign that you are fragile or imagining things. It's a body doing exactly what it's designed to do, reacting to something it has learned to treat as a threat. And because it's learned, it can be updated.
One thing you can try this week
Because the vagus nerve responds to a slow out-breath, your breathing is a direct lever on this whole system. For two minutes, breathe out for longer than you breathe in — for example, in for a count of four and out for a count of six. A longer exhale sends a calming signal down the vagus nerve — the same line that carries your gut's signals up to your brain. It will not settle everything, but it is a small, physical way to speak to your gut in its own language. I go deeper into the vagus nerve later in the series.
A breath practice can calm the system in the moment. But if the loop keeps resetting itself, it's worth asking why — and that usually comes down to how we've been taught to think about the problem in the first place.
Two problems, or one?
When someone has anxiety and a functional gastrointestinal disorder, they may still have two clinically distinct conditions. However, those conditions are operating within one connected body/mind system. Treating the digestive symptoms and anxiety as entirely unrelated can therefore miss the feedback loop between them.
Care can still feel fragmented in practice, with the gut addressed in one appointment and anxiety addressed somewhere else.
The emerging field of psychogastroenterology takes a more integrated approach. It considers medical, dietary and brain-gut behavioural treatments as parts of the same overall plan. Gut-directed hypnotherapy works within this territory.
It does not suggest that IBS is "all in your head". It uses focused attention, belief and imagination to influence the communication between the brain, nervous system and gut.
Recent gastroenterology guidelines identify gut-directed psychotherapies — including gut directed hypnotherapy — as a recommended option for treating global IBS symptoms. Recent systematic reviews and meta-analyses report that gut-directed hypnotherapy can improve global IBS symptoms, while noting substantial variability in study quality, effect sizes, and individual response.
I see this connected approach play out regularly in my practice. Progress often becomes possible when someone stops treating their gut symptoms and anxiety as two unrelated battles — and begins working with the feedback loop that connects them.
If that reframe lands for you — one system, not two — it might be worth a conversation about what treating it as one could look like.
This is the second edition in a series on IBS and anxiety. If you missed the first, it covered the hidden loop that keeps symptoms stuck. Next time I look at anticipatory anxiety, the “what if” worry that quietly starts planning your day around the nearest bathroom. Subscribe to follow along.
A quiet next step
If any of this sounds like your own experience, you do not have to work it out in public. You are welcome to reach out privately for a calm, judgement-free conversation.
Schedule your 30-minute Zoom ‘Meet and Ask’ Call. During the consultation, we’ll look at your IBS experience, clarify your management goals, and explore whether my Gut-Brain Connection program aligns with your needs and preferences. It’s a straightforward space to ask questions and assess whether this specialised, tailored approach is the right fit for you.
• Consultation Fee: NZ$49
• Program Credit: This fee is fully deducted from the total program price should you choose to enrol.
Book here: https://irritablebowelsyndromeibshypnotherapynz.as.me/MeetAskCall
Important Information: This article is for general informational purposes only. It is not personal medical advice and is not a substitute for assessment, diagnosis, or treatment from your GP, gastroenterologist, or another appropriately qualified health professional. If you are experiencing gut issues and/or persistent anxiety or have concerns about your mental health, please consult your GP or a registered health practitioner as soon as possible.