Do you know you have two brains?"

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The existence of a "second brain" in our gut is transforming the way medicine comprehends the intricate connections between digestion, mood, overall health, and cognitive processes. Referred to as the enteric nervous system (ENS), this concealed brain within our digestive system is responsible for various physiological functions. Unlike the brain and spinal cord constituting the central nervous system (CNS), the ENS possesses its own reflexes and sensory capabilities, functioning independently.

The ENS, often termed the "second brain" or gut brain, is comprised of two thin layers of neural tissue embedded in the walls of the gastrointestinal tract, extending approximately 9 meters from the esophagus to the anus. With approximately 100 million neurons, the second brain surpasses the neuron count found in both the spinal cord and peripheral nervous system.

This "second brain" in our gut plays a significant role in influencing our decisions and experiences. For instance, when we rely on intuition or experience nervousness resulting in "butterflies in the stomach," we are likely receiving signals from the ENS. Its autonomous functionality and extensive neural network are reshaping our understanding of the intricate interplay between digestion, emotional state, overall well-being, and cognitive processes.

What does your Gut's Brain Control

According to Jay Pasricha, M.D., director of the Johns Hopkins Center for Neurogastroenterology, the second brain, also known as the enteric nervous system (ENS), primarily focuses on controlling digestion-related functions rather than engaging in higher cognitive processes such as religion, philosophy, and poetry. However, it maintains a continuous and bidirectional communication with the brain in our head. Dr. Pasricha's research on the ENS has gained international recognition, particularly highlighting its vital role in managing various aspects of digestion.

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The ENS consists of millions of neurons distributed throughout the gastrointestinal tract, working in harmony to coordinate essential activities. These neurons play a crucial role in generating muscle contractions responsible for propelling waste materials through the final stages of the digestive system. Moreover, they contribute to regulating functions like swallowing, enzyme release to aid in food breakdown, control of blood flow for efficient nutrient absorption, and facilitation of elimination processes.

Second Brain Influences Mood, Well-Being

The gastrointestinal tract demonstrates sensitivity to emotions, with feelings like anger, anxiety, sadness, and elation capable of triggering gut-related symptoms. The brain exerts a direct influence on the stomach and intestines, while the enteric nervous system (ENS) may play a role in inducing significant emotional shifts experienced by individuals dealing with conditions like irritable bowel syndrome (IBS) and functional bowel problems including constipation, diarrhea, bloating, pain, and stomach discomfort. Previously, it was believed that anxiety and depression contributed to these issues.

However, recent studies are uncovering evidence suggesting that irritation within the system can transmit signals to the central nervous system (CNS), leading to changes in mood. This finding elucidates why individuals with IBS and functional bowel problems have a higher likelihood of developing depression and anxiety, as these conditions affect a substantial percentage—around 30-40%—of the population at some point.

This newfound understanding of the connection between the ENS and CNS opens up new opportunities for treatment. It helps to explain why interventions like antidepressants and mind-body therapies such as cognitive behavioral therapy (CBT) and medical hypnotherapy have shown effectiveness in managing IBS and bowel disorders.