Navigating the gut-brain connection

UM Knowledge Exchange explores the brain, gut, health and disease

Last Wednesday, U of M hosted its Knowledge Exchange panel discussion where experts from a variety of backgrounds explored the brain and the gut and their connection to Inflammatory Bowel Disease (IBD) and health.

The panelists included researchers from the Max Rady college of medicine and was moderated by Jean-Eric Ghia, professor in the department of immunology.

“[Gut] microbes communicate with us as a human being and all of the cells throughout our body, and they help tell those cells and those organ systems what they need to do, how they need to function correctly,” explained Heather Armstrong, assistant professor in the department of internal medicine.

In IBD, the composition of gut microbes can change, leading to health issues. Dietary fibres, which we are unable to digest but are broken down by gut microbes through fermentation, play a crucial role. However, in certain diseases, this process is disrupted, leading to gut damage and inflammation.

Armstrong emphasized that even in healthy individuals, everyday factors can alter gut health, impacting overall well-being.

Through her research, Armstrong aims to define what constitutes a healthy diet and lifestyle for individuals, potentially reducing gut-related issues.

“So really what can we change about our day-to-day life to make sure that our microbes are healthy so that we are healthy,” she said.

Lesley Graff, professor and head of the department of clinical health psychology, stressed the vital link between clinical practice and research in treating gut issues, highlighting how insights from patient care shape scientific inquiry and vice versa.

“I really value the ability to move between those two worlds because we learn so much,” Graff said.

Initially, it was uncommon to have psychologists in gastrointestinal (GI) clinics. Yet studies have shown how closely the gut and brain communicate — involving nerve pathways, neurotransmitters and the microbiome.

Stress, for example, has been identified as a significant factor affecting GI health, impacting disease progression and outcomes. IBD patients are twice as likely to experience depression or anxiety, indicating a significant connection between gut health and mental well-being.

“That is an extra sort of burden or challenge to live with a disease,” Graff explained.

Graff’s research efforts have now extended to integrating mental health screening into routine GI care, recognizing the need to address the holistic needs of patients. Her projects focusing on integrated care aim to embed psychologists and dieticians within GI clinics to provide comprehensive support directly, rather than referring patients externally.

Charles Bernstein, distinguished professor in the department on internal medicine has been involved in researching IBD for over 30 years, aiming to provide comprehensive care to patients. He established the IBD Clinical and Research Center at the U of M, collaborating with researchers and physicians.

Bernstein emphasized the importance of addressing mental health alongside physical symptoms in GI diseases.

“It’s quite apparent to me that patients with gut-related problems are greatly impacted by their mental health,” Bernstein said, highlighting the need for further research to understand how addressing mental health issues can improve outcomes for patients with GI diseases.

When Jennifer Kornelsen, assistant professor in the department of radiology, joined the U of M, she collaborated with Bernstein to explore how IBD affects the brain — investigating whether individuals with IBD exhibit structural or functional differences in their brains compared to those without the condition.

Despite the seemingly normal anatomy observed in some IBD patients, Kornelsen’s research revealed differences in brain structure and function.

These findings show that IBD is more complicated than just a gut problem — it affects the brain too.

“We’re finding in our Manitoba sample that show that there is an actual pattern of the brain regions that are involved,” she said.