Brain-gut Therapies with GI Psychologist Dr Megan Riehl

08/15/22 • 46 min

*The information in this podcast is intended for Healthcare Practitioners.

Dr. Megan Riehl is one of only a small number of specialists in the world who practices as a Gastrointestinal Psychologist. She is the Clinical Director of the GI Behavioural Health Program at the University of Michigan, offering comprehensive treatment options for people suffering disorders of gut-brain interaction (DGBI), such as irritable bowel syndrome (IBS). Whilst a great deal of attention in natural medicine is paid to how the gut affects brain function, in this episode, Dr Reihl highlights how the brain can have a profound effect on GI function.

Dr Riehl describes how gastrointestinal (GI) conditions can be better understood and managed by transitioning our framework from a mechanistic model to a biopsychosocial model. She discusses the connection between factors such as early life stress, catastrophising and symptom hypervigilance with the incidence and severity of IBS. Dr Riehl walks listeners through several brain-gut strategies and therapies from self-care to practitioner-guided therapy. Learn about the efficacy of cognitive behvioural therapy (CBT) and gut-directed hypnosis for DGBI and discover several digital tools that practitioners can consider. To finish, the conversation turns to another area Dr Riehl is passionate about – screening and managing disordered eating that is linked to, or can develop from, DGBI. Tune into an episode jammed packed with clinical pearls!

Useful Links

Dr Riehl’s diaphragmatic breathing tutorial - https://www.youtube.com/watch?v=UB3tSaiEbNY

Nerva gut-directed hypnosis app - https://www.mindsethealth.com/hypnotherapy/nerva

ROME Foundation - https://theromefoundation.org/

GI On Demand - https://giondemand.com/

Jagielski CH, Riehl ME. Behavioral Strategies for Irritable Bowel Syndrome: Brain-Gut or Gut-Brain? Gastroenterol Clin North Am. 2021 Sep;50(3):581-593. doi: 10.1016/j.gtc.2021.03.006. Epub 2021 Jun 25. PMID: 34304789. https://pubmed.ncbi.nlm.nih.gov/34304789/

Riehl ME, Scarlata K. Understanding Disordered Eating Risks in Patients with Gastrointestinal Conditions. J Acad Nutr Diet. 2022 Mar;122(3):491-499. doi: 10.1016/j.jand.2021.03.001. Epub 2021 Apr 20. PMID: 33893063. https://pubmed.ncbi.nlm.nih.gov/33893063/

Call out to those who may be interested in participating in an endometriosis study: https://www.nicm.edu.au/research/clinical_trials/endometriosis_study

*The information in this podcast is intended for Healthcare Practitioners.

Useful Links

Dr Riehl’s diaphragmatic breathing tutorial - https://www.youtube.com/watch?v=UB3tSaiEbNY

Nerva gut-directed hypnosis app - https://www.mindsethealth.com/hypnotherapy/nerva

ROME Foundation - https://theromefoundation.org/

GI On Demand - https://giondemand.com/

Call out to those who may be interested in participating in an endometriosis study: https://www.nicm.edu.au/research/clinical_trials/endometriosis_study

Previous Episode

Gut Microbes as Frenemies with Dr Joe Alcock

*The information in this podcast is intended for Healthcare Practitioners.

Dr Joe Alcock is not your typical MD. Joe’s day (or night) job is as a practicing emergency Physician and a Professor in the University of New Mexico Department of Emergency Medicine. However, Joe also has a deep interest in both evolutionary medicine and microbiome science and has the unique skill of integrating and translating these disciplines into practical outcomes.

In this episode, Dr Alcock explains how, since time immemorial, our gut microbes have had a love/hate relationship with us, and how this concept of ‘conflict and co-operation’ can explain the trials and tribulations of research on microbiome composition in disease states, probiotic successes and failures and a new approach to feeding ourselves and our resident microbiome. Tune in for a fun and insightful tour of the microbiome as Joe discusses conditions such as gut health, insulin resistance and mood disorders.

Links and resources

Dr Alcock’s website: http://evolutionmedicine.com
Dr Alcock’s Twitter: https://twitter.com/joealcockmd?lang=en
Wasielewski H, Alcock J, Aktipis A. Resource conflict and cooperation between human host and gut microbiota: implications for nutrition and health. Ann N Y Acad Sci. 2016 May;1372(1):20-8. doi: 10.1111/nyas.13118.
https://pubmed.ncbi.nlm.nih.gov/27270755/
Alcock J, Lin HC. Fatty acids from diet and microbiota regulate energy metabolism. F1000Res. 2015 Sep 9;4(F1000 Faculty Rev):738. doi: 10.12688/f1000research.6078.1.
https://pubmed.ncbi.nlm.nih.gov/27006755/

Next Episode

The Power and the Potential of the Vagus Nerve to Combat Inflammation with Prof Paul Peter Tak

*This information in this podcast is intended for Healthcare Practitioners.

Professor Paul Peter Tak, a pioneering researcher and transformational innovator, joins the podcast to describe the power and potential of a little-known homeostatic pathway, known as the cholinergeric anti-inflammatory pathway (CAP). Prof Tak was a key researcher in the identification of the CAP, which is an innate and reflexive anti-inflammatory response mediated by the vagus nerve.

Learn the origins of the discovery of the CAP and Tak’s groundbreaking work that showed a loss of vagal tone precedes the development of rheumatoid arthritis (RA). Moreover, Prof Tak’s team went on to show that electrical stimulation of the vagus nerve had a profound effect on disease activity in RA. The conversation moves to exploring how the gut, nutrition and lifestyle factors can potentially activate the CAP and help prevent or manage autoimmune and inflammatory disorders. Learn how the CAP can be an important target for combating chronic disease.

Paul Peter Tak is a business leader, academic, entrepreneur and clinician who has over 30 years’ experience in medicine as a prominent expert in Immunology, Internal Medicine, and Rheumatology. Alongside his industry career, Prof Tak has dedicated much of his life to academia and advancing our understanding in medicine. He has served as Professor of Medicine at the University of Amsterdam and holds numerous honours for his service to medicine, with a special focus on Immunology and Rheumatology.

Useful Links

Prof Paul Peter Tak's website: https://paulpetertak.com/

First description of the hypothesis that stimulation of the cholinergic anti-inflammatory pathway may be used to reduce chronic inflammation:
van Maanen MA, Vervoordeldonk MJ, Tak PP. The cholinergic anti-inflammatory pathway: towards innovative treatment of rheumatoid arthritis. Nat Rev Rheumatol. 2009 Apr;5(4):229-32. doi: 10.1038/nrrheum.2009.31. PMID: 19337288.
https://pubmed.ncbi.nlm.nih.gov/19337288/

Pioneering study that found low vagal tone precedes rheumatoid arthritis.
Koopman FA, Tang MW, Vermeij J, de Hair MJ, Choi IY, Vervoordeldonk MJ, Gerlag DM, Karemaker JM, Tak PP. Autonomic Dysfunction Precedes Development of Rheumatoid Arthritis: A Prospective Cohort Study. EBioMedicine. 2016 Apr;6:231-237. doi: 10.1016/j.ebiom.2016.02.029. Epub 2016 Feb 19. PMID: 27211565; PMCID: PMC4856742.
https://pubmed.ncbi.nlm.nih.gov/27211565/

First clinical trial in patients showing the effects of stimulation of the chronic immune-mediated inflammatory disease:
Koopman FA, Chavan SS, Miljko S, Grazio S, Sokolovic S, Schuurman PR, Mehta AD, Levine YA, Faltys M, Zitnik R, Tracey KJ, Tak PP. Vagus nerve stimulation inhibits cytokine production and attenuates disease severity in rheumatoid arthritis. Proc Natl Acad Sci U S A. 2016 Jul 19;113(29):8284-9. doi: 10.1073/pnas.1605635113. Epub 2016 Jul 5. PMID: 27382171; PMCID: PMC4961187.
https://pubmed.ncbi.nlm.nih.gov/27382171/

Interview summarising the discovery of vagal involvement in chronic inflammation
Tak PP. Interview with Paul-Peter Tak: stimulating the vagus nerve to treat rheumatoid arthritis. Bioelectronics in Medicine. 2018 Jan;1(1):17-20.
https://www.futuremedicine.com/doi/10.2217/bem-2017-0012