UPMC Video Rounds - Mind Gut Connection

David Levinthal, MD, PhD, director, Neurogastroenterology and Motility Center:

Emotions are inexorably linked to a change in our body state. That's normal physiology. That's what makes us human. 

What can happen in some disorders is that the tight link between emotion and body state change can become disordered, and that may be the basis for some what we call functional bowel disorders.
An integrated plan for patients that are really are suffering from functional bowel disorders has to exploit some of the mind/body connections that often are at the heart of driving some of the symptoms. 

Medications have a role. But medications alone ignore some of the key disease-driving factors.

We have found great success with steering patients through program that integrates health psychologists who help implement cognitive behavioral therapy and other mind/body interventions such as mindful meditation, even hypnosis.

And we help steer patients to those resources at the same time as using medications to blunt some of the symptoms. 

We were able to publish a study this past summer that documented for the first time the neural map of the adrenal gland in a primate. 

Because the brain areas that we were able to show that are linked to the adrenal gland, which is essentially at the core of a fight-or-flight or stress response may be somewhat of a Rosetta Stone of sorts for understanding how the brain integrates cognition, emotion, and movement with the changes in organ function. Not just to the adrenal, but other organs.

I'm actively engaged in a research program right now to map the cerebral cortical representations of GI organs including the stomach and colon.

If it is on our radar that mind/body processes are as ideologically linked and pathophysiologically important as what's going on in the organ itself I think we're going to do better for our patients faster.

Learn more about the UPMC Division of Gastroenterology, Hepatology, and Nutrition.