Is Your Gut Ruling Your Emotions or The Other Way Around?

The Gut-Brain Axis: Emotions & Digestion are Related

Is Your Gut Ruling Your Emotions or The Other Way Around?

“Trust your gut,” is a phrase most commonly used when referring to a person’s intuition.

Throughout history, people have held the idea that there is a mental component to our gastrointestinal system. Why else would anxiety on a stage be referred to as “butterflies in the stomach?”

Have you ever experienced nervousness, and shortly after the emotion began, you had to rush to the bathroom, or felt depressed, or sad and lost your appetite?

The Gut-Brain Axis: Emotions & Digestion are Related

The gut tube is lined with specialized cells that excrete biochemicals that help us function. These cells are connected to your brain through numerous nerve pathways. When they send out chemicals that act on your nervous system, called neurotransmitters, these create physical actions, such as telling your stomach to start grumbling when you are hungry. As neurotransmitters, they also act on, and in response to, the emotional center in your brain known as the limbic system. As an overall concept, this is called the “Gut-Brain Axis.”

The Five Neurotransmitters Responsible for Emotions

We now know that at least 95% of the neurotransmitter Serotonin and over 50% of the neurotransmitter Dopamine is made and expressed in the intestines. A few others to note are Acetylcholine, γ-Aminobutyric acid (GABA), and Norepinephrine.

These neurotransmitters are made in part from probiotic bacteria, amino acids (the body’s building blocks), glutathione (an extremely important antioxidant), and various B vitamins that go through a process of methylation (adding carbon and oxygen to them, so they can be used in our body’s chemical reactions).


Serotonin is involved in activating GI motility, stimulating muscle contraction and relaxation to move food through our gut. Serotonin also helps moderate pain pathways in the body and creates a sense of emotional well-being, but it also helps us react appropriately to sad situations.


Dopamine likes to hang out in the upper portion of our GI tract—the esophagus and the stomach. It keeps the sphincter between our esophagus and stomach closed so food stays in the stomach and doesn’t come back up. It also helps keep the food in the stomach from the other side, so that it has time to break down before moving along to the next step in the small intestines. Emotionally and mentally, it plays a role in motivation, reward, and experiencing pleasure.


Acetylcholine increases calcium inside GI cells and modulates pain and inflammation in your GI mucosa (the surface layer). It also helps us stay alert and remember things.


GABA regulates smooth muscle contraction, so you can churn and break down your food- it works in conjunction with serotonin. It also helps us to relax and plays a role in sleep.


Norepinephrine decreases overall blood flow to the intestines. This action helps us regulate the absorption of nutrients. Norepinephrine in the mental-emotional realm helps us stay alert, concentrate on tasks, be happy and motivated.

The Brain & Gut In Action

One of the most common GI disorders, Irritable Bowel Syndrome (IBS), has anxiety and/or depression as part of its symptom picture. People who have other GI issues like gas, bloating, constipation, loose stools, etc. will also often note that they have some kind of emotional component that goes along with the GI dysfunction.

What we now know is that emotional symptoms are not always the cause of physical symptoms.

It is actually quite often the opposite story—the malfunctioning GI system is causing the emotional symptom. Anxiety, depression, easy irritability, and even some of the darker states of emotion can all be triggered by gastrointestinal disorders.

Higher up in the GI tract we can have issues such as heartburn (gastric reflux, or GERD) or gastric ulcers, which are strongly tied to dopamine excretion. Most of the time, we doctors ask about the number of fried foods the patient is eating or look at H. Pylori as the culprit in these GI diseases. It could be that the patient is lacking in dopamine or its nutritional building blocks. Again, the opposite may be true—the high intake of fried and fatty foods with too low amounts of whole grain and vegetables may be causing a reduction of dopamine leading to heartburn or ulcers.

It doesn’t matter which gastrointestinal issue it is, Crohn’s, ulcerative colitis, diverticulitis, food allergies or food sensitivities, unbalanced nutrition, IBS, high intake of alcohol, even an infectious disease that alters your digestion, such as the flu or CoVid-19 can start to cause mental-emotional symptoms. Alternately, when we eat on the go or under stress, we can interfere with our physical processes of digestion by triggering the wrong neurotransmitters or depleting the ones we need. Over time, this can lead to chronic gastrointestinal upset or disease.

What’s the Cause?

If you have noticed lately that you are becoming anxious, or maybe you’re snapping at your coworkers a bit, it could be a result of a gastrointestinal problem. Many disease patterns will first show up in the mental-emotional realm. On the other hand, maybe you’ve had some constipation, but your nutrition is well-balanced, you cook most of your own meals, use organic or high-quality ingredients, etc.

You just can’t seem to figure out what the problem is? Possibly, you have some underlying emotional trigger. A neighbor’s irritating habit, a family member who has been trying your last nerve, or you can’t seem to find a solution to some ongoing problem. Anything that upsets a person’s emotional balance, especially if it goes on for a while, can also upset the gut.

There is a Solution

What’s the solution? It may be varied. A thorough history and investigation of the individual patient’s symptoms and patterns are needed. Throwing a probiotic at it may help a bit but is not necessarily going to solve the underlying cause or have a long-term effect. Maybe the patient is a poor methylator? Maybe they have an organic serotonin deficiency or don’t realize they have Celiac disease?

Whatever the cause, Naturopathic Medicine has a multitude of approaches to rebalancing the “Gut-Brain Axis.”

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Want to learn more and see how Dr. Lisa Fortes-Schramm and San Jose Integrative Medicine can help you on your journey? Schedule your free phone consultation HERE.

Dr. Lisa Fortes-Schramm ND specializes in brain & gut chemistry (also known as “the brain below”), and cardiovascular disease, the precursors of which can be found in the mind.

Dr. Lisa Fortes-Schramm
Naturopathic Doctor
(408) 357-3422
San Jose Integrative Medicine
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