The Mind-Gut Connection

The Mind-Gut Connection How the Hidden Conversation Within Our Bodies Impacts Our Mood, Our Choices, and Our Overall Health Emeran Mayer, 2016

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A twenty-five-year-old who could not stop vomiting

Bill walked into Emeran Mayer's UCLA office with his mother. He was twenty-five, otherwise healthy, and desperate. For eight years he had been cycling through emergency rooms several times a week, doubled over with stomach pain and unstoppable vomiting. He had dropped out of college. He had moved back in with his parents. ER doctors handed him narcotics and labeled him a drug-seeker. Specialists ran endoscopies, CT scans, brain scans. Everything came back normal. Nothing made the symptoms stop.

His mother, a businesswoman with no medical training, had typed his symptoms into Google. "I think he has all the symptoms of cyclical vomiting syndrome," she told Mayer.

She was right. The diagnosis was simple. Mayer asked Bill three questions. Was he completely symptom-free between attacks? Yes. Did anyone in the family suffer migraines? His mother and grandmother both did. What did he feel in the fifteen minutes before an attack hit? Intense anxiety, sweating, cold hands, a pounding heart. The attacks always woke him up before sunrise.

Mayer recognized the pattern instantly. Bill's brain was producing huge surges of corticotropin-releasing factor, a stress molecule that peaks in the early morning hours. When CRF levels spike, the gut goes into emergency mode. The stomach reverses direction. The intestines secrete water and mucus. The colon contracts violently. Bill's gut was not broken. His brain was sending a five-alarm signal to it every night, and his gut was obeying.