cover of episode The brain-gut mystery: what’s really causing your IBS? with Dr. Will Bulsiewicz

The brain-gut mystery: what’s really causing your IBS? with Dr. Will Bulsiewicz

2025/4/24
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Jonathan Wolfe: 本期节目探讨了肠易激综合征(IBS)的成因、症状及治疗方法。我本人也有过IBS的经历,过去医生将我的症状归因于压力,建议我避免高纤维食物。但现在,我们对IBS有了更深入的了解,知道肠道菌群在其中扮演着关键角色。 Will Bulsiewicz 医生详细解释了IBS的诊断标准,以及肠道菌群失调如何影响肠道运动和神经敏感性,进而导致腹痛、腹泻或便秘等症状。他还强调了脑肠轴的重要性,指出IBS并非单纯的心理问题,而是肠道和大脑之间相互作用的结果。 Will Bulsiewicz 医生还介绍了低FODMAP饮食等治疗方法,并强调了饮食多样性的重要性。他建议通过增加植物性食物的摄入量来改善肠道菌群,并指出充足的睡眠和运动也有助于缓解IBS症状。此外,他还提到,对于部分患者来说,解决潜在的心理创伤也至关重要。 Will Bulsiewicz: 我是胃肠病学家,也是Zoe的美国医疗总监。我致力于帮助IBS患者找到缓解症状的方法。IBS的诊断主要基于症状模式,没有特定的检测方法。IBS患者通常会出现腹痛、腹泻或便秘等症状,这些症状与肠道菌群失调和脑肠轴紊乱有关。 肠道菌群失调会影响血清素的产生,进而影响肠道运动。同时,肠道神经的敏感性也会增加,导致患者对轻微的刺激都非常敏感。此外,压力等因素也会通过脑肠轴影响肠道,加重IBS症状。 治疗IBS的关键在于改善肠道菌群,这可以通过改变饮食来实现。低FODMAP饮食可以暂时缓解症状,但长期目标应该是增加饮食多样性,摄入更多植物性食物,以促进肠道菌群的平衡。此外,充足的睡眠、运动和减压等生活方式的改变也有助于缓解症状。对于部分患者,解决潜在的心理创伤也至关重要。

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IBS affects over 300 million people globally, yet remains one of the most misunderstood gut conditions. In this episode, we explore the latest science uncovering the real drivers behind IBS - and why your gut microbiome may hold the key to understanding it.

Joining us is Dr. Will Bulsiewicz, a board-certified gastroenterologist and ZOE’s U.S. Medical Director. Dr. Will breaks down why IBS is so difficult to diagnose, how stress and modern lifestyles are making symptoms more common, and what “problematic” poo can tell us.

We then dive into the science: how the gut-brain axis influences everything from pain to food intolerances, why women are disproportionately affected, and how a disrupted microbiome plays a central role in IBS.

Finally, Dr. Will shares practical strategies backed by the latest research -  from dietary changes to cutting-edge treatments - offering hope for healing and prevention.

Whether you're living with IBS or simply want to understand your gut better, this episode is packed with insights into one of the most common yet elusive health conditions of our time.

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Mentioned in today's episode

Irritable Bowel Syndrome and the Gut Microbiome: A Comprehensive Review) (2023) 

Diet and gut microbial associations in irritable bowel syndrome according to disease subtype) (2023)

The association between low birth weight, childhood recollections of parental response to illness, and irritable bowel syndrome: a twin study) (2020)

Analysis of brain networks and fecal metabolites reveals brain–gut alterations in premenopausal females with irritable bowel syndrome) (2020)

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Episode transcripts are available here).