Gut Feelings Are Real: Why Pelvic Health OTs Should Care

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Transcript

New and seasoned OTs are finding their calling in pelvic health. After all, what's more ADL than sex, peeing, and poop? But here's the question. What does it take to become a successful, fulfilled, and thriving OT in pelvic health? How do you go from beginner to seasoned and everything in between? Those are the questions, and this podcast will give you the answers.

 We are inspired OTs. We are out of the box OTs. We are Pelvic Health OTs.

 I'm your host, Lindsay Vestal, and welcome to the OTs in Pelvic Health podcast. Welcome back to the OTs for Pelvic Health podcast. Today, we're diving into something that is absolutely fascinating and super relevant to our work as Pelvic Health OTs, and that is the gut-brain connection.

 We've all heard about the gut feeling, maybe feeling nauseous before a big presentation, or someone talking about butterflies in their stomach. These are all real things, even though we say them so informally and colloquially, because they're literally the gut and brain talking to each other. And what's wild is that this relationship goes both ways.

 A stressed brain can affect your gut, and a distressed gut can influence your brain. This is what we call the gut-brain access, and it's a two-way street. Here's the deal, right? Your brain can trigger digestive responses just by thought alone.

Think about the last time you were in front of your favorite meal, right? Your stomach may have started preparing even before you took a bite. Gurgling sounds, right? That's your brain sending signals down to your GI system. They also can get it sent back up too.

 And that's what's especially fascinating in the newer research, the idea that gut systems can actually drive anxiety, depression, and even pain responses. This is why some people have GI issues without an obvious physical cause, because it could be functional or stress-driven. So as OTs, especially in pelvic health, we can't look at the gut just as organ system or a plumbing system, if you will.

It's actually a nervous system hub. Did you know that your gut actually has its own nervous system? And it's called the enteric nervous system, or ENS for short. And it's made up of over 100 million nerve cells woven throughout your GI tract, from your esophagus all the way down to your rectum.

It's like this mini brain living inside your stomach. And here's the kicker. Even if your brain was completely out of the picture, your ENS could still handle digestion on its own. It manages muscle contractions, enzyme secretions, nutrient absorption, and even blood flow. So this second brain isn't just a helper. It's actually autonomous, operating independently, even though it does communicate constantly with your central nervous system.

Now, the main communicator here between the brain and the gut is the vagus nerve, right? And this nerve is everywhere. It connects your brain to your digestive tract, your heart, your lungs, like literally all of your major organs. And when it comes to digestion, the vagus nerve says, all right, it's safe now.

Let's go ahead and rest and digest. So then it goes on to increase gut movement, acid production, and blood flow, right? All the good stuff. It also carries messages from the gut to the brain about how things are going down there, right? Super fun fact.

I recently read that 90% of the signals along the vagus nerve go up from the gut to the brain. So when we talk about stress and inflammation, the immune response, and even our mood, we have to think about the gut as well. Now let's talk about microbes because your gut is home to trillions, literally trillions of bacteria and other microorganisms that make up your microbiome.

And what's really cool is that this ecosystem is unique to you. It helps to regulate digestion, produce neurotransmitters like serotonin and GABA, and communicate with your immune system and brain. In fact, a huge percentage of your serotonin is actually produced in your gut, not your brain, right? I mean, when I first learned that, I just knew there had to be more to understanding the causes of depression and anxiety because we know that serotonin is that feel-good hormone, right? And if the large percentage of it is in the gut, there's got to be a tremendous connection there.

Researchers are even looking at fecal transplants to shift the microbiome and pack things like anxiety, depression, and even Parkinson's disease. We recently talked about this in Pelvic OTPs United, which is my off social media community. The link for that community is in the show notes.

It's $39 a month. I go live weekly, and we have a very, very active and supportive community there. So I'd love to have you join us.

We talk about the best pelvic health conversations over there. But back to today's topic, right? So what does it mean for us as pelvic health OTs? Pretty much everything, because this is exactly the kind of mind-body connection that OTs were made to address, right? We don't just treat symptoms, we treat systems. I'm going to say that again.

We don't just treat symptoms, we treat systems. And when someone has constipation or IBS or pain with elimination, or honestly, even food-related anxiety, we're not just looking at the digestive system. We're looking at the nervous system, right? We're looking at stress, how they're coping, what strategies they have in place, what support systems do they have in place? We're looking at sleep, and we're addressing simple habits that make dramatic changes to a client's mental and physical preparedness for sleep.

Because we know sleep is the underpinning of so much regulation within our body, right? So addressing sleep is huge, even sensory processing. So asking questions around things that a client might honestly have natural aversions or even preferences for. So certain smells in the house, even things like textures of clothing.

I remember well before I became an OT, I went to a job interview because I actually have an undergraduate degree in English, and I worked as a technical writer for a number of years before going back to grad school. And I was on a job interview, and I was wearing, so they were wool pants, but they had this like silky lining, pretty much everything from below the button to the bottom of the ankle. So the hem was wool and the top where the button was was wool, but everything else was a silky fabric.

 And it wasn't until I started sweating and I was really nervous in this job interview that I realized that I had like this tremendous amount of itchiness on those two places where the silk didn't touch my skin, where the wool was in direct contact. And I, oh my goodness, I just perseverated on this. It like took over my thoughts.

I think it was probably a pretty bad interview for me, but it's like I loved learning that about myself because you better believe I donated all of my wool clothing that had any sense of wool in it. And I was like, okay, I want to set myself up for success. I want to feel calm and cool and not sort of distracted by my sensory system.

So it's things like that. And of course, roles and routines of our clients, right? This is all within the mind-body connection for OTs to address that absolutely impact a client's nervous system and their pelvic floor function. And as this research continues to evolve, it absolutely will impact how we assess and treat pelvic health conditions.

So how do we apply some of these thoughts that we've had during our episode today? Number one, screen for stress and GI symptoms, even if it's not on the referral. So if you have a client coming to see you for urinary incontinence or urgency, right? We're still using the Australian Pelvic Floor Questionnaire because it goes over inventory of all the symptoms or the main, right? A kind of a catch-all for the main symptoms that a client could be experiencing with pelvic floor dysfunction. And we know so many of their symptoms overlap, right? So asking beyond the Australian Pelvic Floor Questionnaire, which is kind of a quick screen, asking more open-ended questions regarding anything they're experiencing with bowel movement, with their elimination, any GI symptoms, and definitely their stress and sort of where they are in their life at that moment when they're coming to see you.

Number two, regardless of any shared conversation regarding overt or covert trauma, I urge you to incorporate nervous system regulation tools into your sessions, right? I have a lot of episodes on the OTs for Pelvic Health podcast. I am almost positive that even the episode right before this one, I was talking about nervous system regulation and kind of my three main tools that are really helpful to give clients a nervous system, a new way to look at their nervous system regulation. So make sure to check out previous episodes because honestly, I geek out, I geek out about the nervous system and the vagus nerve so incredibly much.

So regularly incorporating nervous system regulation tools into your sessions is absolutely paramount. And the other thing that comes to mind for me is referring out when needed, right? So GI specialist, dietician, functional medicine doctors, et cetera, right? Because we can't take it all on. We have our part to play, but I think it is an absolute, absolute paramount skill to recognize what we don't know and to step firmly into what we do.

Because there's no way, even if we take additional courses that we could compare with the level of support that a dedicated dietician or GI specialist or functional medicine practitioner can really provide to our clients. And very often they kind of need that jumpstart, if you will, from some of the interventions that these specialists have at their disposal in order to have our pelvic health interventions really move the needle forward. Plus it's an opportunity to get your clients to really trust you.

Because when you say, listen, I think there's so many things here that working with a nutritionist could really be beneficial adjunct to our sessions together because that really isn't my expertise. You better believe that they lean into what you do tell them, which so much more earnestness because you're such a straightforward, honest communicator and that you are firmly walking in where you know you can add the most benefit, right? So the gut-brain axis is still a growing field and it's definitely continuing and I believe will continue to change how we understand health. So keep your pulse on it, read the studies, attend the webinars, ask the questions, do your own independent research, keep coming back to the OTs for Pelvic Health podcast.

And don't be afraid to ask a client, hey, this might sound a little different, but let's talk about how your gut might be influencing your pelvic health symptoms, right? 


So thank you so much for listening today. I love this topic. If this episode sparked something for you, I'd love to hear about it.Reach out on Instagram, Functional Pelvis, drop a comment in our Facebook group, OTs for Pelvic Health Facebook group. I love this topic. Join us in the Pelvic OTPs United off social media community for $39 a month.

All of these links are in the show notes. Until next time, take care of your nervous system and your gut. 

Thanks for listening to another episode of OTs and Pelvic Health.If you haven't already, hop onto Facebook and join my group, OTs for Pelvic Health, where we have thousands of OTs at all stages of their pelvic health career journey. This is such an incredibly supportive community where I go live each and every week. If you love this episode, please take a screenshot of this episode on your phone and post it to IG, Facebook, wherever you post your stuff and be sure to tag me and let me know why you like this episode.

 This will help me to create in the future what you want to hear more of. Thanks again for listening to the OTs and Pelvic Health podcast.