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– This is the most comprehensive study ever conducted on this group of patients, says the research leader.
The chief physician Trygve Hausken checks with ultrasound that everything is normal in the stomach and intestines. Photo: Eirik Brekke
– How long have you been struggling with your stomach? Asks Chief Physician Trygve Hausken, spraying gel on the bare stomach.
– From the first day of high school, the man responds in the bank.
Now he is past 30 and has come to the hospital for expert help. The diagnosis is irritable bowel syndrome, a disorder that affects up to 20 percent of the population.
The light is dimmed. Hausken passes the ultrasound probe across the man’s forehead while looking at the screen.
– There we have the stomach, yes. The liver looks absolutely fine. Here we have the pancreas and here are the intestines.
Everything seems normal, concludes the superior and adds:
– It is usually irritable bowel.
The soup test involves quickly drinking three cups of broth. Then the doctor checks how fast the stomach empties. In those with irritable bowel syndrome, it is slower. Photo: Eirik Brekke
For the man on the bank, the day goes to exams. First a lot of blood work. Subsequently, concentration and memory will be tested.
In a few days you will have to return for an MRI of the brain. With him at home, he receives a net with a form to fill out and a cup for stool samples.
He then follows a strict diet for three months, before going through a new round of testing.
Birgitte Berentsen leads the research group. Photo: Rune Sævig
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– I have come across many broad smiles
We know very well that thoughts and feelings are felt in the stomach. But not everyone knows that the gut can affect the brain.
– We believe the ratio is 80-20. Eighty percent of the influence goes from the gut to the brain and 20 percent the other way around, says Birgitte Berentsen, who heads the Brain-Gut Research Group.
Masters student Stella Hellgren Rasmussen helps pass the time on the soup test and record the results. Trygve Hausken uses the waiting time to inform the patient. Photo: Eirik Brekke
The research group has the ambition to better understand the diagnosis of irritable bowel syndrome. And not least, what happens in the brains of people with this common disease.
– I have known patients with irritable bowel syndrome who have not been able to work because they have concentration and memory problems. They describe it as brain fog, Berentsen says.
The group will examine the brains and intestines of 100 patients with irritable bowel syndrome and compare them with 40 healthy volunteers. So far they are halfway there.
– We want more participants, both patients and healthy. Healthy people don’t have to follow a strict diet, says Berentsen.
– Do patients feel better after three months on a diet?
– At least I have found many broad smiles, says Berentsen.
– Everything seems normal here, says Chief Physician Trygve Hausken. – Typical of irritable bowel syndrome, he adds. Photo: Eirik Brekke
Two main roads
The connection between the brain and the gut is as much about bacteria as it is about nerve cells. Berentsen explains:
– There are two main roads. One is blood flow. Bacteria in the gut break down nutrients for us. The altered bacterial composition in the intestine can cause further leakage in the intestinal wall. Therefore, bacterial products can follow the blood and sometimes cross the blood-brain barrier.
In people with irritable bowel syndrome, we think this barrier is a bit more hollow.
The second connecting pathway is the vagus nerve, which runs between the brain and the intestines. Here the signs go both ways.
– We see that something has happened
Astri Lundervold is a professor and specialist in clinical neuropsychology and participates in the research group.
She says interest in the project is also great among professionals working with other disorders such as Parkinson’s, diabetes, ADHD and autism.
– We do not yet understand the mechanisms, but the connection between the intestine and the stomach is probably important for several diseases, says Lundervold.
Images taken of the participants’ brains before and after months of dieting have not been fully analyzed.
– We expect brain function to suffer after successful treatment, she says.
The blood is tested for intestinal hormones, vitamins, and minerals. Photo: Eirik Brekke
Reset the gut
The diet that the participants put on is called a low food map. Simply put, it’s about avoiding foods that can irritate the gut. The diet is without stone fruits, wheat, rye, onion, garlic and milk sugar, among other things.
– The idea is that this diet eliminates foods that easily cause stomach ailments. When this is done, the intention is to carefully reintroduce one food at a time, to see what the stomach actually reacts to, says clinical nutritionist Eline Randulff Hillestad.
She guides the participants through the three months of dieting.
Seven out of ten have a good low food map effect.
– One of our objectives is to be able to point out who will benefit from the diet. It will save many participants from a failed attempt and save hospital resources, Berentsen says.
The brains of the study participants are examined with fMRi, a form of MRI in which active parts of the brain are illuminated.
– Mood and form improve
Ingrid Gjerde is among the approximately 50 patients who have undergone Brain-gut.
She has struggled with her stomach for 10 years and says it worked well with the diet.
– Did you feel more obvious when your stomach was in order?
– Mood and form improve when you don’t feel sick to your stomach, but it’s hard to tell if your head cleared.
The problem for her has been sticking to the new habits.
– The intention is to introduce new foods with care, but I have not been as systematic as this requires. I like forbidden food too much. It feels in the stomach.
