The precise cause of irritable bowel syndrome (IBS) remains a mystery. A novel new hypothesis suggests that IBS could result from the body’s inability to manage gravity.
Gravity may be the “unifying factor in multiple seemingly disparate and mutually incompatible theories of IBS,” Brennan Spiegel, MD, director of Health Services Research at Cedars-Sinai Medical Center, Los Angeles, told this news organization. Dr. Spiegel’s gravity hypothesis of IBS is described in an article published in the December issue of American Journal of Gastroenterology.
A human being’s relationship to gravity is not unlike the relationship of a fish to water, he explained.
“We live our entire life in it, are shaped by it, yet hardly notice its ever-present influence on our body. Every fiber of our body is affected by gravity every day, including our gastrointestinal tract,” said Dr. Spiegel.
The abdominal contents are like a sack of heavy potatoes that we’re destined to carry around for our entire lives. To meet this demand, our body evolved to support the abdominal load with a set of mechanisms that hoist the viscera against gravity in an upright posture, Dr. Spiegel explained.
A failure of these mechanisms could lead to a host of problems, including motility problems or bacterial overgrowth in the gut and symptoms of IBS.
Dr. Spiegel’s gravity hypothesis, however, goes beyond the gastrointestinal tract.
“Our nervous system has evolved its own ways of managing gravity and how gut feelings arise when our nervous system detects gravity challenges, like getting ‘butterflies’ when falling on a roller coaster or in a turbulent airplane,” Dr. Spiegel said.
“Even our neuropsychological orientation to gravity is found in our language, like when people talk about feeling down in the dumps, feeling low, [or say they] can’t get out of bed. These are directional metaphors that we use that refer to the fact that there is something about getting pulled down that’s obviously negative,” he noted.
‘A big ask’
Dr. Spiegel said his gravity theory of IBS draws from “extensive literature to build a hypothesis that IBS may result from ineffective anatomical, physiological, and neuropsychological gravity-management systems designed to optimize GI form and function, protect body integrity, and maximize survival in a gravity-bound world.”
He acknowledged that it’s “a big ask” to get people to consider a unifying theory of anything. “But when we dig down deep, it’s not terribly controversial to me to suggest that our health has something to do with gravity. How could it not?” he said.
Dr. Spiegel also thinks this line of thinking has clinical implications.
“While we can’t change gravity, we can change our relationship to gravity in different ways,” he said.
“For starters, we can bolster our body to manage gravity better, through losing weight, exercise, and strengthening the anti-gravity extensor muscles along the back, which supports the spine, which is the chassis that holds up the whole body and includes maintaining the shape of the abdominal cavity,” Dr. Spiegel said.
The reason physical therapy and exercise are effective for IBS could be because these interventions strengthen the GI support systems, he said.