Why Does it Matter What I Eat?

A healthy, balanced diet can be difficult to consistently self-manage if you are in chronic pain. Be it difficulties moving around the kitchen or inability to go out to buy groceries, chronic pain presents many culinary challenges that make it much easier to heat up a frozen dinner or get drive-through than it is to cook. However, a poor diet exacerbates pain more in the long-term far beyond what you would experience in the moment of cooking.

Most neurotransmitters are made and processed in the brain, but an important one for pain is primarily made in the intestines. Serotonin, a neurotransmitter that can help with pain reduction, is produced 90% by gut bacteria. When nutrients found in fried and processed foods are broken down in the stomach, they can inhibit serotonin production, leading to increased sensitivity of pain neurons. Additionally, high sugar intake can interact with the brain’s reward system if you are taking opioids. This interaction increases the reward system’s activation of opioid use, increasing the potential for addiction.

This all is not to say never eat unhealthy food. It tastes great, after all. Instead, focus on a diet of healthier nutritional values. Foods rich in Omega-3 like fish and nuts are natural anti-inflammatories, which help the gut produce serotonin. An increase in serotonin production reduces the brain’s inflammatory pain response, meaning you will feel better in the long run.

What Should I Do if I Have Gastrointestinal Issues?

Gastrointestinal (GI) issues are one way for the body to indicate something is wrong. These signals could be from problems with gut bacteria, medication, or even a form of chronic pain3. For people with chronic GI issues, keeping water down can be difficult, in which a hospital may administer an IV to bypass gut reactions.For mild-to-moderate GI problems, the BRAT(Y) diet is recommended: bananas, rice, applesauce, toast, and sometimes yogurt. In addition to being easy for the stomach to digest, they are harder for the body to expulse. The CRAM diet (cereal, rice, applesauce, and milk) is also recommended since it has similar properties to the BRATY diet but is less restrictive.

Diet Resources

• Pain Doctor Dietary Advice: Outlines different diets that are easy to keep down and process.
• References:
• Moschiano, F., D’Amico, D., Ramusino, M. C., & Micieli, G. (2013). The role of diet and lifestyle in adolescents with headache: a review. Neurological Sciences, 34(S1), 187–190.
• Brain, K., Burrows, T. L., Rollo, M. E., Chai, L. K., Clarke, E. D., Hayes, C., … Collins, C. E. (2018). A systematic review and meta-analysis of nutrition interventions for chronic noncancer pain. Journal of Human Nutrition and Dietetics, 32(2), 198–225.
• Mager, D. R., Liu, A., Marcon, M., Harms, K., Brill, H., Mileski, H., … Turner, J. M. (2019). Diet patterns in an ethnically diverse pediatric population with celiac disease and chronic gastrointestinal complaints. Clinical Nutrition ESPEN, 30, 73–80.