Expert care for chronic gut symptoms

Listen for Calm

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Trace the Path of the Gut - Brain Axis

Listen to this meditation regularly to develop an embodied connection.

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Dr Rabia's Rapid Relaxation

A series of 3 minute audio guided breathwork techniques.

Breathe for balance

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Slow Deep Breathing

A daily practice of my 3 layer technique (10 minutes)

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Breathe for your Gut

A breath work educational course in collaboration with IBDRelief

 

 

 

 

 

Move for digestive ease

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Grow to the tallest version of you

A morning practice to lengthen the spine and awaken the belly (25minutes)

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From centre to periphery

Live yoga class exploring the notion of how our belly connects with our periphery (approx: 35 minutes)

The Gut-Brain Connection

Have you ever had a gut feeling about something? What if I told you it isn’t simply an expression, but a statement grounded in scientific fact. This is the story of how your gut and brain have been in constant communication with one another since birth and how you might like to listen in to their conversation.

The intelligence of our individual organs and their integration with the intelligence of our whole body has long been underestimated. Much of modern medical practice has evolved to martyr our individual organs to a speciality of doctors, for example – Cardiologists look after the heart and Gastroenterologists; the gut and so forth. The result is one of crafted expertise, yet each group of doctors is made to focus on only one part of the body. As we mature into our professions, many doctors come to realise that this is in fact not the reality of how the body itself evolved and the movement towards integrated, holistic care begins again.

Back in the womb, a single layer of cells divided to form a long vertical tube down the central line of your body. It is this same tube that formed both the organs of your digestive tract, the so-called gut, and at the same time – your spinal cord and nervous system. Married from birth, these organs were destined for lifelong companionship. The gut even began by mushrooming its own unique nervous system, the so-called Enteric Nervous System, which believe it or not, contains 100 million nerve cells operating without any input from your brain, hence you may have heard the gut called our second brain.

Yet the conversation is even more wonderous than plumbing and electrics… The gut tells the brain when it is full, hungry or when you need the toilet by talking in multiple ‘languages’ - all at the same time. These languages involve hormones (the endocrine system), blood cells (the immune system) and bacteria (the microbiome). Did you know that the bacteria and viruses of your gut outnumber your genes by 150 to 1? That is 100 trillion bugs living in your gut. It is thought that 90% of all diseases can be linked in some way back to the health of this ecosystem. Not only that, but these bugs produce approximately 90% of the happy hormone serotonin – which simply put, signals to your brain feelings of well-being and happiness. No wonder chocolate makes us feel so good!

“All Disease Begins in The Gut.”

Hippocrates

Food and mood are intrinsically linked – and we are the architects of whether this relationship is positive or negative. Unfortunately changes in our food industry, in western societies at least, mean that we need to be forearmed with knowledge of what we are eating and where our food has come from in order to make wise choices and influence this food-mood relationship. For example, the need to feed a growing population requires the use of pesticides and specific animal feeds which change the composition of our food to contain many more hormones and additives which historically our bodies have not evolved to cope with. The rising rate of digestive issues in western society, such as heartburn and Irritable Bowel Syndrome (IBS) can be linked to this phenomenon. Not to mention how ‘popular’ allergies and intolerances have become. Yet this is only half the burden that living a modern life places on our digestion.

How often do you find yourself eating on the go? Or finishing a meal having been so preoccupied talking, texting or looking at your computer screen that you barely noticed how each bite tasted? When we rush our food, we put our nervous system under stress – so called ‘fight or flight’ mode. This signals to our body that instead of digesting a meal, we should be put all our vital energy into surviving to meet that work deadline or not running late to pick the kids up from school. Science also tells us that sensations such as smell, taste and texture influence our hunger levels and the satisfaction we get from having eaten a meal. So eating in a rushed, non-mindful way can have detrimental effects on your weight and digestion.

So, what can we all do to honour this conversation and promote healthy digestion? Firstly, opt for fresh food whenever possible. By this I mean, everything that comes from the Earth. For every single packaged food item you buy, why not count the ingredients? If there are words you don’t recognise or can’t pronounce, be sure to remember that your gut can’t understand them either! The fewer ingredients on your packaging the better.

Secondly, notice how you feel when you eat particular groups of foods – do they make you feel bloated or uncomfortable afterwards? Perhaps it is time to choose differently.

Thirdly, why not sit, breathe and give thanks before you embark on a meal – this signals to your nervous system that it is time to flip the switch from ‘fight or flight’ to ‘rest and digest’ mode.

Finally, when you suffer from low mood or weak digestion, kindly recognise that stress is felt in every cell of your body. Eating is meant to be a slow, steady and nourishing process. Take a step back and remember that you are more than the sum of your individual parts and since your gut is listening, make your thoughts easy to digest.

By Dr. Rabia - written for The.Ismaili UK Website

Is Gut – Brain sensitivity the prime cause of your IBS?

Irritable Bowel Syndrome (IBS) affects up to 5% of the world's population (1). In this article, I am going to explore the role of increased gut sensitivity in IBS and the use of a Hypnotherapy technique to support your IBS journey.

Definitions: 

• Disorder: a state of confusion (lack of order) within an otherwise well-functioning system (in this case – your body)
• Irritable bowel: recurrent abdominal pain associated with a change in bowel habit (Rome IV criteria)
• Gut – brain connection: bi-directional communication between the gut and brain via the nervous system
• Hypnotherapy: fixed attention (focus) upon a dominant idea with a positive expectation (Braid, 1860) 

“All Disease Begins in The Gut.”

Hippocrates

Mainstream misconceptions

Some bowel problems are the result of structural issues like ulcers, inflammation and bleeding. But as you have likely been told with your IBS, there’s nothing wrong with the structure of your gut. So there must be more to the story!

IBS is a poorly misunderstood condition by patients and doctors alike. Originally, it was said to be a ‘psychosomatic’ condition and then a ‘functional’ syndrome – which both carry a degree of stigma and dismissal. Hypnotherapy is the same, plagued by historical narratives which persist due to lack of valid, well presented information. So let’s strip it back and start at the very beginning.

Gut – brain talk

Think of the gut as one long tube from mouth to bottom that has both structure (layers of cells, nerves, blood vessels which make it up) and function (digestion, motion and sensitivity). If this isn’t complex enough, combine it with the immune system, nervous system and the trillions of gut microbes and you get an interaction called the gut brain axis.

For decades, the brain was believed to be the master of the gut, but in fact, it may be the other way around. We now know that the gut has more connections leading up to the brain, than the brain has down to the gut. No wonder things go wrong when one of these systems get irritable! What’s important to understand, is that all these systems play a very important role in IBS symptoms (2).

Following exclusion of more significant medical issues involving the structure of your gut (for example, Inflammatory Bowel Disease (IBD) or Coeliac Disease) you will often be faced with a diagnosis explained thus: “don’t worry it is just IBS.” Whilst this statement is not strictly untrue, it promotes dismissal of what you experience to be a very real lack of order (disorder) within your own body. Since we now have gut doctors like myself who focus solely on disorders of the gut-brain axis like IBS – it can’t possibly be all in your head!

Why so sensitive?

As science continues to unravel the root causes of IBS (note: there is rarely a single cause and by extension, rarely a single solution) it also uncovers common themes. One theme is an altered or heightened sensitivity of your bowel to normal or low level sensations (so-called visceral hypersensitivity to use the medical term). Far from being a new discovery, this idea has been studied since the 1970’s when it was found that pumping gas into the bottom of IBS patients caused more complaints of bloating and pain compared to healthy people (3) – aren’t you glad you weren’t part of that study!

"To keep things simple, it’s like your gut & brain are talking on loudspeaker and you have no volume control."

Studies have since confirmed the same volume of gas in an IBS bowel is less well tolerated by a healthy bowel - largely due to impaired movement of the IBS bowel rather than IBS patients simply producing more gas. (4). Furthermore, stretch in the bowel can lead to discomfort or pain and pain signals are amplified in IBS due to altered processing of your nervous system – your sensitivity threshold is lowered.

Even more interestingly, your sensitivity threshold can shift up or down with mental stress. This is true for everyone but IBS sufferers process this differently. One study tested this by blowing up a balloon into the bottom (rectum) of IBS patients versus healthy people before, during and after mental stress (5). Both groups showed lower thresholds to pain after the stressful event (i.e. more painful) but fascinatingly, only the healthy group were able to increase their threshold during the stressful event to tolerate the pain – whereas IBS patients were not. IBS patients also showed differences in their stress hormone response (cortisol levels) which contributes to heightened sensitivity.

This is of course, only part of the story. Why this occurs and how other aspects of the gut-brain interaction intertwine will be covered future articles. Yet in my mind, this information begs the question – can IBS sufferers relearn to tolerate more gas or increase their threshold of pain perception*? How do you get back the volume control?

*Note: pain is usually an alarm signal from the body to call your attention and let you know something is wrong. This is why any pain that is sudden onset, new for you (i.e. less than 6 weeks in duration) or different from your usual pain should be investigated by an appropriate medical doctor before concluding that you should be altering it in any way.

Retrain your attention

Paul Mckenna famously said “if I could only give one piece of advice to somebody, it would be that we get more of what we focus on”

Attention is our most powerful internal resource i.e. your ability to focus on an idea, feeling or activity of your choice, whilst filtering out unwanted distractions.

In today’s digital age this has become a dwindling ability, as rapidly advancing technology provides us with immediate gratification. Our brains become ‘hardwired’ to seek immediate gratification or we simply lose interest. Often, this is automatic– whereby we are pulled in the direction of our most dominant thought or idea.

"We have lost our innate freedom to choose."

In our bodies, our attention gets pulled into - and stuck onto - feelings or symptoms that pose a threat to our survival. While this is helpful if we have an injury that needs emergency treatment, in the world of gut-brain disorders it only serves to (a) magnify threat (b) increase our stress response and (c) increase our sense of a focal, separate self.

In other words, explicit focus on your symptoms can lead to a perpetuating cycle of fear, anxiety and worry that makes your symptoms worse.

Yet you can rewire this process to support clear, calm & coherent gut -brain communication. The key technique therefore is learning to retrain your attention towards positive thoughts, emotions and sensations. This will reduce gut sensitivity because it reduces reinforcement along the signalling pathways up to the brain which are being reinforced by the attention you place on your symptoms.

“Attention is the key to transformation – and full attention also implies acceptance. Attention is like a beam of light – the focused power of your consciousness that transmutes everything into itself”

Eckhart Tolle

Cognitive Behavioural Hypnotherapy (CBH)

This simple idea has been extensively researched in the landscape of biology & psychology. Our thoughts, emotions and behaviours have a direct influence on the way we process & perceive our physical sensations. CBH is a combination of techniques designed to enable you to develop a highly focused and relaxed state of attention, in which positive suggestions can be fully realised. You can take back the volume control and take one step forward on your journey with IBS.

Four Ways to Improve Your Constipation

Constipation affects up to 1 in 7 of us and can be a source of great distress. In this article, we’re going to explore what your constipation is all about and four ways to improve your flow.

Definitions:

• Colon: the large bowel
• Sphincter: a ring-shaped muscle that relaxes or tightens to open or close a passage in the body
• IBS-C: irritable bowel syndrome of constipation subtype
• Muladhara chakra: mula meaning 'root' and 'adhara' meaning base. In yoga, it is said that this energy centre is associated with safety, security and our ability to let go of fear

What is the colon?

Before diving in, I think we should take a moment to remind ourselves what this incredible organ does for us each and every day.

The colon is a 1.5 metre long section of our digestive system responsible for absorbing water and salt, whilst storing and eliminating our waste. In order to perform this function the colon relies on a complex network of nerves and muscles as well as trillions of microbes.

And like most organs in our body - it’s not until something isn’t working that we really notice and appreciate all that it does for us.

Are you really constipated?

It’s important to establish what a normal and healthy bowel habit is for you.

Bowel habits vary significantly from person to person. Some people go once every couple of days, and others go three times per day. There is no true normal pattern. However, most people tend to feel it is abnormal when their bowel movements are less than 3 times per week or they cause pain, discomfort and negatively impact their quality of life.

Signs of chronic constipation include two or more of the following over the last three months; hard or lumpy stools; straining; a feeling of not being completely empty; or less than three bowel movements per week.

Note: If you are bleeding from your back passage, please see your doctor. While piles or haemorrhoids are extremely common in constipation, it should always be checked out.

"Remember - nearly everyone experiences changes in their bowel habit due to certain foods, when we travel abroad and for women during menstruation."

The three mechanisms of constipation

I would like you to think of your colon as both a river and a reservoir.

Here are the three mechanisms by which your colon can run into problems - leading to chronic constipation:

1. The wave machine

Our colon makes wave-like movements to move the stool along. These waves are linked to our circadian (roughly 24-hour) rhythms, which is why so many of us open our bowels first thing in the morning or after meals and why many people get constipated when they travel around the globe!

Constipation can be caused by a reduction in the number or strength of these wave-like movements which are responsible for motion along the river bed. Perhaps your colon has always been a little slow to move or has become sluggish over time and this leads to what we call slow transit.

2. The sphincter muscles

Our rectum (back passage) is the so-called reservoir and holds onto our stool via the incredibly well-timed co-ordination of our anal sphincter muscles - think of them like a dam preventing overflow! Constipation can be caused by a lack of coordination in these muscles which can affect their ability to relax and release stool. Causes of this can include damage to the sphincters during childbirth or surgery.

3. The pelvic floor muscles

Finally, constipation can occur when our pelvic floor muscles are not intact, strong and flexible. This can be caused by weakening during pregnancy, trauma or simply not having worked at them throughout our lives to make them strong and responsive.

Four ways to improve your constipation

1. The 2 F’s - Fibre & Fluid

I think everybody knows about the importance of fibre these days. A lot of people, however, think about the insoluble forms like bran flakes and green leafy vegetables, which can actually irritate the gut lining. There is a another very important fibre called soluble fibre which forms a soothing gel over the colon lining and together with insoluble fibre bulks up the stool. If you eat plenty of fruits and vegetables you will be getting a good combination of both fibres.

Yet some soluble fibres are also fermentable, which may worsen bloating and abdominal distension in people who have IBS-C. If this is you, I would recommend going for foods that have the highest percentage of soluble fibre yet are non-fermentable, for example: oats, linseeds/flaxseeds and the flesh of low fodmap fruits and vegetables.

To help fibre do its job, we also need plenty of fluids. If you increase your consumption of fibre then increasing your consumption of water (i.e. to 2 litres per day) is essential.

Top Tip - the best sources of combined soluble and insoluble fibre:

(a) Flaxseed (milled or crushed): an ancient plant crop from Southern Europe and Asia which contains an oil rich in omega-3 fatty acid, alpha-linolenic acid. Sprinkle on your breakfast cereal or over yoghurt – approx. 1 x tablespoon per day will do.
 
(b) Kiwi fruit: a berry of two varieties – green or gold. Kiwis are high in vitamins C, E, K and micronutrients potassium, folate and phytochemicals but especially fibre! This study trialled a dose of two kiwi fruit per day (contains about 9g of dietary fibre) and found significant impacts on stool frequency and consistency, confirming it “can be used as a dietary alternative to laxatives in mild constipation”

"But what if dietary changes don’t do the trick?"

2. Short-term laxatives

If dietary changes don’t do the trick, the short-term step would be to try laxatives.

Now, many of my patients avoid taking regular laxatives because they feel they will become dependent on them. This is simply not the case – I am here to tell you that laxatives do not make your bowel lazy! It is far more preferable to keep your internal river moving smoothly by taking regular laxatives than to let yourself teeter on the edge of discomfort, as this can cause other issues.

Generally speaking, there are two types of laxatives: stimulants (e.g. senna / senokot) and stool softeners (e.g. sodium docusate / dulcolax). Stimulants generate stronger wave-like movements of the colon whereas stool softeners actually soften your stools to make them easier to pass. Then there are suppositories and enemas which are most effective if you have symptoms such as straining or incomplete emptying.

"Top tip – start with the choice of laxative which best treats what you feel is the issue for you (i.e. slow transit e.g. stimulants; or hard stools e.g. stool softeners; or incomplete emptying e.g. suppositories) and then add a second type because they work better together."

3. Behavioural therapy – with a Yogic spin!

Before the advent of modern toilets, our ancestors used to squat on the ground to empty their bowels. Little did we know that we have gone backwards instead of forwards!

The muscles of our pelvis have a significant role to play in our ability to poo normally, specifically - our puborectalis muscle which forms something called the anorectal angle.

Sitting on a modern toilet the anorectal angle is closed and so your poo has to navigate a tight corner to make its exit! When we assume a squatting position (i.e. raise our knees above our hips) we open the anorectal angle by relaxation of the puborectalis muscle and the pelvic floor – thus enabling a straight and easy passage of poo.

Top tips:

1. use a foot stool or ‘squatty potty’ to open up the anorectal angle
2. place your elbows on your knees and relax your shoulders
3. breath evenly, do not your hold your breath (see my breathing videos here)
4. when you push down, exhale and sustain the push towards your thighs for 10 seconds then relax for 10 seconds – avoid straining
5. sit for a minimum of 7 minutes and a maximum of 10 minutes – then wipe and walk away!

Now for the Yoga posture to encourage relaxation of the pelvic floor muscles: Happy Baby pose (Ananda Balasana)

Here are the five steps to practicing:

1. lie on your back and hug your knees into your chest, take a few deep breaths to settle down.
2. take hold of the outside edges of your feet with your hands (you can have your arms on the inside or outside of your legs)
3. open your knees slightly wider than your torso and flex the soles of your feet to the sky, position each ankle directly over your knee
4. gently push your feet into your hands to create some resistance and take gentle breaths for 5 minutes or so
5. release your arms and hug your knees back into your chest for a few breaths.

"The word constipation comes from the Latin constipatio which means ‘contraction of body tissues.’ The question is, when you suffer from constipation, does contraction only occur in the bowel? What about the pelvic floor muscles? What about … the mind?"

4. Identifying the ‘root’ of the problem

Let’s face it, there is nothing more satisfying than having a good bowel movement! This is because emptying our bowels involves relaxation of the pelvic floor muscles via the vagal & pudendal nerves which communicate a relaxation response to the whole body.

The ancient Yogic texts describe several anatomical points located along the central axis of the body – so-called chakras, believed to provide a passage for energy to enter and exit the body. Interestingly, they do in fact loosely correspond to western anatomical points.

In this study, Muladhara chakra was found to be in close association with the inferior hypogastric plexus – a collection of nerves supplying our pelvic organs. In yoga, it is said that our root chakra is associated with our sense of safety, security and our ability to let go of fear.

So if our basic emotional needs are not met, eastern philosophy would suggest that we may develop issues in our pelvic organs - including the bowel. Or perhaps it is the other way around - if we suffer from constipation, can we feel unsafe, insecure or fearful?

"Top tip: Managing a physical issue holistically involves addressing the underlying cause. Be open and explore the role your mental health plays in constipation, which may begin close to these ancient roots."

Tying it all together

The above tips and tricks are meant to be tried in combination as they target different areas of the pelvic floor and colon that could be an issue. Yet it may come down to the places you contract where you could do with relaxing.

If you feel you have tried everything and are close to giving up, my advice is to engage with mind-body tools which encourage your gut and nervous system to go with the flow - like Yoga for IBS: my monthly programme or Gut-directed hypnotherapy - so get in touch with me to discuss more.

In the meantime, I wish you all - happy elimination!

The Doctors Kitchen Podcast

Join Dr Rupy & I for a lively discussion on all things food & mood

The Gut Loving Podcast

Join Laura & I to hear all about IBS and the role of the gut-brain axis in managing symptoms

Yakult Podcast

In this episode I discuss the influence of stress on the gut-brain connection and in particular, our microbiome!

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Data Collected	How I Collect the Data
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Type of Data	How Long I Keep It
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All subject access requests should be made in writing and sent to the email or postal addresses shown in Part 12. To make this as easy as possible for you, a Subject Access Request Form is available for you to use. You do not have to use this form, but it is the easiest way to tell me everything I need to know to respond to your request as quickly as possible.

There is not normally any charge for a subject access request. If your request is ‘manifestly unfounded or excessive’ (for example, if you make repetitive requests) a fee may be charged to cover My administrative costs in responding.

I will respond to your subject access request within 14 days and, in any case, not more than one month of receiving it. Normally, I aim to provide a complete response, including a copy of your personal data within that time. In some cases, however, particularly if your request is more complex, more time may be required up to a maximum of three months from the date I receive your request. You will be kept fully informed of My progress.

12. How Do I Contact You?

To contact me about anything to do with your personal data and data protection, including to make a subject access request, please use the following details:

Email address: doctor.rabia10@gmail.com.

Telephone number: 07940166820.

Postal Address: 153 Mallinson Road, London, SW11 1BH.

13. Changes to this Privacy Policy

I may change this Privacy Notice from time to time. This may be necessary, for example, if the law changes, or if I change My business in a way that affects personal data protection.

Any changes will be immediately posted on My Site and you will be deemed to have accepted the terms of the Privacy Policy on your first use of My Site following the alterations. I recommend that you check this page regularly to keep up-to-date. This Privacy Policy was last updated on 02.03.2021.

Disclaimer

Please be aware that I cannot provide medical advice via email and I am not currently offering private healthcare consultations.

All material on this website is believed to be accurate at the time of writing, to the best of my judgement and opinion. It is intended as information only and must not be misconstrued as medical advice or instruction. Any issue related to your physical or mental health and wellbeing should be discussed with an appropriate healthcare professional. This material is not a replacement for seeking timely advice. I wish you well on your journey.

It may take me some time to get back to you as I work full-time. Your patience is greatly appreciated.

About Me

I’m Dr Rabia, and I specialise in helping people with persistant gut symptoms, even when tests are normal or they’ve been told “nothing is wrong”.

🩺 Consultant Neurogastroenterologist
I work with people living with IBS, abdominal pain, reflux and other disorders of gut–brain interaction — the kind that are real, disruptive, and often misunderstood.

🔬 PhD Researcher in Gut–Brain Disorders
I translate the latest science into practical, reliable guidance you can actually use (without the overwhelm of online gut health advice).

🧠 CBT & Gut-Directed Hypnotherapist
These are evidence-based approaches that help calm the gut by working through the gut–brain connection — supporting real symptom improvement, not just coping.

🧘 Yoga Teacher
Because nervous system regulation, breath and gentle movement can play a powerful role in digestive health. I also offer workshops and retreats focused on gut health, with incredible meals prepared by gut-friendly chefs.

My aim is simple: to help you feel less alone, less confused, and more self-empowered about your gut health.