You’ve done the elimination diet. You’ve taken the probiotics. You’ve followed the protocol — and yet your gut symptoms keep coming back. If that’s you, this episode might be the missing piece you didn’t know you were looking for.
Dr Susan Trachman is a board-certified psychiatrist with over 30 years of experience treating medically unexplained illness, and the gut shows up at the centre of those mystery cases far more often than most people expect. In this conversation, she brings a perspective that’s rarely part of the gut health conversation: what your brain is doing to your gut, why stress and unresolved trauma can silently reshape your microbiome, and how anxiety can keep your gut symptoms stuck even when the treatment looks right on paper.
This isn’t about dismissing your symptoms. It’s about understanding why gut symptoms keep coming back when the gut-focused approach alone isn’t enough — and what to do about it.
GUEST BIO
Dr Susan B. Trachman, MD, is an award-winning practising psychiatrist with over 30 years of experience and an expert in treating medically unexplained illness through a psychiatric lens. She is an Assistant Clinical Professor of Psychiatry at Virginia Commonwealth University and Clinical Associate Professor of Psychiatry at George Washington University, where she teaches medical students, residents, and post-residency fellows. Dr Trachman is a regular contributor to Psychology Today and the author of It’s Not Just in Your Head: Demystifying the Brain-Body Connection in Medical Illness.
WHAT YOU’LL LEARN ABOUT WHY GUT SYMPTOMS KEEP COMING BACK
This conversation explores the brain-body connection in gut health — what psychiatry reveals about why gut symptoms keep coming back, and what to do when conventional approaches aren’t enough.
— What alexithymia is and why it keeps gut symptoms stuck even when everything else looks fine
— How the gut and brain are literally derived from the same embryonic cells — and why that changes everything
— Why early childhood trauma and prenatal stress can wire the gut for dysfunction decades later
— What the Dutch Famine Study reveals about how stress shapes the microbiome before birth
— How chronic psychological stress reduces microbial diversity and shifts the gut environment
— Why anxiety and gut distress feed each other — and which one to address first
— What leaky gut actually means from a psychiatric perspective, and how gut inflammation drives depression
— The MENDS framework: Dr Trachman’s 5-step clinical approach to gut and mental health
— Why exercise may be the single most underrated tool for improving gut motility
— The threshold effect of over-exercise and what it does to the microbiome
— How sleep deprivation prevents the brain from cleaning itself — and what that means long term
— What gut-directed hypnotherapy is and how it supports IBS
IN THIS EPISODE, YOU’LL DISCOVER:
✅ What alexithymia is and why it keeps gut symptoms stuck
✅ How early childhood trauma wires the gut for dysfunction in adulthood
✅ The real reason your gut symptoms flare when you’re anxious — and why it works both ways
✅ Dr Trachman’s MENDS framework: the 5-step approach she uses with patients
✅ Why exercise may be the single most underrated tool for gut health
✅ The threshold effect of over-exercise on your microbiome
✅ What leaky gut actually means from a psychiatrist’s perspective
✅ How to approach a patient whose gut treatment looks right on paper but isn’t working
✅ The surprising connection between sleep deprivation and neurodegenerative disease
✅ Where to start when you’re anxious, gut symptoms are flaring, and you feel overwhelmed
Dr Trachman is also the author of It’s Not Just In Your Head: Demystifying the Brain-Body Connection in Medical Illness — a must-read for anyone whose symptoms have been dismissed.
If your gut symptoms keep coming back despite doing everything right, the missing piece may not be in your gut at all. The brain-gut relationship is bidirectional — what happens in the mind directly shapes what happens in the microbiome, and vice versa. Dr Trachman’s work is a powerful reminder that treating gut health without addressing the nervous system is working with half the picture.
Whether you’re a patient, a practitioner, or an integrative GP, this conversation offers a framework for understanding why gut symptoms keep coming back — and how to finally close the loop.
LISTEN HERE
SHOW NOTES
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This content is for educational purposes only and is not intended as medical advice. Please consult with your healthcare provider before making any changes to your health routine.