Doctor consulting patient with stomach pain at table in clinic, back view
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Traumatic brain injury (TBI) happens when a sudden blow or jolt to the head disrupts normal brain function. This can occur from car accidents, falls, sports impacts, or blasts. While many people focus on the immediate effects like headaches or memory loss, TBI also affects other parts of the body in surprising ways. One key area is the gut. After a TBI, the gut can become leaky, its bacteria can become out of balance, and its nerve signals can become impaired. These changes can lead to problems such as nausea, constipation, or diarrhea. Worse, they can make the brain injury feel even more severe by spreading inflammation around the body.
This article explores how TBI injures the gut and why fixing it matters for healing the brain. It also examines how integrative chiropractic care can benefit individuals by targeting the spine to enhance nerve signals between the brain and the gut. Drawing on recent studies, we’ll break down the science in simple terms and share real-world insights from experts, such as Dr. Alexander Jimenez, a chiropractor with over 30 years of experience in treating injuries and gut-related issues (Jimenez, n.d.). Understanding this brain-gut link can inform more effective recovery paths.
TBI ranges from mild cases, like a concussion, to severe ones that change lives forever. In the United States, about 2.8 million people seek emergency care for TBI each year (Flint Rehab, 2023). Symptoms include dizziness, confusion, and sleep troubles right after the injury. However, long-term effects, such as trouble concentrating or mood swings, can persist for months or even years.
What many don’t realize is that TBI isn’t just a brain problem. The brain connects to every organ through nerves, hormones, and immune signals. When the brain gets hurt, these connections break down. This “brain-gut axis” is a two-way street: the brain controls gut movements, and the gut sends signals back to influence mood and thinking (Hanscom et al., 2021). A damaged axis after TBI can turn a head bump into body-wide chaos.
Research shows that gut problems after TBI are common but understudied. For example, one study found that people with TBI have higher rates of digestive issues than the general population, with symptoms like bloating or irregular bowels affecting up to 50% of severe cases (Cognitive FX, 2023). Ignoring the gut can slow recovery, as poor nutrition and ongoing inflammation make brain healing harder (Nicholson et al., 2019).
To understand what goes wrong after a TBI, let’s examine the gut’s everyday functions. The gut is more than a food processor—it’s home to trillions of bacteria, collectively known as the microbiome. These microbes help digest food, make vitamins, and train the immune system. The gut lining acts like a strong wall, allowing nutrients in while keeping harmful substances out.
Nerves in the gut, part of the enteric nervous system (ENS), control digestion like a second brain. The vagus nerve links the gut to the main brain, sending calming signals to reduce stress and inflammation (El Baassiri et al., 2024). Hormones from gut cells, like serotonin (95% made in the gut), boost mood and sleep (Mercado et al., 2022).
A healthy gut supports the brain by providing energy from food and helping to fight off toxins. It even helps repair brain cells after stress (Xiong et al., 2023). But when TBI hits, this balance crumbles.
After TBI, the body goes into survival mode. Stress hormones flood the system, nerves misfire, and immune cells overreact. This chaos travels down the brain-gut axis, hitting the gut hard. Let’s break down the main disruptions.
One of the first hits is “leaky gut.” Normally, tight proteins like occludin and ZO-1 seal gaps in the gut wall. TBI breaks these seals, making the gut porous (Katzenberger et al., 2015). Bacteria, toxins, and food bits slip into the blood, sparking body-wide inflammation.
Studies in mice show this leak starts hours after injury. Bacterial components, specifically lipopolysaccharides (LPS), leak out, triggering immune responses that exacerbate brain swelling (Bansal et al., 2009). In humans, TBI patients exhibit higher levels of markers, such as lactulose in urine, indicating more leaks (Hang et al., 2003). This not only causes gut pain but also feeds back to the brain, delaying healing (Weaver, 2021).
Dr. Alexander Jimenez, who treats many injury patients, notes that leaky gut after head trauma often leads to fatigue and foggy thinking. In his functional medicine approach, he views this as a root cause of ongoing symptoms, emphasizing the importance of early gut support to break the cycle (Jimenez, n.d.a).
The microbiome shifts fast after TBI—sometimes in just two hours (Treangen et al., 2018). Good bacteria, such as Lactobacillus, decline, while harmful ones, like Proteobacteria, increase. This dysbiosis comes from slowed gut movements, fewer protective mucus layers, and antibiotic use during recovery (Urban et al., 2020).
Dysbiosis refers to the imbalance of beneficial and less beneficial chemicals, such as short-chain fatty acids (SCFAs), which help calm inflammation and nourish brain cells (Opeyemi et al., 2021). Instead, bad metabolites fuel immune overdrive, which is linked to worse memory and mood issues (Celorrio et al., 2021). One review found dysbiosis lasts years, raising risks for depression or Alzheimer’s (Pyles et al., 2024).
In clinical practice, Dr. Jimenez observes dysbiosis in patients with post-traumatic brain injury (TBI) gut issues. He utilizes nutrition plans that incorporate prebiotics, such as onions and garlic, to restore bacterial balance, reporting improved energy and focus among his patients at the El Paso clinic (Jimenez, n.d.b).
The ENS, with its 500 million neurons, runs gut motility. TBI disrupts it through sympathetic overdrive—fight-or-flight nerves that slow everything down (Ma et al., 2017). This causes gastroparesis (delayed stomach emptying) in half of severe TBI cases and ileus (paralyzed bowels) (Raouf et al., 2024).
Vagus nerve damage disrupts anti-inflammatory signals, allowing cytokines like TNF-α to run rampant (Bonaz et al., 2018). Serotonin signals for peristalsis (wave-like movements) falter, leading to constipation or diarrhea (Mercado et al., 2022). A study in rats showed TBI alters serotonin genes in the colon, explaining chronic slowdowns (Mercado et al., 2022).
These motility issues trap food, breeding more bad bacteria and worsening leaks. Patients feel bloated, nauseous, or lose appetite, as noted in post-concussion reports (Cognitive FX, 2023).
Gut disruptions don’t stay silent—they cause real discomfort. Common signs include:
These aren’t just annoyances. Poor eating habits mean fewer brain-fueling nutrients, such as omega-3s, which can slow recovery (Flint Rehab, 2023). Mental health suffers too—gut serotonin drops link to anxiety (Mercado et al., 2022).
Dr. Jimenez shares case stories on his platform where TBI patients with severe constipation improved after addressing ENS function through diet and adjustments. He emphasizes tracking symptoms to catch issues early (Jimenez, n.d.a).
Gut woes don’t stop at tummy troubles—they can also affect the brain. Leaky gut allows cytokines to cross the blood-brain barrier, amplifying microglia (brain immune cells) and leading to increased swelling (El Baassiri et al., 2024). Dysbiosis cuts SCFA supply, harming neuron repair (Xiong et al., 2023).
This feedback loop raises risks for long-term problems. One study found a link between early dysbiosis and poorer cognition six months later (You et al., 2022). Inflammation spreads to the lungs or kidneys, causing multi-organ stress (Yang et al., 2022). In kids or athletes, it delays return to normal life (Cognitive FX, 2023).
The brain-gut axis break also affects vagal tone—the gut’s calming influence on the brain. A low tone indicates higher levels of stress hormones, which can contribute to chronic fatigue (Weaver, 2021). Breaking this cycle is crucial to achieving a full recovery.
Standard TBI care focuses on medication and rest, but integrative approaches, such as chiropractic care, can also incorporate spine-based healing. The spine houses the spinal cord, a highway for brain-gut signals. Misalignments (subluxations) from injury pinch nerves, worsening axis disruption (Eugene Chiropractor, 2023).
Chiropractic adjustments realign the spine, freeing nerves. This boosts vagal tone, reduces inflammation, and enhances gut-brain communication (Liester & Zadina, 2025). A review notes spinal work modulates the autonomic system, aiding digestion and mood (Northwest Florida Physicians Group, 2023).
Dr. Jimenez incorporates this approach into his practice, utilizing gentle upper-neck adjustments for patients with TBI. He reports reduced nausea and improved bowel habits in weeks, combining these techniques with nutrition for gut repair (Jimenez, n.d.b). His LinkedIn posts highlight how functional chiropractic targets root causes, such as nerve compression, for holistic wins (Jimenez, n.d.c).
Studies support this: Probiotics, combined with adjustments, have been shown to lower cytokines in injury models (Ma et al., 2019). Patients experience less brain fog as inflammation levels decrease (Flint Rehab, 2023).
Recovery starts with daily choices. Eat anti-inflammatory foods, such as salmon for omega-3 fatty acids, berries for antioxidants, and yogurt for probiotics (Flint Rehab, 2023). Drink plenty of water and walk gently to stimulate the bowels.
Stress management techniques, such as deep breathing, activate the vagus nerve (Cognitive FX, 2023). Track symptoms in a journal—note foods and moods. Consult professionals: a chiropractor for spine checks and a doctor for gut tests.
Dr. Jimenez recommends personalized plans, such as his clinic’s macro-balanced meals, to support the microbiome without overwhelming digestion (Jimenez, n.d.a). Start small for big gains.
Research on TBI-gut links is booming. Trials have investigated the use of probiotics, such as Lactobacillus, to reduce hospital stays (Noshadi et al., 2022). Spinal therapies show promise for mental health ties (Liester & Zadina, 2025).
Challenges remain: More human studies are needed, as most data is from animals (Pyles et al., 2024). However, experts like Dr. Jimenez advocate for integrative models, which blend chiropractic with nutrition for improved outcomes (Jimenez, n.d.c).
With awareness, TBI survivors can reclaim health. The gut-brain connection reminds us: Healing one helps all.
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Celorrio, M., Rodríguez, M. J., Lacasa, C., Aguas-Arqui, D., Ulibarri, A., Vilas, D., … & Matute, C. (2021). Gut microbial dysbiosis after traumatic brain injury modulates the immune response and impairs neurogenesis. Acta Neuropathologica Communications, 9(1), 63. https://doi.org/10.1186/s40478-021-01167-2
Cognitive FX. (2023). Post-concussion stomach problems: Loss of appetite, pain, & more. https://www.cognitivefxusa.com/blog/concussion-loss-of-appetite-and-other-stomach-problems
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Jimenez, A. (n.d.a). Injury specialists. https://www.dralexjimenez.com/
Jimenez, A. (n.d.b). Gut health, inflammation & auto-immunity [Webinar]. https://www.linkedin.com/in/dralexjimenez/
Jimenez, A. (n.d.c). Dr. Alexander Jimenez, DC, APRN, FNP-BC, IFMCP, CFMP, ATN ♛ – Injury Medical Clinic PA [LinkedIn profile]. https://www.linkedin.com/in/dralexjimenez/
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Opeyemi, O. J., Rothman, S., & Sah, R. (2021). Sustained dysbiosis and decreased fecal short-chain fatty acids after traumatic brain injury. Journal of Neurotrauma, 38(22), 3190–3200. https://doi.org/10.1089/neu.2021.0012
Pyles, R. B., Hlavacek, J., & Morris, A. J. (2024). The altered TBI fecal microbiome is stable and functionally distinct. Gut Microbes, 16(1), 2309672. https://doi.org/10.1080/19490976.2024.2309672
Treangen, T. J., Wagner, J., Burns, M. P., & Villapol, S. (2018). Traumatic brain injury in mice induces acute bacterial dysbiosis within the fecal microbiome. mSystems, 3(5), e00140-18. https://doi.org/10.1128/mSystems.00140-18
Urban, R. J., Dillon, E. L., & Chinkes, D. L. (2020). Altered fecal microbiome years after traumatic brain injury. Journal of Neurotrauma, 37(17), 1942–1953. https://doi.org/10.1089/neu.2019.6765
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Xiong, Y., Chen, X., & Chen, Y. (2023). Microbiota-derived short-chain fatty acids promote brain repair after stroke. Journal of Neuroscience, 43(15), 2745–2757. https://doi.org/10.1523/JNEUROSCI.1337-22.2023
You, S. H., Wang, X., & Li, Y. (2022). Traumatic brain injury induces gastrointestinal dysfunction, dysbiosis, and bile acid alterations. Journal of Neurotrauma, 39(11-12), 789–802. https://doi.org/10.1089/neu.2021.0456
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Welcome to El Paso's Premier Wellness and Injury Care Clinic & Wellness Blog, where Dr. Alex Jimenez, DC, FNP-C, a board-certified Family Practice Nurse Practitioner (FNP-BC) and Chiropractor (DC), presents insights on how our team is dedicated to holistic healing and personalized care. Our practice aligns with evidence-based treatment protocols inspired by integrative medicine principles, similar to those found on this site and our family practice-based chiromed.com site, focusing on restoring health naturally for patients of all ages.
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