Gut-to-Brain or Brain-to-Gut axis – terms I hear frequently when supervising student clinic and indeed I use in discussion with my own clients. While there is a common understanding that the brain-gut pathways are bi-directional, recent research indicates it might be important to clarify the impact of this bidirectional pathway. Does the brain have a stronger influence on the gut and creating, for example IBS-like symptoms or is the gut driving our brain, leading to anxiety, depression and mood changes? Importantly, whatever the case, does this impact on how we manage treatment?