Abstract
Visceral hyperalgesia, intestinal dysfunction and unexplained irritability in neurological impaired children is a medical enigma for many healthcare professionals. The neuro-medical management can be challenging and difficult, due to poor understanding of the underlying aetiology and pathophysiology of the condition. Neuro-enteric axis has been proposed as emerging physiologic mechanism in the pathogenesis of many gastrointestinal diseases. The bidirectional connection between enteric and central nervous system may represent a direct relationship between neurological system and gut physiology. Insult to the brain indirectly contribute to the ongoing gut and brain axis sequalae. Microbiota has been an important modulator in the brain-gut axis. Irritability episodes in severe neurological impairment children has been commonly associated with pain originated from gastrointestinal pathology. Management of such condition requires a holistic approach to tackle multidimensional factors that has contributed to the ‘totality’ of the symptoms.
Highlights
Parent commonly associated pain in neurologically impaired children with the gastrointestinal disorders
Neuro-enteric dysfunction is seen in severe neuro-disability conditions as a result from combination between oromotor dysfunction, communication difficulties and motor impairment, leading to faltering in growth [1]
The relationship between gastrointestinal microbial pathogen and brain arose from observation of patients with hepatic encephalopathy who improved following administration of oral antibiotics [2]
Summary
Parent commonly associated pain in neurologically impaired children with the gastrointestinal disorders. For various reasons, these children are often irritable and difficult to manage. Microbiota was thought to have a role in conditions such as depressive, anxiety and dysbiosis in autism [2], and modulating afferent sensory nerve, gut motility and pain perception [3]. This interaction between gut, microbiota and brain has an important pathological and physiological outcome of such conditions. Constipation and ‘wind’ have been blamed in children with severe neurological impairment (SNI) following optimal management of motility disorders. Even colonic distention produced chronic visceral hypersensitivity, characterised as allodynia, primarily from central neuronal sensitization
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
