The Brain-Gut Axis in the Pathophysiology of Irritable Bowel Syndrome

Abstract

Summarypathophysiology of irritable bowel syndrome (IBS) is attributed in cumulative neural, hormonal and immunological alterations. We retrospectively reviewed literature data from MEDLINE and EMBASE about the role of brain-gut interactions in the pathophysiology of IBS. Different patterns of regional brain activation, spinal hyperexcitability, autonomic nervous system dysregulation, exaggerated hypothalamus-pituitary-adrenal axis stress response, altered serotonin metabolism, psychiatric comorbidity and low level immune activation are common in patients with IBS. The factors mentioned above mainly sensitize visceral perception and secondarily contribute in the occurrence of both abnormal gastrointestinal motility and extraintestinal symptoms. Visceral hypersensitivity is considered to be the mutual and final result of a multiple level dysregulation of the brain-gut axis in patients with functional gastrointestinal disorders. Immunogastroenterology 2012; 1:23-26