Brain‐Gut Axis

Camilleri, Michael; Lorenzo, Carlo Di

doi:10.1097/mpg.0b013e31823d34c3

Cited by 66 publications

(22 citation statements)

References 121 publications

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“…Briefly, prefrontal lobe may modulate the neural activities coming from limbic and paralimbic regions, anterior cingulate cortex and hypothalamus, which in turn down modifies the activities of descending inhibitory and facilitatory pathways through the periaqueductal gray and pontomedullary nuclei. The neuronal activities among these corticolimbic pontine networks can coordinate the final perception of cognitional and emotional impacts on the visceral pain and discomfort 87. The putative neurolimbic pain network of migraine maybe adoptable to the IBS although the neuro-pathways or networks of both disorders may not be exactly the same.…”

Section: Pathogenesesmentioning

confidence: 99%

“…Basically, 5-HT exists abundantly in the gut with the roles to modulate gut movement, sensation, secretion and blood circulation, and this substance is still an essential CNS neurotransmitter to activate many neuronal functions particularly the mood 87,88. The defective 5-HT activity either in gut or CNS has been shown to contribute to the pathogenesis of IBS.…”

Section: Pathogenesesmentioning

confidence: 99%

“…The defective 5-HT activity either in gut or CNS has been shown to contribute to the pathogenesis of IBS. It is why its agonists and antagonists are employed to treat IBS 87,89,90. Similarly, 5-HT related agents e.g., sumatriptane (5-HT 1B/1D agonist) have been long used to treat migraine 89.…”

Section: Pathogenesesmentioning

confidence: 99%

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Irritable Bowel Syndrome and Migraine: Bystanders or Partners?

Chang¹,

Lu²

2013

J Neurogastroenterol Motil

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Irritable bowel syndrome (IBS) and migraine are distinct clinical disorders. Apart from the characteristics of chronic and recurrent pain in nature, these pain-related disorders apparently share many similarities. For example, IBS is female predominant with community prevalence about 5-10%, whereas that of migraine is 1-3% also showing female predominance. They are often associated with many somatic and psychiatric comorbidities in terms of fibromyaglia, chronic fatigue syndrome, interstitial cystitis, insomnia and depression etc., even the IBS subjects may have coexisted migraine with an estimated odds ratio of 2.66. They similarly reduce the quality of life of victims leading to the social, medical and economic burdens. Their pathogeneses have been somewhat addressed in relation to biopsychosocial dysfunction, heredity, genetic polymorphism, central/visceral hypersensitivity, somatic/cutaneous allodynia, neurolimbic pain network, gonadal hormones and abuses etc. Both disorders are diagnosed according to the symptomatically based criteria. Multidisciplinary managements such as receptor target new drugs, melantonin, antispasmodics, and psychological drugs and measures, complementary and alternatives etc. are recommended to treat them although the used agents may not be necessarily the same. Finally, the prognosis of IBS is pretty good, whereas that of migraine is less fair since suicide attempt and stroke are at risk. In conclusion, both distinct chronic pain disorders to share many similarities among various aspects probably suggest that they may locate within the same spectrum of a pain-centered disorder such as central sensitization syndromes. The true pathogenesis to involve these disorders remains to be clarified in the future.

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Section: Pathogenesesmentioning

confidence: 99%

Section: Pathogenesesmentioning

confidence: 99%

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Irritable Bowel Syndrome and Migraine: Bystanders or Partners?

Chang¹,

Lu²

2013

J Neurogastroenterol Motil

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“…The brain-gut axis relationship is being entertained as a theoretical explanation to the pathogenesis of irritable bowel syndrome (Mayer and Tillisch 2011;Wilhelmsen 2000;Camilleri and Di Lorenzo 2012;Prins 2011;Aerssens et al 2007). The brain-gut axis relationship is being entertained as a theoretical explanation to the pathogenesis of irritable bowel syndrome (Mayer and Tillisch 2011;Wilhelmsen 2000;Camilleri and Di Lorenzo 2012;Prins 2011;Aerssens et al 2007).…”

Section: Brain-bladder Axismentioning

confidence: 99%

Biomechanics of the Human Urinary Bladder

Miftahof¹,

Nam²

2013

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“…It is believed that prefrontal lobe may modulate the neural activities coming from limbic and paralimbic regions, anterior cingulate cortex, and hypothalamus, which in turn down modifies the activities of descending inhibitory and facilitatory pathways through the periaqueductal gray and pontomedullary nuclei. The neuronal activities among these cortico-limbic pontine networks can coordinate the final perception of cognitional and emotional impacts on the visceral pain and discomfort in IBS subjects [56,58] .…”

Section: Visceral Hypersensitivitymentioning

confidence: 99%

Irritable bowel syndrome: The evolution of multi-dimensional looking and multidisciplinary treatments

Chang¹

2014

WJG

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Irritable bowel syndrome (IBS) is common in the society. Among the putative pathogeneses, gut dysmotility results in pain and disturbed defecation. The latter is probably caused by the effect of abnormal gut water secretion. The interaction between abnormal gas accumulation, abdominal pain and bloating remains controversial. Visceral hypersensitivity and its modification along with the central transmission are the characteristics of IBS patients. The identification of biologic markers based on genetic polymorphisms is undetermined. Imbalanced gut microbiota may alter epithelial permeability to activate nociceptive sensory pathways which in turn lead to IBS. Certain food constituents may exacerbate bowel symptoms. The impact of adult and childhood abuses on IBS is underestimated. Using the concept of biopsychosocial dysfunction can integrate multidimensional pathogeneses. Antispasmodics plus stool consistency modifiers to treat the major symptoms and defecation are the first-line drug treatment. New drugs targeting receptors governing bowel motility, sensation and secretion can be considered, but clinicians must be aware of their potential serious side effects. Psychiatric drugs and modalities may be the final options for treating intractable subjects. Probiotics of multi-species preparations are safe and worth to be considered for the treatment. Antibiotics are promising but their long-term safety and effectiveness are unknown. Diet therapy including exclusion of certain food constituents is an economic measure. Using relatively safe complementary and alternative medicines (CAMs) may be optional to those patients who failed classical treatment. In conclusion, IBS is a heterogeneous disorder with multidimensional pathogeneses. Personalized medicines with multidisciplinary approaches using different classes of drugs, psychiatric measures, probiotics and antibiotics, dietary therapy, and finally CAMs, can be considered.

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Brain‐Gut Axis

Cited by 66 publications

References 121 publications

Irritable Bowel Syndrome and Migraine: Bystanders or Partners?

Irritable Bowel Syndrome and Migraine: Bystanders or Partners?

Biomechanics of the Human Urinary Bladder

Irritable bowel syndrome: The evolution of multi-dimensional looking and multidisciplinary treatments

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