The stress concept in gastroenterology: from Selye to today

Abstract

More than eighty years after Hans Selye (1907–1982) first developed a concept describing how different types of environmental stressors affect physiological functions and promote disease development (called the “general adaptation syndrome”) in 1936, we herein review advances in theoretical, mechanistic, and clinical knowledge in stress research, especially in the area of gastroenterology, and summarize progress and future perspectives arising from an interdisciplinary psychoneurobiological framework in which genetics, epigenetics, and other advanced ( omics) technologies in the last decade continue to refine knowledge about how stress affects the brain-gut axis in health and gastrointestinal disease. We demonstrate that neurobiological stress research continues to be a driving force for scientific progress in gastroenterology and related clinical areas, inspiring translational research from animal models to clinical applications, while highlighting some areas that remain incompletely understood, such as the roles of sex/gender and gut microbiota in health and disease. Future directions of research should include not only the genetics of the stress response and resilience but also epigenetic contributions.

Exploring the Biopsychosocial Model in Irritable Bowel Syndrome : with emphasis on stress, comorbidities and fatigue

“…Both perceived stress and HPA axis activity is associated with IBS in this thesis as well as in previous literature (37,53,61). The most interesting finding in paper I of this thesis was low HCC in a considerable portion of IBS patients despite significantly higher perceived stress in the IBS group compared to other PHC patients.…”

“…Exposure to stress is an important factor in the biopsychosocial concept in general, and in IBS in particular (36,37). The biological underpinnings of the hypothalamic-, pituitary-, adrenal-(HPA) axis and the sympathetic part of the autonomic nervous system (ANS), involved in the stress reaction, are thought to play important roles in the pathophysiology of IBS (36,38,39).…”

The Role of Chronic Stress in Normal Visceroception: Insights From an Experimental Visceral Pain Study in Healthy Volunteers

“…We observed significantly elevated state anxiety and cortisol concentrations in our cohort of individuals with higher perceived chronic stress across experimental time points. Hence, higher perceived chronic stress was clearly associated with differences in "state" measures, which reportedly modulate visceral pain processing (43), but also with psychological traits, such as increased trait anxiety, maladaptive pain coping, and lower self-efficacy. While our explorative covariance and regression analyses widely supported the observed effects to be distinctly attributable to chronic stress, our study design and the present results do not allow conclusive answers.…”

Behavioural and neural responses to aversive visceral stimuli in women with primary dysmenorrhoea

“…In addition to pain‐specific behavioural and neural measures, we also repeatedly assessed cognitive aspects relevant to pain perception, given accumulating knowledge about expectations as fundamental mechanisms underlying placebo and nocebo effects in the context of visceral pain (Elsenbruch & Enck, ; Elsenbruch & Labrenz, ). Finally, given the broad role of stress‐related factors in visceral pain modulation (for a recent review, see Elsenbruch & Enck, ) and knowledge regarding stress and particularly of the hypothalamic‐pituitary‐adrenal (HPA) axis in CPP and endometriosis (for review, see Brawn, Morotti, Zondervan, Becker, & Vincent, ), we analysed stress‐related measures based on ratings and blood samples, that is state anxiety, perceived arousal, cortisol and prolactin.…”