Traumatic Brain Injury and the Gastrointestinal Tract: The Role of Female Sexual Hormones

Abstract

Traumatic brain injury (TBI) is an important public health problem which can lead to several complications like gastrointestinal dysfunction. Patients with TBI often suffer from gastrointestinal dysfunctions such as enteral feeding intolerance. Gastric ulceration is induced by various forms of stress like surgery, ischemia and trauma. TBI causes a delayed but significant decrease in intestinal contractile activity in the ileum leading to delayed transport. The association between severity of brain injury and enteral feeding intolerance suggests a strong link between the central nervous system and the non-functional gut. The results of recent basic and clinical studies revealed the beneficial effects of estrogen and progesterone hormones in the treatment of gastrointestinal dysfunction. Females have more resistance to stress and fewer gastrointestinal lesions occur in females as compared to males. Sex steroid hormones have sparked interest as possible neuroprotective agents after traumatic injury and many studies have been done on this subject. This article reviews the literature related to some possible physiological effects of female sexual hormones on the gastrointestinal tract following TBI.