Brain-gut connections in functional GI disorders: anatomic and physiologic relationships

Area of Science:

• Neuroscience
• Gastroenterology
• Psychology

Background:

• The gut and brain communicate bidirectionally via the autonomic nervous system (ANS) and hypothalamic-pituitary-adrenal (HPA) axis.
• The limbic system in the central nervous system (CNS) is key to gut control, emotionality, and homeostasis.
• Mind-body interactions and emotional influences on gut sensations are largely mediated by the limbic system.

Purpose of the Study:

• To elucidate the neural regulation of gut function and sensation.
• To explore the link between emotionality, hypervigilance, gut function, and pain.
• To improve understanding of functional gastrointestinal disorders (FGID) by defining pathophysiologic patient categories.

Main Methods:

• Review of neuroanatomic and neurophysiological pathways.
• Analysis of the role of the limbic system in visceral control and pain perception.
• Integration of CNS, enteric nervous system (ENS), and enteric immune system interactions.

Main Results:

• The limbic system is central to the neural regulation of gut function, emotionality, and visceral pain.
• Bidirectional communication between the gut and brain influences emotional states and symptom perception.
• Understanding these neural circuits is crucial for defining FGID.

Conclusions:

• Neural regulation of the gut, particularly by the limbic system, is integral to emotionality and pain perception.
• A deeper understanding of CNS-ENS-immune interactions can refine FGID classification.
• Targeting neural pathways may offer new therapeutic strategies for functional gut disorders.