Document Detail


The brain-gut axis in abdominal pain syndromes.
MedLine Citation:
PMID:  21090962     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The importance of bidirectional brain-gut interactions in gastrointestinal (GI) illness is increasingly recognized, most prominently in the area of functional GI syndromes such as irritable bowel syndrome (IBS), functional dyspepsia, and functional chest pain. The brain receives a constant stream of interoceptive input from the GI tract, integrates this information with other interoceptive information from the body and with contextual information from the environment, and sends an integrated response back to various target cells within the GI tract. This system is optimized to assure homeostasis of the GI tract during physiological perturbations and to adapt GI function to the overall state of the organism. In health, the great majority of interoceptive information reaching the brain is not consciously perceived but serves primarily as input to autonomic reflex pathways. In patients with functional abdominal pain syndromes, conscious perception of interoceptive information from the GI tract, or recall of interoceptive memories of such input, can occur in the form of constant or recurrent discomfort or pain. This is often associated with alterations in autonomic nervous system output and with emotional changes. A model is proposed that incorporates reported peripheral and central abnormalities in patients with IBS, extrapolates similar alterations in brain-gut interactions to patients with other chronic abdominal pain syndromes, and provides novel treatment targets.
Authors:
Emeran A Mayer; Kirsten Tillisch
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Annual review of medicine     Volume:  62     ISSN:  1545-326X     ISO Abbreviation:  Annu. Rev. Med.     Publication Date:  2011  
Date Detail:
Created Date:  2011-01-13     Completed Date:  2011-05-17     Revised Date:  2012-02-22    
Medline Journal Info:
Nlm Unique ID:  2985151R     Medline TA:  Annu Rev Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  381-96     Citation Subset:  IM    
Affiliation:
Center for Neurobiology of Stress, Division of Digestive Diseases, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, California, USA. emayer@ucla.edu
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MeSH Terms
Descriptor/Qualifier:
Abdominal Pain / drug therapy,  physiopathology*
Brain / drug effects,  physiopathology*
Chronic Disease
Female
Gastrointestinal Diseases / drug therapy,  microbiology,  physiopathology*
Gastrointestinal Motility / drug effects
Homeostasis / drug effects
Humans
Male
Mast Cells / drug effects
Neuroimmunomodulation / drug effects
Spinal Cord / drug effects,  physiopathology
Syndrome
Grant Support
ID/Acronym/Agency:
R01 DK048351-13/DK/NIDDK NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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