Format

Send to:

Choose Destination
See comment in PubMed Commons below
Aust N Z J Psychiatry. 2015 Mar;49(3):207-14. doi: 10.1177/0004867415569801.

Pathways in gut-brain communication: evidence for distinct gut-to-brain and brain-to-gut syndromes.

Author information

  • 1Academic Unit of Psychiatry & Addiction Medicine, Australian National University Medical School, Canberra, Australia.
  • 2Faculty of Health and Medicine, University of Newcastle, Australia.
  • 3Faculty of Health and Medicine, University of Newcastle, Australia Nicholas.Talley@newcastle.edu.au.

Abstract

OBJECTIVE:

The rich interconnectedness between gut and brain is increasingly being identified. This article reviews the evidence for brain-gut and gut-brain syndromes, particularly recent epidemiological evidence, and animal studies demonstrating bi-directionality at the formative stage of development.

METHOD:

Narrative literature review with selection for relevance and quality.

RESULTS:

Population surveys show a strong correlation between anxiety, depression, and functional gastrointestinal disorders, contradicting early suspicions that the high prevalence of anxiety and depression in the clinic was mainly due to neurotic health seeking behaviour. Five and 12 year follow-up shows that psychological distress can predict later onset of a functional gastrointestinal disorder and vice versa. Brain-gut pathways include the autonomic nervous system, hypothalamic-pituitary-adrenal axis including corticotrophin releasing factor directly acting on the gut. Gut-brain pathways include ascending pain pathways, cytokines including tumour necrosis factor alpha in response to bacterial translocation and inflammation, 5-hydroxytryptamine secretion by entero-endocrine cells and psychoactive chemicals of bacterial origin which may enter the blood stream, such as gamma-aminobutyric acid, fatty acids and 5-hydroxytryptamine precursors. The ability to control rodent temperament and HPA responsiveness with early modification of gastrointestinal flora, and the effects of early stress on the barrier function of the gastrointestinal tract and flora, suggests an ability of both systems to prime each other in early life for later problems. This hypothesis seems to be supported by a possible protective effect of a probiotic strain of bacteria in a model of early rat psychological trauma.

CONCLUSION:

Psychological treatments are known to improve functional gastrointestinal disorders, the next wave of research may involve preventative microbiological gut based treatments for primary psychological presentations, both to treat the presenting complaint and inoculate against later functional gastrointestinal disorders.

© The Royal Australian and New Zealand College of Psychiatrists 2015.

KEYWORDS:

Irritable bowel syndrome; attachment; cytokines; epidemiology

PMID:
25710826
[PubMed - indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for HighWire
    Loading ...
    Write to the Help Desk