Interactions of Little-brain and Big-brain in Explaining Abdominal Symptoms

Abstract

For a long time, the role of an extensive neurological network in the gut (the little-brain) has been under-recognized because the enteric nervous system (ENS) is thought to have little impact beyond digestion. More recently, there has been a paradigm shift in understanding interactions between the gut and brain, i.e., the gut-brain axis, especially in clinical disorders termed functional gastrointestinal disorders (FGIDs). In a global epidemiology study commissioned by the Rome Foundation, among 70,000 adults, at least one FGID wasdiagnosed in 40.3% of internet surveys and 20.7% of household survey. FGIDs are perhaps the second most common consults in gastroenterology practice in Asia (the first being chronic liver disorders largely due to a high burden of viral hepatitis). These disorders include functional dyspepsia (FD) and irritable bowel syndrome (IBS). During the recent fourth iteration of the Rome diagnostic criteria, FGIDs have been relabeled as disorders of gut-brain interactions (DGBIs)

Keywords

• gut-brain axis
• interactions
• abdominal symptoms
• mechanisms