Clinical Gastroenterology Vol.30 No.2(4-2)

Theme Unraveling of the Pathophysiology of Functional Gastrointestinal Disorders and Updated Treatments
Title Functional Gastrointestinal Disorders and Brain—gut Interactions : Neuroendocrine Mechanisms
Publish Date 2015/02
Author Koji Yakabi Department of Gastroenterology and Hepatology, Saitama Medical Center, Saitama Medical University
[ Summary ] Functional gastrointestinal disorders (FGID) are syndromes which present various unpleasant symptoms in the abdomen without displaying any organic disorders. In the pathogenesis for FGID, brain‒gut interactions or the brain‒gut axis seem to be vital as potential mechanisms which induce symptoms in the abdomen. Physical or psychological stress in the brain are assumed to be transmitted to the gut through brain‒gut interactions, resulting in induction of unpleasant symptoms in the abdomen. We recently elucidated that the stress‒related peptide urocortin 1 (UCN1) induces anorexia and delayed gastric emptying through suppression of ghrelin production and secretion. We also elucidated that the effects of UCN1 are thought to be dependent on activation of sympathetic nerves which act on adrenergic α2 receptors. The results may indicate an important mechanism for functional dyspepsia. Another mechanism for the pathogenesis of FD as observed in previous studies is examined. Low vagal activity may be one possible route for the pathogenesis of FD. Further studies are required to verify these theories.
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