Document Type

Journal Article

Department/Unit

School of Chinese Medicine

Language

English

Abstract

Psychological stress is an important factor for the development of irritable bowel syndrome (IBS). More and more clinical and experimental evidence showed that IBS is a combination of irritable bowel and irritable brain. In the present review we discuss the potential role of psychological stress in the pathogenesis of IBS and provide comprehensive approaches in clinical treatment. Evidence from clinical and experimental studies showed that psychological stresses have marked impact on intestinal sensitivity, motility, secretion and permeability, and the underlying mechanism has a close correlation with mucosal immune activation, alterations in central nervous system, peripheral neurons and gastrointestinal microbiota. Stress-induced alterations in neuro-endocrine-immune pathways acts on the gut-brain axis and microbiota-gut-brain axis, and cause symptom flare-ups or exaggeration in IBS. IBS is a stresssensitive disorder, therefore, the treatment of IBS should focus on managing stress and stress-induced responses. Now, non-pharmacological approaches and pharmacological strategies that target on stress-related alterations, such as antidepressants, antipsychotics, miscellaneous agents, 5-HT synthesis inhibitors, selective 5-HT reuptake inhibitors, and specific 5-HT receptor antagonists or agonists have shown a critical role in IBS management. A integrative approach for IBS management is a necessary.

Keywords

Immune activation, Irritable bowel syndrome, Microbiota-gut-brain axis, Psychological stress

Publication Date

10-2014

Source Publication Title

World Journal of Gastroenterology

Volume

20

Issue

39

Start Page

14126

End Page

14131

Publisher

Baishideng Publishing Group Co. Limited

Peer Reviewed

1

Copyright

This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial.

DOI

10.3748/wjg.v20.i39.14126

Link to Publisher's Edition

http://dx.doi.org/10.3748/wjg.v20.i39.14126

ISSN (print)

10079327

ISSN (electronic)

22192840

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