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"Visceral Sensations and Brain-Gut Mechanisms

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"Visceral Sensations and Brain-Gut MechanismsBy: Emeran A. Mayer, M.D., Professor of Medicine, Physiology and Psychiatry; Director, Center for Neurovisceral Sciences & Women's Health, David Geffen School of Medicine at UCLAIntroduction Over the past several years, different mechanisms located within the gut, or gut wall have been implicated as possible pathophysiologic mechanisms underlying the characteristic IBS symptoms of abdominal pain and discomfort. The list ranges from altered transit of intestinal gas, alterations in the colonic flora, immune cell activation in the gut mucosa, and alterations in serotonin containing enterochromaffin cells lining the gut. For those investigators with a good memory, these novel mechanisms can be added to an older list of proposed pathomechanisms, including altered gut motility ("spastic colitis") and alterations in mucus secretion. While the jury on any of these novel mechanisms is still out, one unique aspect about the gut and its connection to the brain are often forgotten: Our brain-gut axis is not designed to generate conscious perceptions of every alteration in gut homeostasis and internal environment, in particular when these changes are chronic, and when there is no adaptive behavioral response an affected organism could generate. "
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