Riggott, C., Ford, A.C. orcid.org/0000-0001-6371-4359 and Gracie, D.J. (2024) Review article: The role of the gut–brain axis in inflammatory bowel disease and its therapeutic implications. Alimentary Pharmacology and Therapeutics, 60 (9). pp. 1200-1214. ISSN 0269-2813
Abstract
Background Treatments targeting the gut–brain axis (GBA) are effective at reducing symptom burden in irritable bowel syndrome (IBS). The prevalence of common mental disorders and IBS-type symptom reporting is significantly higher in inflammatory bowel disease (IBD) than would be expected, suggesting potential GBA effects in this setting. Manipulation of the GBA may offer novel treatment strategies in selected patients with IBD. We present a narrative review of the bi-directional effects of the GBA in IBD and explore the potential for GBA-targeted therapies in this setting.
Methods We searched MEDLINE, EMBASE, EMBASE Classic, PsychINFO, and the Cochrane Central Register of Controlled Trials for relevant articles published by March 2024.
Results The bi-directional relationship between psychological well-being and adverse longitudinal disease activity outcomes, and the high prevalence of IBS-type symptom reporting highlight the presence of GBA-mediated effects in IBD. Treatments targeting gut–brain interactions including brain–gut behavioural treatments, neuromodulators, and dietary interventions appear to be useful adjunctive treatments in a subset of patients.
Conclusions Psychological morbidity is prevalent in patients with IBD. The relationship between longitudinal disease activity outcomes, IBS-type symptom reporting, and poor psychological health is mediated via the GBA. Proactive management of psychological health should be integrated into routine care. Further clinical trials of GBA-targeted therapies, conducted in selected groups of patients with co-existent common mental disorders, or those who report IBS-type symptoms, are required to inform effective integrated models of care in the future.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2024 John Wiley & Sons Ltd. This is the peer reviewed version of the following article: Riggott C, Ford AC, Gracie DJ. Review article: The role of the gut–brain axis in inflammatory bowel disease and its therapeutic implications. Aliment Pharmacol Ther. 2024; 60: 1200–1214., which has been published in final form at https://doi.org/10.1111/apt.18192. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. This article may not be enhanced, enriched or otherwise transformed into a derivative work, without express permission from Wiley or by statutory rights under applicable legislation. Copyright notices must not be removed, obscured or modified. The article must be linked to Wiley’s version of record on Wiley Online Library and any embedding, framing or otherwise making available the article or pages thereof by third parties from platforms, services and websites other than Wiley Online Library must be prohibited. |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Leeds Institute of Medical Research (LIMR) > Division of Gastroenterology and Surgery |
Depositing User: | Symplectic Publications |
Date Deposited: | 29 Nov 2024 12:29 |
Last Modified: | 29 Nov 2024 12:29 |
Status: | Published |
Publisher: | Wiley |
Identification Number: | 10.1111/apt.18192 |
Related URLs: | |
Sustainable Development Goals: | |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:220206 |
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