IBD: We may finally know why psychological stress worsens gut inflammation

Researchers have identified a pathway between the brain and the immune system in mice that may explain why psychological stress can worsen gut inflammation. Inflammatory bowel disease patients commonly experience symptoms flare-ups when stressed, but the reason for the connection has not been presented until now. Christoph Thaiss at the University of Pennsylvania and his team analysed mice with IBD-like symptoms and found that persistently elevated hormones called glucocorticoids had changes in specialised neural cells called enteric glia, leading to gut inflammation. Genetic analysis also revealed that stress alters neurons in the gut, making them appear less mature. This is detrimental because mature neurons are necessary to drive bowel movement and motility.

The researchers validated these findings in 63 people with IBD by collecting and genetically analysing tissue samples from everyone’s colons. Participants also completed a questionnaire assessing stress which found that people who experienced more stress had more intestinal damage and greater increases in inflammatory markers, similar to those seen in mice. The study has demonstrated the exact connection between the brain and gut that many have long believed existed in gastrointestinal disorders. The study tells clinicians that they have to look at the patient as a whole, not just treat the symptoms in flare-ups, but also other problems that may be stress-related.

The big question now is whether the same pathway might dictate people’s degree of responsiveness to different treatments. If so, it could improve how IBD is treated or lead to new drug targets for the condition. Previous studies have shown that many people with IBD also experience elevated symptoms of anxiety and depression and people with the chronic condition often report that their emotional states can directly influence symptoms. Positive thinking, meditation, and talking therapies may help bring control over thoughts and emotions that can exacerbate physical symptoms. The brain-gut connection could also lead to new treatments and therapies such as “psychobiotics”, which are bacteria that produce anti-inflammatory agents linking to the brain-gut axis. Another possible future treatment that has cultivated attention is fecal microbiota transplant, a technique that’s delivered some promise in treating various health issues by rebalancing the gut microbiome. The mechanism has not yet been fully understood, but recent research has shown that it may be associated with lowering levels of inflammation.



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