Narrative review examines neuromodulators and brain-gut therapies for disorders of gut-brain interaction
This narrative review synthesizes neurophysiological, psychological, pharmacological, and psychotherapeutic literature related to disorders of gut-brain interaction (DGBI), including irritable bowel syndrome and functional dyspepsia. The population examined is individuals with DGBI. The review discusses interventions including neuromodulators (e.g., tricyclic antidepressants) and brain-gut behavior therapies (BGBTs) such as cognitive behavioral therapy and gut-directed hypnotherapy, alongside dietary interventions. No specific comparator was reported for the interventions discussed.
The main findings from the synthesis indicate that neuromodulators demonstrate modest efficacy in treating DGBI, though specific effect sizes, absolute numbers, and statistical measures were not reported. Brain-gut behavior therapies were reported to exhibit comparable efficacy to pharmacologic treatments, with the added findings of sustained symptom relief and additional benefit on mood and illness-related beliefs. The review also notes that neuroimaging and genetic studies support the role of emotional and cognitive circuits in gut sensitivity, and that psychiatric comorbidity, particularly anxiety, is bidirectionally linked to DGBI and influences treatment response.
Safety and tolerability data for the interventions were not reported in this review. Key limitations stem from the nature of the publication; it is a narrative review synthesizing existing literature rather than a primary study reporting specific trial data, effect sizes, or safety outcomes. The practice relevance suggested by the authors is that DGBI represent complex, stress-sensitive conditions best managed through multidisciplinary care, integrating pharmacologic neuromodulation, psychotherapeutic interventions, and dietary strategies targeting the brain-gut axis.
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