The broad role of stress in the brain-gut axis is widely acknowledged, with implications for multiple prevalent health conditions that are characterized by chronic gastrointestinal symptoms. These include the functional gastrointestinal disorders (FGID), such as irritable bowel syndrome and functional dyspepsia, as well as inflammatory bowel diseases (IBD) like ulcerative colitis and Crohn's disease. Although the afferent and efferent pathways linking the gut and the brain are modulated by stress, the fields of neurogastroenterology and psychoneuroendocrinology (PNE)/ psychoneuroimmunology (PNI) remain only loosely connected. We aim to contribute to bringing these fields closer together by drawing attention to a fascinating, evolving research area, targeting an audience with a strong interest in the role of stress in health and disease. To this end, this review introduces the concept of the brain-gut axis and its major pathways, and provides a brief introduction to epidemiological and clinical aspects of FGIDs and IBD. From an interdisciplinary PNE/PNI perspective, we then detail current knowledge regarding the role of chronic and acute stress in the pathophysiology of FGID and IBD. We provide an overview of evidence regarding non-pharmacological treatment approaches that target central or peripheral stress mechanisms, and conclude with future directions, particularly those arising from recent advances in the neurosciences and discoveries surrounding the gut microbiota.

中文翻译：

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功能性和慢性炎症性胃肠疾病中的压力和脑肠轴：跨学科挑战

压力在脑 - 肠轴中的广泛作用已得到广泛承认，对以慢性胃肠道症状为特征的多种普遍健康状况有影响。这些包括功能性胃肠道疾病 (FGID)，如肠易激综合征和功能性消化不良，以及炎症性肠病 (IBD)，如溃疡性结肠炎和克罗恩病。尽管连接肠道和大脑的传入和传出通路受到压力的调节，但神经胃肠病学和心理神经内分泌学 (PNE)/心理神经免疫学 (PNI) 领域的联系仍然松散。我们的目标是通过吸引人们对一个迷人的、不断发展的研究领域的关注，将这些领域拉近，目标是对压力在健康和疾病中的作用有浓厚兴趣的受众。为此，本综述介绍了脑肠轴的概念及其主要途径，并简要介绍了 FGID 和 IBD 的流行病学和临床方面。从跨学科 PNE/PNI 的角度，我们详细介绍了当前关于慢性和急性压力在 FGID 和 IBD 病理生理学中的作用的知识。我们概述了针对中枢或外周压力机制的非药物治疗方法的证据，并总结了未来的方向，特别是神经科学的最新进展和围绕肠道微生物群的发现。从跨学科 PNE/PNI 的角度，我们详细介绍了当前关于慢性和急性压力在 FGID 和 IBD 病理生理学中的作用的知识。我们概述了针对中枢或外周压力机制的非药物治疗方法的证据，并总结了未来的方向，特别是神经科学的最新进展和围绕肠道微生物群的发现。从跨学科 PNE/PNI 的角度，我们详细介绍了当前关于慢性和急性压力在 FGID 和 IBD 病理生理学中的作用的知识。我们概述了针对中枢或外周压力机制的非药物治疗方法的证据，并总结了未来的方向，特别是神经科学的最新进展和围绕肠道微生物群的发现。