Chapter 14
The Brain–Gut Axis
Adam D. Farmer,
Qasim Aziz,
Adam D. Farmer
Barts and the London School of Medicine & Dentistry, Queen Mary University of London, London, UK
Search for more papers by this authorQasim Aziz
Barts and the London School of Medicine & Dentistry, Queen Mary University of London, London, UK
Search for more papers by this authorAdam D. Farmer,
Qasim Aziz,
Adam D. Farmer
Barts and the London School of Medicine & Dentistry, Queen Mary University of London, London, UK
Search for more papers by this authorQasim Aziz
Barts and the London School of Medicine & Dentistry, Queen Mary University of London, London, UK
Search for more papers by this authorBook Editor(s):Daniel K. Podolsky MD,
Michael Camilleri MD,
J. Gregory Fitz MD FAASLD,
Anthony N. Kalloo MD,
Fergus Shanahan MD,
Timothy C. Wang MD,
Daniel K. Podolsky MD
President, University of Texas Southwestern Medical Center, Professor of Internal Medicine, Department of Internal Medicine, University of Texas Southwestern Medical School, Dallas, TX, USA
Search for more papers by this authorMichael Camilleri MD
Executive Dean for Development, Atherton and Winifred W. Bean Professor, Professor of Medicine, Physiology and Pharmacology, Distinguished Investigator, Mayo Clinic, Rochester, MN, USA
Search for more papers by this authorJ. Gregory Fitz MD FAASLD
Executive Vice President for Academic Aff airs and Provost, University of Texas Southwestern Medical Center, Dean, Professor of Internal Medicine, Department of Internal Medicine, University of Texas Southwestern Medical School, Dallas, TX, USA
Search for more papers by this authorAnthony N. Kalloo MD
Professor of Medicine, Johns Hopkins University School of Medicine, Director, Division of Gastroenterology & Hepatology, Johns Hopkins Hospital, Baltimore, MD, USA
Search for more papers by this authorFergus Shanahan MD
Professor and Chair, Department of Medicine, Director, Alimentary Pharmabiotic Centre, University College Cork, National University of Ireland, Cork, Ireland
Search for more papers by this authorTimothy C. Wang MD
Chief, Division of Digestive and Liver Diseases, Silberberg Professor of Medicine, Department of Medicine and Irving Cancer Research Center, Columbia University Medical Center, New York, NY, USA
Search for more papers by this authorSummary
Common personal experience readily informs us that emotions can influence gastrointestinal function. Over the last 200 years, this interaction has been interrogated with increasingly sophisticated techniques across a diverse range of scientific and clinical disciplines. Bottom-up processing from gut-to-brain and top-down autonomic, immune and neuroendocrine mechanisms in brain-to-gut signaling constitutes a bi-directional circuit of communication, known as the brain gut axis. The brain gut axis itself comprises a diverse array of component parts as well as those that influence its function. This chapter provides a review of functional anatomy and physiology of the brain gut axis and examine both the bottom-up and top-down interactions, encompassing the role of the GI microbiome, autonomic nervous system and the hypothalamic pituitary adrenal axis. Knowledge emanating from these interactions has informed understanding of appetite/satiety regulation and how alterations can lead to clinical syndromes.
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