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The gut and brain are linked. This link involves neurotransmitters, inflammatory cytokines, the vagus nerve, and the hypothalamic-pituitary-adrenal axis. Visceral hyperalgesia explains FGID symptoms. Gut-brain axis disorder is a new term for these disorders. Antibiotic-induced dysbiosis can lead to post-infectious Irritable Bowel Syndrome (IBS). Cognitive and mood disorders are common in these conditions.
A spectrum of gastrointestinal disorders associated with chronic or fluctuating gastrointestinal symptoms, such as abdominal pain, diarrhea, constipation, bloating and nausea, without harboring an apparent organic structural or biochemical explanation for these symptoms.
With 40% of persons worldwide anticipated to meet the criteria for Functional gastrointestinal disorder (FGIDs) / Disorders of gut-brain interaction (DGBIs), Functional gastrointestinal disorder (FGIDs) / Disorders of gut-brain interaction (DGBIs) are the most frequent cause of gastroenterological consultations; thus, resulting in major economic effects on global health care systems.
Sperber et al. 2020 Gastroenterology 160(1): 99-114
The pathophysiology is complex, but involves bidirectional dysregulation of brain-gut interaction, via the Brain-Gut-Microbiome-Axis / Gut-Brain Axis (MGBA), as well as microbial dysbiosis within the gut , altered mucosal immune function, visceral hypersensitivity, and abnormal gastrointestinal motility
The pathogenesis of Functional gastrointestinal disorder (FGIDs) / Disorders of gut-brain interaction (DGBIs) is not well-defined and these disorders are associated with psychiatric co-morbidities, including panic attack, anxiety disorder, depression, hypochondriac behavior and somatization.
The population prevalence of Rome IV-diagnosed functional gastrointestinal disorders (FGIDs) and their cumulative effect on health impairment is unknown.
Roughly a third of the general adult population fulfils diagnostic criteria for a Rome IV FGID. In a third of this subset multiple GI regions are involved and this overlap is associated with increased health impairment.