Pathophysiological and Therapeutic Association between Brain-Gut Axis and Irritable Bowel Syndrome: A Systematic Review
DOI:
https://doi.org/10.12669/pjms.42.7.14944Keywords:
Brain-gut axis, Dysbiosis, Enteric nervous system, FODMAP diet, Irritable bowel syndrome, Microbiota, PsychotherapyAbstract
Objective: To identify the association among the gut, brain, and related microbiota, to reach the best-suited personalized management plan for Irritable Bowel Syndrome (IBS).
Methodology: A systematic review was conducted by reviewing studies across multiple Databases, i.e., Scopus, MEDLINE, PubMed, Web of Science, ScienceDirect (Elsevier), Cochrane Library, Embase, and Google Scholar. The timeframe of selected publications was from 2007 to 2025. The results were extracted from 49 selected manuscripts using PRISMA guidelines. The review discussed the pertinent link between the brain-gut axis and IBS, in relation to etiology, clinical features, and underlying pathophysiological mechanisms, and an optimal management plan that aligns with the new concept of personalized health care, alongside evidence-based medicine.
Results: IBS is a multidimensional ailment concerning gut hypersensitivity, hyper-immunity, imbalanced gut flora, and excessive anxiety or derailed psychology, each presented with a particular feature and associated with related etiology. Conventional therapeutic management benefits from reducing fermentation through a suitable diet plan, antibiotics to regulate gut flora, and neuroregulators that augment signaling pathways between visceral (gut-related) and central (brain) nervous systems. Stress-reducing interventions helped to decline the nociception and symptomatic-anxiety bursts. Upcoming advanced techniques such as Fecal microbiota transplantation (FMT), psychedelic-assisted therapy, traditional Chinese medicine, and the use of neuromodulator devices express possibilities to cure.
Conclusion: IBS is a multisystem pathology triggered by gut dysbiosis, hyper-immune responses, visceral hypersensitivity, and stress-axis dysregulation. Thus, it is evident that a multimodal personalized management approach, including dietary, microbiome-targeted, pharmacological, and psychological therapies, is recommended for IBS, based on symptomology and etiology.
