Stephen M. Stahl, M.D., Ph.D.
Issue: The brain and the gut have parallel pharmacologic regulatory systems that are also interlinked. Since irritable bowel syndrome may result from malfunctioning of these pharmacologic systems and their regulatory mechanisms, future treatments could be directed simultaneously at both the brain and the gut.
| Psychiatrist to gastroenterologist: "Isn't it surprising how many brain neurotransmitters are also in the gut?" Gastroenterologist to psychiatrist: "Not at all, but it sure is interesting how many gut neurotransmitters are in the brain." The brain and gut are not only parallel pharmacologic systems, they are also interlinked pharmacologic systems. This link is not surprising given that the enteric nervous system, which innervates the gut, is embryologically derived from the same part of the neural crest that evolves into the brain.1-4Thus, the brain and gut go in separate directions during early development but preserve links that exert mutual and reciprocal regulatory influences on one another. Hence, the enteric nervous system is sometimes called the "little brain."3 |
