The autonomic nervous system in functional bowel disorders – Chronic Fatigue Syndrome and fibromyalgia related research

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Communications along the brain-gut axis involve neural
pathways as well as immune and endocrine mechanisms. The two
branches of the autonomic nervous system are integrated
anatomically and functionally with visceral sensory pathways,
and are responsible for the homeostatic regulation of gut
function. The autonomic nervous system is also a major
mediator of the visceral response to central influences such
as psychological stress. As defined, functional disorders
comprise a constellation of symptoms, some of which suggest
the presence of altered perception, while other symptoms point
to disordered gastrointestinal function as the cause of the
symptoms. A growing number of reports have demonstrated
disordered autonomic function in subgroups of functional bowel
patients.

While a number of different methods were used to
assess autonomic function, the reports point to a generally
decreased vagal (parasympathetic) outflow or increased
sympathetic activity in conditions usually associated with
slow or decreased gastrointestinal motility, while other
studies found either an increased cholinergic activity or a
decreased sympathetic activity in patients with symptoms
compatible with an increased motor activity. Under certain
conditions, altered autonomic balance (including low vagal
tone and increased sympathetic activity) may alter visceral
perception.

Autonomic dysfunction may also represent the
physiological pathway accounting for many of the
extraintestinal symptoms seen in irritable bowel syndrome
patients and some of the frequent gastrointestinal complaints
reported by patients with disorders such as chronic fatigue
and fibromyalgia.

Tougas G

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