The distribution of the common acupoints of acupuncture-moxibustion for gastrointestinal diseases conforms to the rule of the segmental homology of somatic afferent nerve-visceral nerve circuit at the spinal cord level. Acupuncture-moxibustion regulates the gastrointestinal function through the nerve-endocrine-immune system, and especially depending on the integrity of the structure and function of nervous system. The somatic afferent nerve-visceral nerve circuit plays an important role in the process of acupuncture and moxibustion for regulating the gastrointestinal function. There are three dimensions. ① The somatic afferent nerve-visceral nerve circuit at the peripheral level, including the somatic afferent nerve-visceral afferent nerve circuit centered on the dorsal root ganglion, and the somatic afferent nerve-visceral efferent nerve circuit centered on the sympathetic ganglia; ② that at the spinal cord level; ③ that at the supra-spinal cord level, focusing on the various reflex circuits with the solitary nucleus involved. The somatic afferent nerve-visceral nerve circuit at the spinal level and inferior to it determines the segmental regulation of acupuncture-moxibustion in the gastrointestinal system, while that at the level superior to the spinal cord determines the supersegmental action of acupuncture-moxibustion in regulating the gastrointestinal system. The neurophysiological mechanism of acupuncture-moxibustion is multi-circuits and multi-targets in regulating gastrointestinal function.
Humans ; Moxibustion ; Acupuncture Therapy ; Acupuncture Points ; Gastrointestinal Tract/physiology* ; Animals ; Neurons, Afferent/physiology* ; Afferent Pathways/physiology*

Brain science is the frontier of modern science, and new advances have been made in brain-like designs and brain-computer interfaces to simulate or develop brain functions. However, given that the brain is hermetically sealed within the skull, exploration and deciphering of the brain structure and functions are limited. Growing evidence suggests that the gut is not just a digestive organ. It not only provides essential nutrients and electrolytes for brain neurodevelopment and the maintenance of brain function, but it also transmits external environmental and intestinal wall signals from the intestinal lumen to the central nervous system through multiple pathways to regulate brain activity, function, and structure. A variety of gut-brain interaction pathways have been identified, including neural pathways, neuroimmune signaling, endocrine pathways, and biochemical messengers produced by gut microbes. Gut microbes interact with food and the gut to modulate gut-brain communication. The gut's important role and potential in neurodevelopment, maintenance of normal function, and disease development make it an increasingly important area of research in brain science and neuropsychiatric disorders. The gut's unique role in brain functions and its accessibility for research (compared to direct brain studies) establish it as a critical gate to understanding the mysteries of brain science. Crucially, intestinal nutrients and microbes provide two unique keys to unlock this gate-enabling neural regulation and novel treatments for neuropsychiatric diseases.
Humans ; Brain/physiology* ; Animals ; Gastrointestinal Microbiome/physiology* ; Gastrointestinal Tract/microbiology*

Patients with depression are more likely to have chronic gastrointestinal (GI) symptoms than the general population, but such symptoms are considered only somatic symptoms of depression and lack special attention. There is a chronic lack of appropriate diagnosis and effective treatment for patients with depression accompanied by GI symptoms, and studying the association between depression and GI disorders (GIDs) is extremely important for clinical management. There is growing evidence that depression is closely related to the microbiota present in the GI tract, and the microbiota-gut-brain axis (MGBA) is creating a new perspective on the association between depression and GIDs. Identifying and treating GIDs would provide a key opportunity to prevent episodes of depression and may also improve the outcome of refractory depression. Current studies on depression and the microbially related gut-brain axis (GBA) lack a focus on GI function. In this review, we combine preclinical and clinical evidence to summarize the roles of the microbially regulated GBA in emotions and GI function, and summarize potential therapeutic strategies to provide a reference for the study of the pathomechanism and treatment of depression in combination with GI symptoms.
Humans ; Gastrointestinal Microbiome/physiology* ; Depression/microbiology* ; Gastrointestinal Diseases/physiopathology* ; Brain ; Animals ; Brain-Gut Axis ; Gastrointestinal Tract/microbiology*

Gut microbiota have been validated to play a pivotal role in metabolic regulation. As the most effective treatment for obesity and related comorbidities, bariatric surgery has been shown to result in significant alterations to the gut microbiota. Literature have recently suggested temporal and spatial features of alterations to the intestinal bacteria following bariatric surgery, which is possibly attributed to the gut adaptation to the surgical modification on the gastrointestinal tract. More importantly, the gut microbiota have been appreciated as a critical contributor to the metabolic improvements following bariatric surgery. Although not fully elucidated, the underlying mechanisms are associated with the molecular pathways mediating the crosstalk between gut microbiota and host . On the other hand, change of the gut microbiota has been found to be related to the prognosis of patients receiving bariatric surgery. Some studies even point out negative effects of the gut microbiota on certain surgical complications . In this review, we summarize the characteristics of alterations to the gut microbiota following bariatric surgery as well as its relevant impacts to better understand the role of gut microbiota in bariatric surgery.
Bariatric Surgery ; Gastrointestinal Microbiome/physiology* ; Gastrointestinal Tract ; Humans ; Obesity/surgery* ; Treatment Outcome

OBJECTIVETo systematically review the updated information about the gut microbiota-brain axis.

DATA SOURCESAll articles about gut microbiota-brain axis published up to July 18, 2016, were identified through a literature search on PubMed, ScienceDirect, and Web of Science, with the keywords of "gut microbiota", "gut-brain axis", and "neuroscience".

STUDY SELECTIONAll relevant articles on gut microbiota and gut-brain axis were included and carefully reviewed, with no limitation of study design.

RESULTSIt is well-recognized that gut microbiota affects the brain's physiological, behavioral, and cognitive functions although its precise mechanism has not yet been fully understood. Gut microbiota-brain axis may include gut microbiota and their metabolic products, enteric nervous system, sympathetic and parasympathetic branches within the autonomic nervous system, neural-immune system, neuroendocrine system, and central nervous system. Moreover, there may be five communication routes between gut microbiota and brain, including the gut-brain's neural network, neuroendocrine-hypothalamic-pituitary-adrenal axis, gut immune system, some neurotransmitters and neural regulators synthesized by gut bacteria, and barrier paths including intestinal mucosal barrier and blood-brain barrier. The microbiome is used to define the composition and functional characteristics of gut microbiota, and metagenomics is an appropriate technique to characterize gut microbiota.

CONCLUSIONSGut microbiota-brain axis refers to a bidirectional information network between the gut microbiota and the brain, which may provide a new way to protect the brain in the near future.

Animals ; Brain ; metabolism ; physiology ; Central Nervous System ; metabolism ; physiology ; Gastrointestinal Microbiome ; physiology ; Gastrointestinal Tract ; microbiology ; Humans ; Hypothalamo-Hypophyseal System ; metabolism ; physiology ; Pituitary-Adrenal System ; metabolism ; physiology

Gastrointestinal Microbiome ; physiology ; Gastrointestinal Tract ; microbiology ; Humans ; Intestinal Diseases ; microbiology

OBJECTIVETo compare the effects of electroacupuncture (EA) and moxibustion therapies on patients with diarrhea-predominant irritable bowel syndrome (D-IBS).

METHODSA total of 60 D-IBS patients were randomly allocated to the EA group (30 cases) and moxibustion group (30 cases). Before and after treatment, the gastrointestinal symptoms and psychological symptoms were scored by Visual Analogue Scale, Bristol Stool Form Scale, Hamilton Anxiety Rating Scale (HAMA), and Hamilton Depression Rating Scale (HAMD); the expressions of 5-hydroxytryptamine (5-HT), 5-HT3 receptor (5-HT3R), and 5-HT4 receptor (5-HT4R) in the sigmoid mucosal tissue were measured by immunohistochemical staining. Additionally, the effects on the functional brain areas of the anterior cingulate cortex (ACC), insular cortex (IC) and prefrontal cortex (PFC) were observed by functional magnetic resonance imaging.

RESULTSCompared with before treatment, both EA and moxibustion groups reported significant improvements in abdominal pain and abdominal bloating after treatment (P<0.01 or P<0.05). The moxibustion group reported greater improvements in defecation emergency, defecation frequency, and stool feature than the EA group (P<0.01). Both HAMA and HAMD scores were significantly decreased in the moxibustion group than in the EA group (P<0.01). Both groups demonstrated significantly reduced expressions of 5-HT, 5-HT3R and 5-HT4R in the colonic mucosa after treatment (P<0.01), with a greater reduction of 5-HT in the moxibustion group (P<0.05). Finally, decreased activated voxel values were observed in the left IC, right IC and PFC brain regions of patients in the moxibustion group under stimulation with 150 mL colorectal distension after treatment (P<0.05 or P<0.01), while in the EA group only PFC area demonstrated a reduction (P<0.05).

CONCLUSIONMoxibustion can significantly improve the symptoms of D-IBS, suggesting that moxibustion may be a more effective therapy than EA for D-IBS patients.

Adult ; Anxiety ; Brain ; physiology ; Cerebral Cortex ; physiopathology ; Colon, Sigmoid ; chemistry ; Depression ; Diarrhea ; physiopathology ; Electroacupuncture ; Gastrointestinal Tract ; physiology ; Gyrus Cinguli ; physiopathology ; Humans ; Immunohistochemistry ; Intestinal Mucosa ; chemistry ; Irritable Bowel Syndrome ; physiopathology ; psychology ; therapy ; Magnetic Resonance Imaging ; Moxibustion ; Pain Measurement ; Prefrontal Cortex ; physiopathology ; Receptors, Serotonin, 5-HT3 ; analysis ; Serotonin ; analysis

Overweight or obesity has become a serious public health problem in the world, scientists are concentrating their efforts on exploring novel ways to treat obesity. Nowadays, the availabilities of bariatric surgery and pharmacotherapy have enhanced obesity treatment, but it should has support from diet, physical exercise and lifestyle modification, especially the functional food. Resistant starch, an indigestible starch, has been studied for years for its beneficial effects on regulating blood glucose level and lipid metabolism. The aim of this review is to summarize the effect of resistant starch on weight loss and the possible mechanisms. According to numerous previous studies it could be concluded that resistant starch can reduce fat accumulation, enhance insulin sensitivity, regulate blood glucose level and lipid metabolism. Recent investigations have focused on the possible associations between resistant starch and incretins as well as gut microbiota. Resistant starch seems to be a promising dietary fiber for the prevention or treatment of obesity and its related diseases.
Dietary Carbohydrates ; metabolism ; Dietary Fiber ; metabolism ; therapeutic use ; Gastrointestinal Tract ; microbiology ; physiology ; Microbiota ; Obesity ; diet therapy ; prevention & control ; Starch ; metabolism ; Weight Loss

Assessment of transit through the gastrointestinal tract provides useful information regarding gut physiology and pathophysiology. Although several methods are available, each has distinct advantages and limitations. Recently, an ingestible wireless motility capsule (WMC), similar to capsule video endoscopy, has become available that offers a less-invasive, standardized, radiation-free and office-based test. The capsule has 3 sensors for measurement of pH, pressure and temperature, and collectively the information provided by these sensors is used to measure gastric emptying time, small bowel transit time, colonic transit time and whole gut transit time. Current approved indications for the test include the evaluation of gastric emptying in gastroparesis, colonic transit in constipation and evaluation of generalised dysmotility. Rare capsule retention and malfunction are known limitations and some patients may experience difficulty with swallowing the capsule. The use of WMC has been validated for the assessment of gastrointestinal transit. The normal range for transit time includes the following: gastric emptying (2-5 hours), small bowel transit (2-6 hours), colonic transit (10-59 hours) and whole gut transit (10-73 hours). Besides avoiding the use of multiple endoscopic, radiologic and functional gastrointestinal tests, WMC can provide new diagnoses, leads to a change in management decision and help to direct further focused work-ups in patients with suspected disordered motility. In conclusion, WMC represents a significant advance in the assessment of segmental and whole gut transit and motility, and could prove to be an indispensable diagnostic tool for gastrointestinal physicians worldwide.
Colon ; Constipation ; Deglutition ; Diagnosis ; Endoscopy ; Gastric Emptying ; Gastrointestinal Motility ; Gastrointestinal Tract ; Gastrointestinal Transit ; Gastroparesis ; Humans ; Hydrogen-Ion Concentration ; Physiology ; Reference Values

OBJECTIVETo investigate the effect of electrical stimulation to sacral spinal nerve 3 (S₃ stimulation) on gastrointestinal dysfunction after spinal cord injury (SCI).

METHODSSix rabbits were taken as normal controls to record their gastrointestinal multipoint biological discharge, colon pressure and rectoanal inhibitory reflex. Electrodes were implanted into S₃ in another 18 rabbits. Then the model of SCI was conducted following Fehling's method: the rabbit S₃ was clamped to induce transverse injury, which was claimed by both somatosensory evoked potential and motion evoked potential. Two hours after SCI, S₃ stimulation was conducted. The 18 rabbits were subdivided into 3 groups to respectively record their gastrointestinal electric activities (n=6), colon pressure (n=6), and rectum pressure (n=6). Firstly the wave frequency was fixed at 15 Hz and pulse width at 400 μs and three stimulus intensities (6 V, 8 V, 10 V) were tested. Then the voltage was fixed at 6 V and the pulse width changed from 200 μs, 400 μs to 600 μs. The response was recorded and analyzed. The condition of defecation was also investigated.

RESULTSAfter SCI, the mainly demonstrated change was dyskinesia of the single haustrum and distal colon. The rectoanal inhibitory reflex almost disappeared. S₃ stimulation partly recovered the intestinal movement after denervation, promoting defecation. The proper stimulus parameters were 15 Hz, 400 μs, 6 V, 10 s with 20 s intervals and 10 min with 10 min intervals, total 2 h.

CONCLUSIONS₃ stimulation is able to restore the intestinal movement after denervation (especially single haustrum and distal colon), which promotes defecation.

Animals ; Disease Models, Animal ; Electric Stimulation ; Electrodes, Implanted ; Evoked Potentials, Motor ; physiology ; Evoked Potentials, Somatosensory ; physiology ; Gastrointestinal Tract ; physiopathology ; Rabbits ; Sacrum ; innervation ; Spinal Cord Injuries ; physiopathology