Am J Gastroenterol. 2022 Jun 1;117(6):937-946.doi: 10.14309/ajg.0000000000001812. Epub 2022 May 4.

Karen Van den Houte ¹, Premysl Bercik ², Magnus Simren ³, Jan Tack ¹, Stephen Vanner ⁴

Author information

¹Translational Research Center for Gastrointestinal Diseases, University of Leuven, Leuven, Belgium.

²Department of Medicine, Farncombe Digestive Health Research Institute, McMaster University, Hamilton, Ontario, Canada.

³Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.

⁴Gastrointestinal Diseases Research Unit, Queen's University, Kingston General Hospital, Kingston, Ontario, Canada.

Abstract

There has been a dramatic increase in clinical studies examining the relationship between disorders of gut-brain interactions and symptoms evoked by food ingestion in the upper and lower gastrointestinal tract, but study design is challenging to verify valid endpoints. Consequently, mechanistic studies demonstrating biological relevance, biomarkers and novel therapeutic targets are greatly needed. This review highlights emerging mechanisms related to nutrient sensing and tasting, maldigestion, physical effects with underlying visceral hypersensitivity, allergy and immune mechanisms, food-microbiota interactions and gut-brain signaling, with a focus on patients with functional dyspepsia and irritable bowel syndrome. Many patients suffering from disorders of gut-brain interactions exhibit these mechanism(s) but which ones and which specific properties may vary widely from patient to patient. Thus, in addition to identifying these mechanisms and the need for further studies, biomarkers and novel therapeutic targets are identified that could enable enriched patient groups to be studied in future clinical trials examining the role of food in the generation of gut and non-gut symptoms.