title: The Intestinal Microenvironment and Functional Gastrointestinal Disorders.
abstract: For decades, interactions between the enteric neuromuscular apparatus and the central nervous system have served as the primary focus of pathophysiological research in the functional gastrointestinal disorders. The accumulation of patient reports, as well as clinical observations, has belatedly led to an interest in the role of various luminal factors and their interactions with each other and the host in functional gastrointestinal disorders. Most prominent among these factors has been the role of food. As a consequence, while not always evidence-based, dietary interventions are enjoying a renaissance in irritable bowel syndrome management. Not surprisingly, given its exploration in many disease states, the gut microbiota has also been studied in functional gastrointestinal disorders; data remain inconclusive. Likewise, there is also a considerable body of experimental and some clinical data to link functional gastrointestinal disorders pathogenesis to disturbances in epithelial barrier integrity, abnormal entero-endocrine signaling and immune activation. These data provide growing evidence supporting the existence of micro-organic changes, particularly in subgroups of patients with functional dyspepsia and IBS. However, their exact role in the complex pathophysiology and symptom generation of functional gastrointestinal disorders needs to be further studied and elucidated particularly with longitudinal and interventional studies.
authors.affiliation: Department of Medical and Surgical Sciences, School of Medicine, University of Bologna, Italy. Electronic address: giovanni.barbara@unibo.it.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Barbara
authors.affiliation: University of Adelaide Discipline of Medicine, and National Health and Medical Research Council of Australia Centre of Research Excellence in Translating Nutritional Science to Good Health, University of Adelaide Discipline of Medicine, Adelaide, South Australia.
authors.forename: Christine
authors.initials: C
authors.lastname: Feinle-Bisset
authors.affiliation: Department of Gastroenterology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India.
authors.forename: Uday C
authors.initials: UC
authors.lastname: Ghoshal
authors.affiliation: Lynda K and David M Underwood Center for Digestive Disorders, Division of Gastroenterology and Hepatology, Houston Methodist Hospital and Weill Cornell Medical College, Houston, Texas, USA.
authors.forename: Eamonn M
authors.initials: EM
authors.lastname: Quigley
authors.affiliation: Lab Neuro-immune-gastroenterology, Digestive System Research Unit, Department of Gastroenterology, Institut de Recerca Vall d'Hebron, Hospital Vall d'Hebron, Barcelona, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Santos
authors.affiliation: Gastrointestinal Diseases Research Unit, Queen's University, Kingston, Ontario, Canada.
authors.forename: Steve
authors.initials: S
authors.lastname: Vanner
authors.affiliation: Inserm, U1220, Toulouse, France; Université de Toulouse, UPS, Institut de Recherche en Santé Digestive (IRSD), Toulouse, France.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Vergnolle
authors.affiliation: Laboratory of Microbiology, Department of Agrotechnology and Food Sciences, Wageningen University, the Netherlands.
authors.forename: Erwin G
authors.initials: EG
authors.lastname: Zoetendal
keywords: bile acids; food; functional dyspepsia; immune system; irritable bowel syndrome; microbiota; serotonin