Gut–Brain Axis and Gut–Mind Interaction: Clinical, Psychosomatic, and Public Health Perspectives from Pakistan

Abstract

The gut-brain axis is a two-way transmission system between the gastrointestinal tract and the central nervous system via neural, hormonal, immunological and microbial pathways. Accumulating evidence is showing that gastrointestinal physiology has a strong impact on mood, thinking, and behaviour while psychological stress can have a strong impact on gut motility, secretion, permeability, immune activation and microbiota composition. Functional gastrointestinal disorders, in particular, irritable bowel syndrome, and functional dyspepsia are the best established clinical models for this interaction. Data from Pakistan, but not abundant, seem to persistently show a high prevalence of functional gut pathology with significant psychiatric co-morbidity (particularly anxiety and depression). Emerging local evidence has also mostly suggested associations between gut health and cognitive performance. This brief review in the discussion highlights role of biological mechanisms, clinical presentation, regional epidemiology and public health implications of gut - mind interactions with special reference to Pakistan.