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Unmet needs of drugs for irritable bowel syndrome and inflammatory bowel diseases: interest of vagus nerve stimulation and hypnosis

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Abstract

The gut and the brain communicate bidirectionally through the autonomic nervous system. The vagus nerve is a key component of this gut–brain axis, and has numerous properties such as anti-inflammatory, antinociceptive, anti-depressive effects. A perturbation of this gut–brain communication is involved in the pathogeny of functional digestive disorders, such as irritable bowel syndrome, and inflammatory bowel diseases. Stress plays a role in the pathogeny of these diseases, which are biopsychosocial models. There are presently unmet needs of pharmacological treatments of these chronic debilitating diseases. Treatments are not devoid of side effects, cost-effective, do not cure the diseases, can lose effects over time, thus explaining the poor satisfaction of patients, their lack of compliance, and their interest for non-drug therapies. The gut–brain axis can be targeted for therapeutic purposes in irritable bowel syndrome and inflammatory bowel disease through non-drug therapies, such as hypnosis and vagus nerve stimulation, opening up possibilities for responding to patient expectations.

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Abbreviations

ANS:

Autonomic nervous system

CD:

Crohn’s disease

CNS:

Central nervous system

CRF:

Corticotrophin-releasing factor

ELS:

Early-life stress

GDH:

Gut-directed hypnosis

GI:

Gastrointestinal

IBD:

Inflammatory bowel diseases

IBS:

Irritable bowel syndrome

LC:

Locus ceruleus

SNRIs:

Serotonin–norepinephrine reuptake inhibitors

SSRIs:

Selective serotonin and norepinephrine reuptake inhibitors

taVNS:

Transcutaneous auricular vagus nerve stimulation

UC:

Ulcerative colitis

VN:

Vagus nerve

VNS:

Vagus nerve stimulation

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  1. Service d’hépato-Gastroentérologie, Grenoble Institut Neurosciences, Université Grenoble-Alpes, Grenoble, France

    Bruno Bonaz

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Bonaz, B. Unmet needs of drugs for irritable bowel syndrome and inflammatory bowel diseases: interest of vagus nerve stimulation and hypnosis. Inflammopharmacol 32, 1005–1015 (2024). https://doi.org/10.1007/s10787-024-01446-7

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