The Abdominal Brain and Enteric Nervous System

McMillin, David L.; Richards, Douglas G.; Mein, Eric A.; Nelson, Carl D.

doi:10.1089/acm.1999.5.575

Cited by 19 publications

(18 citation statements)

References 46 publications

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“…Although peripheral pathways mediate the actual vomiting process (Lang, 1999;McMillin, Richards, Mein and Nelson, 1999), nausea and vomiting in migraine …”

Section: Gastrointestinal Symptomsmentioning

confidence: 99%

Migraine and motion sickness: What is the link?

Cuomo-Granston

Drummond

2010

Progress in Neurobiology

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The brainstem is a structurally complex region, containing numerous ascending and descending fibres that converge on centres that regulate bodily functions essential to life. Afferent input from the cranial tissues and the special senses is processed, in part, in brainstem nuclei. In addition, brainstem centres modulate the flow of pain messages and other forms of sensory information to higher regions of the brain, and influence the general excitability of these cortical regions. Thus, disruptions in brainstem processing might evoke a complex range of unpleasant symptoms, vegetative changes and neurovascular disturbances and that, together, form attacks of migraine. Migraine is linked with various co-morbid conditions, the most prominent being motion sickness. Symptoms such as nausea, dizziness and headache are common to motion sickness and migraine; moreover, migraine sufferers have a heightened vulnerability to motion sickness. As both maladies involve reflexes that relay in the brainstem, symptoms may share the same neural circuitry. In consequence, subclinical interictal persistence of disturbances in these brainstem pathways could not only increase vulnerability to recurrent attacks of migraine but also increase susceptibility to motion sickness. Mechanisms that mediate symptoms of motion sickness and migraine are explored in this paper. The physiology of motion sickness and migraine is discussed, and neurotransmitters that may be involved in the manifestation of symptoms are reviewed. Recent findings have shed light on the relationship between migraine and motion sickness, and provide insights into the generation of migraine attacks.

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“…Although peripheral pathways mediate the actual vomiting process (Lang, 1999;McMillin, Richards, Mein and Nelson, 1999), nausea and vomiting in migraine …”

Section: Gastrointestinal Symptomsmentioning

confidence: 99%

Migraine and motion sickness: What is the link?

Cuomo-Granston

Drummond

2010

Progress in Neurobiology

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“…Neuropeptides and neurotransmitters produced in the gastrointestinal tract regulate gastrointestinal motility, blood flow, secretion, and absorption. 20,21 The enteric nervous system and central nervous system have direct effects on each other. For example, stress is known to aggravate the gastrointestinal tract by stimulating the release of neuropeptides and neurotransmitters, triggering various gastrointestinal responses.…”

mentioning

confidence: 99%

Systematic Review of Treatments for Recurrent Abdominal Pain

Weydert

Ball²,

Davis³

2003

Pediatrics

193

100

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ABSTRACT.Objective. To conduct a systematic review of evaluated treatments for recurrent abdominal pain (RAP) in children.Methods. Online bibliographic databases were searched for the terms "recurrent abdominal pain," "functional abdominal pain," "children," or "alternative therapies" in articles classified as randomized controlled trials. The abstracts or full text of 57 relevant articles were examined; 10 of these met inclusion criteria. Inclusion criteria required that the study involve children aged 5 to 18 years, subjects have a diagnosis of RAP, and that subjects were allocated randomly to treatment or control groups. The methodology and findings of these articles were evaluated critically, and data were extracted from each article regarding study methods, specific interventions, outcomes measured, and results.Results. Studies that evaluated famotidine, pizotifen, cognitive-behavioral therapy, biofeedback, and peppermint oil enteric-coated capsules showed a decrease in measured pain outcomes for those who received the interventions when compared with others in control groups. The studies that evaluated dietary interventions had conflicting results, in the case of fiber, or showed no efficacy, in the case of lactose avoidance.Conclusions. Evidence for efficacy of treatment of RAP in children was found for therapies that used famotidine, pizotifen, cognitive-behavioral therapy, biofeedback, and peppermint oil enteric-coated capsules. The effects of dietary fiber were less conclusive, and the use of a lactose-free diet showed no improvement. There seemed to be greater improvement when therapy (famotidine, pizotifen, peppermint oil) was targeted to the specific functional gastrointestinal disorder (dyspepsia, abdominal migraine, irritable bowel syndrome). The behavioral interventions seemed to have a general positive effect on children with nonspecific RAP. Many of these therapies have not been used widely as standard treatment for children with RAP. Although the mechanism of action for each effective therapy is not fully understood, each is believed to be safe for use in RAP. Pediatrics 2003;111:e1-e11. URL: http://www.pediatrics.org/cgi/ content/full/111/1/e1; recurrent abdominal pain, treatment, children, alternative therapies, systematic review.ABBREVIATIONS. RAP, recurrent abdominal pain; IBS, irritable bowel syndrome; RCT, randomized controlled trial; SPC, standard pediatric care; CBFI, cognitive-behavioral family intervention; BF, biofeedback; CBI, cognitive-behavioral intervention.

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“…It is not surprising that there are reflexes from the colon that affect the entire nervous system, given the importance of the "abdominal brain" or enteric nervous system (McMillin et al, 1999). It is estimated that 80% of vagal fibers are visceral afferents (Davenport, 1978).…”

Section: Experimental Research Related To Colonic Irrigationsmentioning

confidence: 99%

Colonic Irrigations: A Review of the Historical Controversy and the Potential for Adverse Effects

Richards

McMillin²,

Mein³

et al. 2006

The Journal of Alternative and Complementary Medicine

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Colonic irrigations enjoy widespread popularity in the alternative medicine community, while being viewed with considerable skepticism by the conventional medical community. While proponents make claims of substantial health benefits, skeptics cite the lack of evidence for health benefits, and emphasize the potential for adverse effects. Yet historically, there are clinical reports of effectiveness, and virtually no research refuting these reports. Instead there was a campaign against exaggerated claims by non-medical practitioners that resulted in a movement away from this form of therapy without any scientific study of efficacy. Given the current popularity of colonic irrigations, it is important that such research be performed, but it is first necessary that a quantitative estimate of the potential for adverse effects be made for the purposes of informed consent. Although there is little specific literature on colonic irrigations, a review of the literature on related procedures such as enemas and sigmoidoscopies suggests that the risk of serious adverse effects is very low when the irrigations are performed by trained personnel using appropriate equipment.

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The Abdominal Brain and Enteric Nervous System

Cited by 19 publications

References 46 publications

Migraine and motion sickness: What is the link?

Migraine and motion sickness: What is the link?

Systematic Review of Treatments for Recurrent Abdominal Pain

Colonic Irrigations: A Review of the Historical Controversy and the Potential for Adverse Effects

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