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GASTROENTEROLOGY
International Conference on
J u n e 2 5 - 2 6 , 2 0 1 8 | D u b l i n , I r e l a n d
Journal of Gastronenterology and Digestive Diseases
|
Volume 3
Page 40
T
he enteric nervous system (ENS) or gutbrain has 30 different
neurotransmitters and ninety percent of the body’s serotonin as well
as fifty percent of its dopamine. It also has the gut microbiome and taste
receptors which sense ‘sweetness’ on the tongue and levels of glucose in the
bloodstream. These taste receptors regulate insulin and are a good example of
how the ENS really acts as our gutbrain and is capable of independent action.
The processing of the gut instinct or gut reaction to incidents is a prerequisite
for sensorimotor focused eye movement desensitisation and reprocessing for
psychoherapy and peak performance. This talk presents research by John F
Cryan andTimothy GDinanwhich shows how the gut microbiota communicates
with the CNS through neural, endocrine and immune pathways. This provides
scientific evidence for an influenciing role in the regulation of anxiety, mood,
cognition and pain. The microbiota are integrated into the illustrated gutbrain
axia and impact on the brain in states from satiety to stress. A range of
mechanisms have been proposed by which gut flora affect the CNS: altering
composition of the gut flora- they can compete for dietary ingredients such
as growth substrates, they can produce vitamins, reduce inflammation and
stimulate innate immune responses. All these can change gut-brain signalling,
Immune activation- the immune system interacts bidirectionally with the CNS.
Also indirectly the gut flora affects the immune system altering cytokine levels.
These are both pro and anti inflammatory and directly impact brain function,
Vagus Nerve- as illustrated below this regulates bronchial constriction,
heart rate and gut motility. About eighty percent of nerve fibres are sensory,
conveying sensory information about the body organs to the CNS. Many of the
effects of gut flora are dependent on vagal activity. The mechanisms of vagal
afferent activation by gut microbiotica have yet to be elucidated, Metabolism
of tryptophan- this essential amino acid is a precursor of serotonin. This
metabolic pathway becomes dysregulated in many brain and gastrointestinal
tract disorders. Two key enzymes involved in the metabolism are activated
by inflammatory mediators and corticosteroids, Microbial metabolites- Gut
flora are essential in the production of bile acids, choline and short chain
fatty acids. Complex carbohydrates are digested and fermented in the colon
by gut microorganisms into neuroactive short chain fatty acids and Microbial
neurometabolites- these neurotransmitters act on the enteric nervous system
and may have anti-nociceptive properties. Bacterial cell wall sugars-these may
Biography
Art O’Malley has worked as a consultant child
and adolescent Psychiatrist from 2004 and am
accredited as an EMDR consultant from 2008. I
have also trained in sensorimotor psychothera-
py. I have been a member of the UK and Ireland
EMDR Association since 2002 and was a mem-
ber of the European Conference organizing com-
mittee for the London Conference and the Child
and Adolescent Committee. I have presented
at their AGMs in Glasgow, Manchester, Dublin
and at the European conferences in Paris and
London. I have presently widely in the fields of
trauma, neglect and the developing brain, attach-
ment disorders, personality disorders, emotional
dysregulation in ADHD and ASD diagnosis and
management. I first presented on this model at
the ISSTD 28th Annual conference in Montreal
November 2011. Recent articles on the clinical
effectiveness of BART psychotherapy have been
published to complement the book, The Art of
BART which was published by Karnac books in
London in 2015 and is available in print and as an
eBook from Amazon and Routledge. The updat-
ed version of the book, “Sensorimotor Focused
EMDR for Psychotherapy: A New Paradigm for
Peak Performance will soon be published by Tay-
lor and Francis (Routledge ).
artmail@doctors.org.ukHOW THE GUT MICROBIOTA
COMMUNICATES WITH THE CNS
THROUGH NEURAL, ENDOCRINE AND
IMMUNE PATHWAYS
Art O’Malley
Mascot Child and Family Services limited, UK
Art O’Malley, J Gastroenterol Dig Dis 2018, Volume 3