ArticleNeurogastroenterology and motility2009
Dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis in irritable bowel syndrome.
Article in Neurogastroenterology and motility, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 110 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
110 citing papers in PubMed, 2 syntheses or guidelines pooled it, 250 citations in OpenAlex.
- Evaluation of the effectiveness of exercise therapy for irritable bowel syndrome: a systematic review and meta-analysis.Frontiers in medicine · 2026Pooled it
- Examining the Association between Coffee Intake and the Risk of Developing Irritable Bowel Syndrome: A Systematic Review and Meta-Analysis.Nutrients · 2023Pooled it
- Somatization in patients with predominant diarrhoea irritable bowel syndrome: the role of the intestinal barrier function and integrity.BMC gastroenterology · 2021Trial
- Corticotropin-releasing factor receptor 1 antagonist alters regional activation and effective connectivity in an emotional-arousal circuit during expectation of abdominal pain.The Journal of neuroscience : the official journal of the Society for Neuroscience · 2011Trial
- Protocol for a randomized controlled study of Iyengar yoga for youth with irritable bowel syndrome.Trials · 2011Trial
- Do corticotropin releasing factor-1 receptors influence colonic transit and bowel function in women with irritable bowel syndrome?American journal of physiology. Gastrointestinal and liver physiology · 2009Trial
- Irritable bowel syndrome and restless legs syndrome: a narrative review of epidemiological and pathophysiological overlap.Annals of medicine and surgery (2012) · 2026Review
- Article
- Oral and Gut Health, (Neuro) Inflammation, and Central Sensitization in Chronic Pain: A Narrative Review of Mechanisms, Treatment Opportunities, and Research Agenda.International journal of molecular sciences · 2025Review
- Psychological self-efficacy and coping styles as mediators between perceived stress and IBS symptom severity: a cross-sectional study.Annals of medicine and surgery (2012) · 2025Article
- Effects ofInternational journal of molecular sciences · 2025Article
- Irritable bowel syndrome remains a complex disorder of gut-brain interaction: Too many actors on stage.World journal of gastroenterology · 2025Article
- A Comprehensive Evidence Summary for Pain Assessment and Management After Hemorrhoidal Surgery to Inform Clinical Practice Guidelines.Journal of multidisciplinary healthcare · 2025Review
- Morphological Changes of the Pituitary Gland in Patients with Irritable Bowel Syndrome Using Magnetic Resonance Imaging.Journal of imaging · 2024Article
- Article
- Gastrointestinal symptoms in patients with postural orthostatic tachycardia syndrome in relation to hemodynamic findings and immunological factors.Frontiers in physiology · 2024Article
- Environmental enrichment reverses stress-induced changes in the brain-gut axis to ameliorate chronic visceral and somatic hypersensitivity.Neurobiology of stress · 2024Article
- Low-level inflammation, immunity, and brain-gut axis in IBS: unraveling the complex relationships.Gut microbes · 2023Review
- The Biology of Stress Intolerance in Patients with Chronic Pain-State of the Art and Future Directions.Journal of clinical medicine · 2023Review
- Social and physical predictors of mental health impact in adult women who have anGenetics in medicine open · 2023Article
50 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors at 4 institutions in 1 country.
Funding
Abstract
Enhanced stress responsiveness has been implicated as a potential mechanism contributing to the pathophysiology of irritable bowel syndrome (IBS), and should be reflected in altered function of the hypothalamic-pituitary-adrenal (HPA) axis and the sympathetic nervous system. Both of these systems can modulate mucosal immune function. The aims of this study were: (i) to characterize the basal circadian rhythm of adrenocorticotropin hormone (ACTH) and cortisol in IBS vs healthy controls; (ii) to compare stimulated ACTH, cortisol and noradrenaline responses to a pelvic visceral stressor (sigmoidoscopy) in IBS and controls; and (iii) to correlate neuroendocrine responses with colonic mucosal cytokine expression and symptoms in IBS. Two separate studies were conducted in women. In Study 1, basal cortisol levels were analysed in 41 IBS and 25 controls using 24-h collections of plasma ACTH and cortisol (q10 min sampling). In Study 2, 10 IBS patients with diarrhoea (IBS-D) and 10 controls underwent sigmoidoscopy with measurements of stimulated neuroendocrine responses and cytokine mRNA expression in colonic tissue. Basal ACTH levels were significantly blunted (P < 0.05), while basal and stimulated plasma cortisol levels were higher in patients. Basal cortisol levels prior to an experimental visceral stressor positively correlated with anxiety symptoms (P < 0.004), but not IBS symptoms. Irritable bowel syndrome patients with diarrhoea had significantly decreased mRNA expression of mucosal cytokines [interleukin (IL)-2, IL-6] in the sigmoid colon vs controls (P < 0.05). Although dysregulations in stress-responsive systems such as the HPA axis and mucosal immune function are demonstrated in IBS, they do not appear to have a primary role in modulating IBS severity and abdominal pain.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.