American Physiological Society, American Journal of Physiology - Gastrointestinal and Liver Physiology, 2020
Visceral hypersensitivity of the lower gastrointestinal tract, defined as an increased response to colorectal distension, frequently prompts episodes of debilitating abdominal pain in Irritable Bowel Syndrome (IBS). Although the pathophysiology of IBS is not yet fully elucidated, it is well known that stress is a major risk factor for development and acts as a trigger of pain sensation. Stress modulates both immune responses as well as the gut microbiota and vice versa. Additionally, either microbes themselves or through involvement of the immune system, activate or sensitize afferent nociceptors. In this paper, we review current knowledge on the influence of stress along the gut-brain-microbiota axis and exemplify relevant neuro-immune crosstalk mechanisms in visceral hypersensitivity, working towards understanding how gut microbiota-neuro-immune cross-talk contributes to visceral pain sensation in IBS patients.