Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
Share the Article
Hu XX, Zhang XP, Wang CX, Yang RR, Ma LX, Wu SW, Jiang WQ, Deng PM, Zhang T, Su XL, Wei W. Autonomic nervous system as a key modulator in stress-related inflammatory bowel disease: Mechanisms and therapeutic implications. World J Gastroenterol 2027; 33(2): 123982 [DOI: 10.3748/wjg.123982]
Xin-Xin Hu, Xue-Ping Zhang, Cheng-Xiang Wang, Rui-Rong Yang, Pu-Min Deng, Tao Zhang, Xiao-Lan Su, Wei Wei, Department of Gastroenterology, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing 100102, China
Li-Xin Ma, Suo-Wei Wu, Wen-Qi Jiang, Graduate School, Beijing University of Chinese Medicine, Beijing 100020, China
Co-corresponding authors: Xiao-Lan Su and Wei Wei.
Author contributions: Su XL, Wei W, and Hu XX contributed to the conceptualization of the article; Zhang XP, Ma LX, Yang RR, and Wu SW contributed to the literature survey; Wang CX, Jiang WQ, Deng PM, and Zhang T contributed to figure preparation; Zhang XP, Ma LX, Yang RR, Wu SW, Wang CX, Jiang WQ, Deng PM, and Zhang T contributed to manuscript revision; Hu XX wrote the manuscript; Wei W and Su XL reviewed the manuscript and offered suggestions for revision as co-corresponding authors. All authors approved the final version to publish.
AI contribution statement: No AI tools were used in this review.
Supported by Beijing Pharmaceutical and Health Collaborative High-Quality R&D Project on Traditional Chinese Medicine, No. zyygzl-2026-004; and National Pilot Project for Integrated Chinese and Western Medicine in the Management of Severe and Refractory Diseases: Ulcerative Colitis (Chronic Dysentery), and the Specialized Research Program for Self-Proposed Projects at Wangjing Hospital, China Academy of Chinese Medical Sciences, No. WJYY-ZZXT-2025-35.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Wei Wei, MD, Chief Physician, Principal Investigator, Professor, Department of Gastroenterology, Wangjing Hospital, China Academy of Chinese Medical Sciences, No. 6 South Middle Ring Road, Wangjing, Chaoyang District, Beijing 100102, China. sxxtyy@sina.com
Received: June 3, 2026 Revised: July 29, 2026 Accepted: September 16, 2026 Published online: January 14, 2027 Processing time: 157 Days and 15.3 Hours
Abstract
Inflammatory bowel disease (IBD) is a chronic inflammatory intestinal disorder affecting more than 7 million people worldwide, with a growing global burden. Psychological stress may aggravate intestinal inflammation by disrupting autonomic nervous system (ANS) balance. This review considers the contribution of the ANS to stress-related IBD. Sympathetic and vagal pathways can exert distinct effects on intestinal barrier integrity, immune responses, and inflammatory activity through neurotransmitters and neuroimmune signaling. We also explore ANS-targeted therapies, such as β-blockers and vagus nerve stimulation, as potential precision interventions for IBD.
Core Tip: This review provides a novel perspective on stress-associated inflammatory bowel disease by highlighting autonomic nervous system dysregulation as a key link between psychological stress and intestinal inflammation. We discuss the dual roles of sympathetic and vagal pathways, disease-specific autonomic responses in ulcerative colitis and Crohn’s disease, and emerging autonomic nervous system-targeted therapies. Current controversies and future directions toward personalized neuromodulation are also addressed.
