Autonomic nervous system as a key modulator in stress-related inflammatory bowel disease: Mechanisms and therapeutic implications

doi:10.3748/wjg.123982

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World Journal of Gastroenterology

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1007-9327

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Gastroenterol. Jan 14, 2027; 33(2): 123982
Published online Jan 14, 2027. doi: 10.3748/wjg.123982

Autonomic nervous system as a key modulator in stress-related inflammatory bowel disease: Mechanisms and therapeutic implications

Xin-Xin Hu, Xue-Ping Zhang, Cheng-Xiang Wang, Rui-Rong Yang, Li-Xin Ma, Suo-Wei Wu, Wen-Qi Jiang, Pu-Min Deng, Tao Zhang, Xiao-Lan Su, Wei Wei

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

Core Tip

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.