Ettienne EB, Rose K. Disorders of gut-brain interaction are a new challenge of our increasingly complex society, with worldwide repercussions. World J Clin Pediatr 2025; 14(2): 103608 [DOI: 10.5409/wjcp.v14.i2.103608]
Corresponding Author of This Article
Klaus Rose, MD, Chief Physician, Pediatric Drug Development and More, Medical Science, Äussere Baselstrasse 308, Riehen CH-4125, Switzerland. klaus.rose@klausrose.net
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Editorial
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Pediatr. Jun 9, 2025; 14(2): 103608 Published online Jun 9, 2025. doi: 10.5409/wjcp.v14.i2.103608
Disorders of gut-brain interaction are a new challenge of our increasingly complex society, with worldwide repercussions
Earl B Ettienne, Klaus Rose
Earl B Ettienne, College of Pharmacy, Howard University College of Pharmacy, Washington, DC 20059, United States
Klaus Rose, Pediatric Drug Development and More, Medical Science, Riehen CH-4125, Switzerland
Author contributions: Rose K provided a first draft; Ettienne EB revised and expanded the draft. Both authors worked jointly on the final version.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Klaus Rose, MD, Chief Physician, Pediatric Drug Development and More, Medical Science, Äussere Baselstrasse 308, Riehen CH-4125, Switzerland. klaus.rose@klausrose.net
Received: November 25, 2024 Revised: January 23, 2025 Accepted: February 14, 2025 Published online: June 9, 2025 Processing time: 113 Days and 15.8 Hours
Abstract
The term disorders of gut-brain interaction (DGBIs) encompasses gastrointestinal disorders that globally affect more than one third of all people. The Rome IV criteria replaced the former term “functional gastrointestinal disorders.“ DGBIs can seriously challenge health and quality of life (QoL). A traditional but outdated approach differentiated “organic” vs “functional“ disorders, seen by some as real vs psychiatric or undefined ones. This traditional distinction did not help patients whose health and QoL are seriously affected. DGBIs include motility disturbance; visceral hypersensitivity; altered mucosal and immune function; altered central nervous system processing, and more. Several DGBIs affect both children and adolescents. DGBIs are characterized by clusters of symptoms. Their pathophysiology relates to combinations of altered motility, visceral sensitivity, mucosal immune function, and more. Routine investigations find no structural abnormality that would easily explain the symptoms. Symptom-based criteria were developed to better understand patients where no mechanistic explanation was available for clinical practice and inclusion into clinical trials. To understand DGBIs and to find ways to treat them, these rigid mechanistic views fall short.
Core Tip: Disorders of gut-brain interaction can seriously challenge patients‘ health and quality of life (QoL). This new approach no longer differentiates organic from functional (or psychiatric) disorders. This former, now outdated distinction did not help patients whose QoL was and is seriously impaired. Instead, todays symptom-based criteria attempts to better understand patients. The traditional explanations did not allow satisfying clinical treatment nor inclusion into exploratory trials with new drugs or biologics. With this new approach, the hope is to overcome the shortcomings of traditional approaches.
