cholecystokinin and Psychophysiologic-Disorders

Epidemiological studies indicate that irritable bowel syndrome represents the most frequent somatoforme disorder. Current pathogenetic concepts as well as newer results in pathophysiology, neurobiology and psychoendocrinology are described. As an example of the "brain-gut-link", the role of cholecystokinin (CCK) is discussed. The positive results of psychotherapeutic intervention studies are described in more detail. An intensified cooperation between the gastroenterologist and the psychotherapist is recommended.

Topics: Cholecystokinin; Colonic Diseases, Functional; Combined Modality Therapy; Humans; Patient Care Team; Psychophysiologic Disorders; Psychotherapy

Exact cause of the metabolic syndrome [MS], a global epidemic, is still unclear. Man has same fundamental needs to live as animals but modern man's life-style compels him to acquire certainty of resources for all his needs in a complex social network. Today money has become the sole life essential need. Contrarily none of the animals needs to earn money. Brain is also an organ of the human body with a unique thought process to define logical actions to achieve a person's goals. This way life is a flow of desires followed by logical actions. The person struggles to attain desired goals via the allostatic load but a perceived insurmountable threat can make his flow of life stalled to freeze him. Published data from varied branches of medical science indicates role of hormones in overall homeostasis. Particularly multifaceted role of serotonin is well documented. Adrenalin being the primary mediator of Cori cycle is also well known. From the integration of observations from published data with reference to common human's modern lifestyle, it is hypothesized that a perceived trapped situation in life creates acute chaos of thoughts in brain, which results in acute excess of stress hormones and concurrent depletion of resting hormones, which in turn triggers MS. In global terms, MS indicates an acute imbalance of a few hormones and implies psychosomatic roots of the disorder. This may pave a better way in deciding a personalized holistic protocol with combination of counter regulatory psychoactive medications.

Topics: Acidosis, Lactic; Allostasis; Animals; Brain; Cardiovascular Diseases; Cholecystokinin; Cholesterol; Diabetes Mellitus, Type 2; Diet; Dopamine; Epinephrine; Exercise; Homeostasis; Hormones; Humans; Hypertension; Life Style; Metabolic Syndrome; Microbiota; Models, Theoretical; Motivation; Obesity; Oxytocin; Psychophysiologic Disorders; Risk Factors; Serotonin

Despite the increasing research on placebos in recent times, little is known about the nocebo effect, a phenomenon that is opposite to the placebo effect and whereby expectations of symptom worsening play a crucial role. By studying experimental ischemic arm pain in healthy volunteers and by using a neuropharmacological approach, we found that verbally induced nocebo hyperalgesia was associated to hyperactivity of the hypothalamic-pituitary-adrenal (HPA) axis, as assessed by means of adrenocorticotropic hormone and cortisol plasma concentrations. Both nocebo hyperalgesia and HPA hyperactivity were antagonized by the benzodiazepine diazepam, suggesting that anxiety played a major role in these effects. The administration of the mixed cholecystokinin (CCK) type-A/B receptor antagonist proglumide blocked nocebo hyperalgesia completely but had no effect on HPA hyperactivity, which suggests a specific involvement of CCK in the hyperalgesic but not in the anxiety component of the nocebo effect. Importantly, both diazepam and proglumide did not show analgesic properties on basal pain, because they acted only on the nocebo-induced pain increase. These data indicate a close relationship between anxiety and nocebo hyperalgesia, in which the CCKergic systems play a key role in anxiety-induced hyperalgesia. These results, together with previous findings showing that placebo analgesia is mediated by endogenous opioids, suggest that the analgesic placebo/hyperalgesic nocebo phenomenon may involve the opposite activation of endogenous opioidergic and CCKergic systems.

Topics: Adrenocorticotropic Hormone; Adult; Anti-Anxiety Agents; Anti-Ulcer Agents; Anxiety; Cholecystokinin; Diazepam; Female; Humans; Hydrocortisone; Hyperalgesia; Hypothalamo-Hypophyseal System; Male; Middle Aged; Opioid Peptides; Pituitary-Adrenal System; Placebo Effect; Proglumide; Psychophysiologic Disorders; Receptors, Cholecystokinin

Topics: Adult; Age Factors; Biliary Tract Diseases; Cholecystectomy; Cholecystography; Cholecystokinin; Cholelithiasis; Colic; Cystic Duct; Female; Humans; Middle Aged; Nausea; Psychophysiologic Disorders; Sex Factors; Vomiting

Topics: Amylases; Cholecystectomy; Cholecystitis; Cholecystography; Cholecystokinin; Common Bile Duct; Female; Gallbladder; Gallbladder Diseases; Humans; Injections, Intravenous; Male; Psychophysiologic Disorders; Spasm