Prophylactic role for complementary and alternative medicine in perinatal programming of adult health

Hypnotherapy and IBS: Implicit, long-term stress memory in the ENS?

The association between irritable bowel syndrome (IBS) and psychiatric and mood disorders may be more fundamental than was previously believed. Prenatal, perinatal, postnatal, and early-age conditions can have a key role in the development of IBS. Subthreshold mental disorders (SMDs) could also be a significant source of countless diverse diseases and may be a cause of IBS development. We hypothesize that stress-induced implicit memories may persist throughout life by epigenetic processes in the enteric nervous system (ENS). These stress-induced implicit memories may play an essential role in the emergence and maintenance of IBS. In recent decades, numerous studies have proven that hypnosis can improve the primary symptoms of IBS and also reduce noncolonic symptoms such as anxiety and depression and improve quality of life and cognitive function. These significant beneficial effects of hypnosis on IBS may be because hypnosis allows access to unconscious brain processes.

Prenatal maternal stress induces visceral hypersensitivity of adult rat offspring through activation of cystathionine-β-synthase signaling in primary sensory neurons

Irritable bowel syndrome is a disorder of unknown etiology characterized by widespread, chronic abdominal pain associated with altered bowel movements. Increasing amounts of evidence indicate that stressors presented during gestational periods could have long-term effects on the offspring's tissue structure and function, which may predispose to gastrointestinal diseases. The aim of the present study is to determine whether prenatal maternal stressis a adverse factor affecting gastrointestinal sensitivity and to investigate possible mechanisms underlying prenatal maternal stress-induced visceral hypersensitivity in adult offspring. Prenatal maternal stress was induced in pregnant Sprague-Dawley rats by exposure to heterotypic intermitent stress from gestational day 7 to delivery. Prenatal maternal stress significantly increased visceromotor response to colorectal distention in adult offspring from the age of 6 weeks to 10 weeks. Prenatal maternal stress also enhanced neuronal excitability including depolarization of resting membrane potentials, reduction in rheobase, and an increase in the number of action potentials evoked by 2× and 3× rheobase current stimultion of colon-specific dorsal root ganglion neurons. Prenatal maternal stress remarkably enhanced expression of cystathionine-β-synthase and Nav1.7 in T13-L2 thoracolumbar dorsal root ganglions both at protein and mRNA levels. Intraperitoneal injection of aminooxyacetic acid, an inhibitor of cystathionine-β-synthase, attenuated prenatal maternal stress-induced visceral hypersensitivity in a dose-dependent manner. A consecutive seven-day administration of aminooxyacetic acid reversed the hyperexcitability of colon-specific dorsal root ganglion neurons and markedly reduced Nav1.7 expression. These results indicate that the presence of multiple psychophysical stressors during pregnancy is associated with visceral hypersensitivity in offspring, which is likely mediated by an upregualtion of cystathionine-β-synthase and Nav1.7 expression. Prenatal maternal stress might be a significant contributor to irritable bowel syndrome, and cystathionine-β-synthase might be a potential target for treatment for chronic visceral hypersensitivity in patients with irritable bowel syndrome.

Early adversity, immunity and infectious disease

Complex interactions between biological, behavioral and environmental factors are involved in mediating individual differences in health and disease. In this review, we present evidence suggesting that increased vulnerability to infectious disease may be at least, in part, due to long-lasting effects of early life psychosocial adversities. Studies have shown that maternal psychosocial stress during pregnancy is associated with long lasting changes in immune function and disease resistance in the offspring. Studies further indicated that harsh environmental conditions during the neonatal period may also cause lasting changes in host response to infectious disease. Although the mechanisms involved in these effects have not been fully examined, several potential mediators have been described, including changes in the development of the offspring hypothalamic-pituitary-adrenal axis, alterations in epigenetic pathways, stress-related maternal health risk behavior and infection during pregnancy. Although there are ample literature indicating that perinatal psychosocial stress increases vulnerability to disease, other reports suggest that mild predictable stressors may benefit the organism and allow better coping with future stressors. Thus, understanding the possible consequences of perinatal adversities and the mechanisms that are involved in immune regulation is important for increasing awareness to the potential outcomes of early negative life events and providing insight into potential therapies to combat infection in vulnerable individuals.

Use of complementary and alternative medicine during pregnancy and delivery

PURPOSE

To assess the use of complementary and alternative medicine (CAM) during pregnancy and birth and the reasons behind it from the patient's perspective.

METHODS

In a prospective study, we assessed the use of CAM before and during pregnancy as well as during delivery in women by means of a self-report questionnaire.

RESULTS

Some 205 patients completed the questionnaire at a response rate of 43.2% (205/475) and 104 women used CAM during pregnancy, especially homoeopathy, acupuncture, and phytotherapy. Stepwise regression analysis identified CAM use prior to pregnancy, greater income, and nationality as the most important predictors of CAM use.

CONCLUSIONS

In accordance with earlier studies from Germany, we determined the most important methods used in the field of obstetrics. Interestingly, these are not evidence-based and those methods which are evidence-based are not now used. Also, the predictors of CAM use in pregnancy were similar to those in oncology. Future studies should focus on the safety and efficacy of CAM in pregnancy.

Prophylactic role of maternal administration of probiotics in the prevention of irritable bowel syndrome

Neonatal stress is a common early life event which alters the development of the endocrine and immune systems. Specifically, exposure to neonatal stress results in alterations to the hypothalamic-pituitary-adrenal (HPA) axis resulting in offspring who hyper-respond to stress in adulthood. Recently, this concept has been applied to the ontogeny of functional gastrointestinal (GI) disturbances such as irritable bowel syndrome (IBS). The high prevalence of this disorder and the ineffectiveness of current treatments results in high direct and indirect costs to the society. Recently, administration of probiotics to neonates has been used as a safe and cost-effective preventative strategy to revoke the long term unfavourable imprinting induced on the gastrointestinal system by early life stressors in animal models of human IBS. It is not as yet known however, whether maternal supplementary probiotics may also contribute to improved GI integrity and gut-associated immune functioning in stressed neonates, if these possible improvements persist into adulthood, or how this protective effect may be mediated. Our hypothesis is an attempt to link this proposed nutritional approach and its possible preventive effects against GI dysfunctions provoked by neonatal stress.

A bio-psycho-socio-molecular approach to pain and stress management

Stress and trauma are interconnected with the experience of pain. This connection is due to a physiological coupling of underlying molecular autoregulatory mechanisms, as well as phenomenological similarities. Nonpharmaceutical therapeutic approaches such as the relaxation response, a process that supports physiological stress reduction and decreases the negative mental and physical effects of stress, also facilitate pain relief, again demonstrating physiological commonalities. These behavioral approaches have a critical impact on molecular patterns of autoregulation, leading to the assumption of a bio-psycho-socio-molecular model of autoregulation, including stress and pain. Thus, molecules and behavior may be seen as two sides of the same problem in pain and stress relief.