Exploration of brain-spinal cord-gut axis abnormalities and the mechanism of acupuncture therapy in irritable bowel syndrome based on magnetic resonance imaging

Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder triggered by the disorder of brain-gut interaction and characterized by abdominal pain, bloating, and altered bowel habits. It is estimated to affect between 5% and 10% of the global population. Although IBS does not have an excessive mortality rate, the disease significantly affects the quality of life and can lead to significant disability. Current treatments mainly focus on relieving abdominal pain and improving bowel habits. However, the effect of drug therapy on the overall symptoms of patients is limited, and the majority of therapeutic drugs are associated with the risk of adverse reactions. Consequently, many patients turn to complementary and alternative therapies to achieve more favorable treatment outcomes. Acupuncture, as a complementary and alternative therapy, has shown potential in the treatment of IBS. Although clinical trials have confirmed the therapeutic effect of acupuncture, its mechanism of action remains unclear, leading to controversy in the global medical community. Researchers, leveraging magnetic resonance imaging (MRI) technology, strive to delve deeply into the biological mechanisms underlying the alleviation of irritable bowel syndrome symptoms through acupuncture therapy, aiming to provide solid support for the scientific basis and efficacy of this treatment method. However, current imaging research primarily focuses on changes in brain structure and function, relatively neglecting the close connection between spinal structure and function and IBS. The spinal cord plays a crucial role in brain-gut interaction, and the development of MRI technology provides a new perspective for exploring the pathogenesis of IBS and the mechanism of acupuncture based on the brain-spinal cord-gut axis. This paper reviews MRI-based studies on abnormalities in brain-spinal cord-gut axis interaction in IBS and acupuncture treatment. Although there have been significant advancements in understanding the causes and using acupuncture to treat IBS, there are still several limitations that need to be addressed. One limitation is the insufficient number of imaging studies on the spinal cord, which hinders our comprehensive understanding of the development of IBS and the underlying mechanisms of acupuncture therapy. In the future, it is necessary to enhance the imaging study of the spinal cord and conduct a thorough analysis of the brain-spinal cord-gut axis mechanism. This will enable us to establish a scientific foundation for understanding the pathogenesis of IBS and the effectiveness of acupuncture treatment. Furthermore, the current research on the impact of acupuncture on IBS primarily concentrates on describing the phenomenon and comparing data but fails to incorporate the principles of neuroscience pain theory. In the future, it is important to prioritize the integration of pain theory and thoroughly investigate the impact of acupuncture on the primary pathways of pain transmission and processing. This will help us understand the intricate mechanism of acupuncture analgesia and facilitate the broader application of acupuncture therapy.