Are stressed out goblets cells to blame for functional dyspepsia symptoms?

It has long been recognised that functional dyspepsia (FD) is associated with stress and anxiety, each of which increase susceptibility to disease onset and drive symptom flares. Despite epidemiological links between stress and FD, the mechanisms driving this link have remained elusive preventing targeted interventions that control FD symptoms.

We read with interest new work by Bruce and colleagues, recently published in Brain, Behaviour and Immunity, which dissects the complex gut-brain communication in this largely unexplained disorder (Bruce et al., 2022). The team elegantly brings together fundamental evidence of how stress influences the hypothalamic–pituitaryadrenal (HPA) axis and existing understanding of the gastrointestinal microenvironment in FD, to build a unique mechanistic hypothesis that may explain the well-appreciated contribution of stress in FD...