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See the full rubric →Barrier restoration as a therapeutic strategy for disorders of gut-brain interaction.
Clinical takeawayThis mechanistic review of gut-barrier restoration (SCFAs, glutamine or tryptophan, probiotics) is hypothesis-generating only; barrier-targeted diet or probiotic therapy for disorders of gut-brain interaction is not yet guideline-supported and should await clinical trials.
What it foundShort-chain fatty acids, amino acids (glutamine and tryptophan), and targeted probiotics enhance tight junction integrity and mucin secretion, while psychological stress, low-fiber diets, and high-fat diets disrupt gut barrier function.
ContextConfirms and refines the growing recognition of gut barrier dysfunction in disorders of gut-brain interaction but highlights the lack of validated clinical interventions targeting barrier restoration.
Emergingsuggested applicable standard· American College of Gastroenterology, 'ACG and CAG Clinical Guideline: Management of Dyspepsia', 2017
Decision at stakethe potential for barrier restoration therapies in functional dyspepsia
American College of Gastroenterology, 'ACG and CAG Clinical Guideline: Management of Dyspepsia', 2017 · reviewed 2026-07-21 ↗After excluding organic causes and confirming H. pylori test-of-cure, manage functional dyspepsia by eradicating H. pylori if positive and giving a PPI (4-8 weeks, dosed 30-60 min before meals); for persistent symptoms consider neuromodulators (e.g., low-dose TCAs like amitriptyline 10-50 mg QHS) for refractory cases, particularly in EPS, or prokinetics cautiously in selected PDS cases. Initial evaluation follows ACG/CAG 2017: test-and-treat H. pylori in patients under 60 without alarm features, and EGD for age ≥60, alarm features, or high gastric-cancer-risk groups. Add psychological therapies (CBT, gut-directed hypnotherapy) and lifestyle measures.
Britton TA, Grover M · Lancet Gastroenterology & Hepatology · IF 30.9 · PubMed ↗