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The enteric nervous system and neurogastroenterology

Nature Reviews Gastroenterology & Hepatology volume 9, pages 286–294 (2012)Cite this article

Subjects

Abstract

Neurogastroenterology is defined as neurology of the gastrointestinal tract, liver, gallbladder and pancreas and encompasses control of digestion through the enteric nervous system (ENS), the central nervous system (CNS) and integrative centers in sympathetic ganglia. This Review provides a broad overview of the field of neurogastroenterology, with a focus on the roles of the ENS in the control of the musculature of the gastrointestinal tract and transmucosal fluid movement. Digestion is controlled through the integration of multiple signals from the ENS and CNS; neural signals also pass between distinct gut regions to coordinate digestive activity. Moreover, neural and endocrine control of digestion is closely coordinated. Interestingly, the extent to which the ENS or CNS controls digestion differs considerably along the digestive tract. The importance of the ENS is emphasized by the life-threatening effects of certain ENS neuropathies, including Hirschsprung disease and Chagas disease. Other ENS disorders, such as esophageal achalasia and gastroparesis, cause varying degrees of dysfunction. The neurons in enteric reflex pathways use a wide range of chemical messengers that signal through an even wider range of receptors. These receptors provide many actual and potential targets for modifying digestive function.

Key Points

  • The enteric nervous system (ENS) is an extensive reflex control system for digestive function that works with the central nervous system (CNS) and neural pathways that pass through sympathetic ganglia

  • The ENS of the small intestine and colon has complete reflex pathways that control patterns of contractile activity, local blood flow and transmucosal movement of fluids

  • The CNS has essential roles in control of esophageal, stomach and colorectal functions

  • Control of transmucosal fluid movement by the ENS and CNS is closely integrated

  • The ENS interacts with both the gut endocrine and immune systems and has roles in modifying nutrient absorption and maintaining the mucosal barrier

  • Enteric neuropathies in which control of muscle contractile activity or neural control of transmucosal fluid movement fail are life-threatening

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Figure 1: The innervation of the gastrointestinal tract.
Figure 2: The organization of the ENS of human and medium–large mammals.
Figure 3: Nerve circuits for control of motility in the small intestine.
Figure 4: Neural control of transmucosal water and electrolyte movement in the small intestine.

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Acknowledgements

Work from the author's laboratory is supported by the National Health and Medical Research Council of Australia. I thank Dr Alan Lomax and Dr Daniel Poole for their helpful comments and Dr Trung Nguyen for assistance with the figures.

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  1. Department of Anatomy and Neuroscience, University of Melbourne, Grattan Street, Parkville, 3010, VIC, Australia

    John B. Furness

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Furness, J. The enteric nervous system and neurogastroenterology. Nat Rev Gastroenterol Hepatol 9, 286–294 (2012). https://doi.org/10.1038/nrgastro.2012.32

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