Gastrointestinal Dysfunction in Stroke

Abstract

Gastrointestinal (GI) complications are seen in over 50% of ischemic stroke survivors; the most common complications are dysphagia, constipation, and GI bleeding. The bidirectional relationship of the gut–brain axis and stroke has recently gained traction, wherein stroke contributes to gut dysbiosis (alterations in the normal host intestinal microbiome) and gut dysbiosis perpetuates poor functional neurologic outcomes in stroke. It is postulated that the propagation of proinflammatory cells and gut metabolites (including trimethylamine N-oxide and short-chain fatty acids) from the GI tract to the central nervous system play a central role in gut–brain axis dysfunction. In this review, we discuss the known GI complications in acute ischemic stroke, our current knowledge from experimental stroke models for gut–brain axis dysfunction in stroke, and emerging therapeutics that target the gut–brain axis.

Keywords

ischemic stroke - gastrointestinal - microbiome - complications - gut–brain axis

Authors' Contributions

H.Y.F.Y., A.G., and C.C.-L. contributed to the literature review. H.Y.F.Y. drafted all the figures and tables, with final input from C.C.-L. and A.G. H.Y.F.Y. wrote the first draft of the manuscript. C.C.-L. approved the final version.

Authors' Statement

The corresponding author C.C.-L. takes full responsibility for the data, the analyses and interpretation, and the conduct of the research; the principal author had full access to all of the data and has the right to publish any and all data separate and apart from any sponsor.

Publication History

Article published online:
10 August 2023

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