本期播客采访了哥伦比亚大学病理学和细胞生物学教授Mike Gershon，他深入探讨了肠脑交流的各个方面。节目首先概述了胃肠道的发育和解剖结构，然后详细介绍了肠道与大脑之间的双向交流，以及食物质量如何影响饱腹感信号。此外，节目还探讨了抗抑郁药和抗生素对消化系统的影响，以及“肠漏”的真相。最后，Mike Gershon讨论了肠道微生物组诊断测试的实用性，以及饮食、益生菌和益生元对微生物组和胃肠道的影响。这是一场关于消化系统与神经系统之间复杂关系的精彩对话。

🧠 胃肠道（GI）系统的基本结构包括消化道、相关腺体和神经系统。消化道从食道开始，经过胃、小肠和大肠，最终到达肛门。神经系统控制着消化过程，包括蠕动、消化液分泌和营养吸收。

👶 胃肠道的早期发育始于胚胎，形成消化管。这个过程涉及复杂的细胞分化和组织构建，最终形成具有独特功能的胃肠道结构，例如小肠的绒毛和隐窝，用于吸收营养。

🍎 肠道在调节食欲方面发挥关键作用，通过释放各种激素和神经递质来影响大脑的饱腹感。食物的质量和种类会影响这些信号，从而影响食欲和能量平衡。

💊 抗抑郁药，尤其是选择性5-羟色胺再摄取抑制剂（SSRIs），会影响肠道内的5-羟色胺信号传导，进而影响消化。5-羟色胺在肠道中扮演着重要的角色，影响肠道蠕动和分泌。

🦠 肠道微生物组在维持肠道健康中起着关键作用。益生菌和益生元可以通过调节肠道菌群来改善消化系统健康。益生菌是活的微生物，而益生元是促进有益细菌生长的食物。

View the Show Notes Page for This Episode

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Mike Gershon is a Professor of Pathology and Cell Biology at Columbia University and has been at the forefront of studying neural control of the gut for the past 60 years. In this episode, Mike gives a tour de force on the pathways of gut-brain communication but first sets the stage with an overview of gastrointestinal tract development and anatomy. He then explains how the gut communicates with the brain and vice versa, from early observations in physiology and anatomy up to our present understanding of what makes the GI tract so unique and complex relative to other organs. He talks about how the gut responds to meals of different food qualities and how that affects satiety signaling to the brain. Additionally, he explains how antidepressants and other drugs impact digestion through effects on serotonin signaling, and he discusses the effects of antibiotics, and what’s really going on with “leaky gut.” Finally, Mike offers his thoughts on the utility—or lack thereof—of gut microbiome diagnostic tests, and wraps up the discussion by considering how diet, probiotics, and prebiotics impact the microbiome and GI tract.

We discuss:

The basics of the gastrointestinal (GI) system [3:45]; The very early development of the GI system [9:30]; The unique properties of the blood supply and portal system in the GI tract [12:45]; An overview of gut anatomy and innervation [16:30]; Turnover of the epithelial lining and why cancer rarely develops in the small intestine [26:45]; Nutrient and water absorption in the small and large intestine [30:30]; Ways in which the gut and brain communicate [34:30]; The gut's role in the regulation of appetite [43:30]; The impact of gastric bypass surgery on satiety signals [51:15]; How varicella-zoster virus (VZV) can infect neurons in the gut and create issues later in life [54:30]; The relationship between autism and gastrointestinal illness [1:02:45]; The important role of serotonin in the gut, and the impact of SSRIs on serotonin in the gut [1:09:45]; Defining “leaky gut” and its most common causes [1:16:45]; The gut microbiome [1:30:45]; Fecal transplants: use cases, limitations, and how they illustrate the importance of gut microbes [1:40:45]; Gut microbiome diagnostic tests: why they aren’t useful outside of special cases such as cancer detection [1:50:30]; Nutritional approaches to a maintain optimal flora in the gut [1:55:00]; Prebiotics and probiotics, and getting your GI system back on track after a course of antibiotics [2:02:30]; More.

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