Pharmacology & therapeuticsMar 1, 2025

Inflammatory bowel disease and mental health problems: How the gut-brain connection works and new treatments targeting gut microbes

Gut-Brain Axis Weekly Brief ↗PubMed ↗DOI ↗

Updated Apr 6, 2026

Abstract

Up to 35% of patients with inflammatory bowel disease (IBD) experience neuropsychiatric disorders.

Inflammatory bowel disease includes Crohn's disease and ulcerative colitis, which are characterized by severe gastrointestinal symptoms.
Neuropsychiatric disorders, such as anxiety and depression, may arise as secondary conditions linked to IBD.
Disturbed communication between the gut and the brain, facilitated by the microbiota-gut-brain axis, may contribute to these neuropsychiatric disorders.
Different pathways involving neural, immune, hormonal, and microbial communication are implicated in the development of central nervous system disorders associated with IBD.
Emerging therapies targeting the microbiota-gut-brain axis, including fecal microbiota transplantation and psychobiotics, may help alleviate symptoms of IBD and related neuropsychiatric conditions.

Simplified

Crohn's disease (CD) and ulcerative colitis (UC) are the two major entities of inflammatory bowel disease (IBD). These disorders are known for their relapsing disease course and severe gastrointestinal symptoms including pain, diarrhoea and bloody stool. Accumulating evidence suggests that IBD is not only restricted to the gastrointestinal tract and that disease processes are able to reach distant organs including the brain. In fact, up to 35 % of IBD patients also suffer from neuropsychiatric disorders such as generalized anxiety disorder and major depressive disorder. Emerging research in this area indicates that in many cases these neuropsychiatric disorders are a secondary condition as a consequence of the disturbed communication between the gut and the brain via the microbiota-gut-brain axis. In this review, we summarise the current knowledge on IBD-associated neuropsychiatric disorders. We examine the role of different pathways of the microbiota-gut-brain axis in the development of CNS disorders highlighting altered neural, immunological, humoral and microbial communication. Finally, we discuss emerging therapies targeting the microbiota-gut-brain axis to alleviate IBD and neuropsychiatric symptoms including faecal microbiota transplantation, psychobiotics, microbial metabolites and vagus nerve stimulation.

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Inflammatory bowel disease and mental health problems: How the gut-brain connection works and new treatments targeting gut microbes

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