The Second Brain: A Groundbreaking New Understanding of Nervous Disorders of the Stomach and Intestineby Published 17 Nov 1999
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“Persuasive, impassioned... hopeful news [for those] suffering from functional bowel disease.” — New York Times Book Review
Dr. Gershon’s groundbreaking book fills the gap between what you need to know—and what your doctor has time to tell you.
Dr. Michael Gershon has devoted his career to understanding the human bowel (the stomach, esophagus, small intestine, and colon). His thirty years of research have led to an extraordinary rediscovery: nerve cells in the gut that act as a brain. This "second brain" can control our gut all by itself. Our two brains—the one in our head and the one in our bowel—must cooperate. If they do not, then there is chaos in the gut and misery in the head—everything from "butterflies" to cramps, from diarrhea to constipation. Dr. Gershon's work has led to radical new understandings about a wide range of gastrointestinal problems including gastroenteritis, nervous stomach, and irritable bowel syndrome.
The Second Brain represents a quantum leap in medical knowledge and is already benefiting patients whose symptoms were previously dismissed as neurotic or "it's all in your head."
The Second Brain: A Groundbreaking New Understanding of Nervous Disorders of the Stomach and Intestine Reviews
This was a good book. The first half was very educational and really written for the non-scientist. The second half, however, started to drag. I suppose that there is really not a lot you can do to make the descriptions of cell migrations and genetic mutations readily accessible to the common folk. But he does his best. I was uncomfortable reading about how bowels were segregated from the animals that once housed them and being reminded over and over again that scientific research of this sort is done on live or once live animals. I have a good mental knowledge that this happens but, like seeing or reading about where my hamburgers come from, I prefer to remain oblivious to the details. He does, however, dedicate the last two pages of the book to justifying the animal experiments. And, yep, it fits with my good mental knowledge. But still. Allow me to live in my fairy tale world!
The early part of the book was so hopeful and encouraging to those of us who suffer from gastrointestinal disorders and diseases. It was extremely informative and gave me a glimpse into what lies right around the corner to help us all out.
Your gut has its own intrinsic nervous system. If you were to cut the vagus nerves (that run between the brain and the bowel), the enteric nervous system would still go on functioning from stomach to colon.
This dude knows his stuff and really breaks it all down.
The author is not a gastroenterologist, but a neurobiologist, whose interest in the serotonin neurotransmitter took him down into the bowels of medicine. This book is a history of the development of the understanding of the intestinal nervous system, a history in which the author played a major role.
How Science is Actually Done
The author describes numerous experiments he and other conducted to figure out the intestinal nervous system. There is a great deal of information and the writing gets rather technical at times. This would be a good book for a college undergraduate science major to read.
Autonomic Nervous System
The autonomic nervous system is motor not sensory and controls smooth muscles and glands, not skeletal muscles. It has three parts:
• Sympathetic Nervous System
• Parasympathetic Nervous System
• Enteric Nervous System
Sympathetic Nervous System
• The nerve cell bodies are located near the spine
• Its nerves exit the spinal chord near the thoracic and lumbar vertebra
• Controls eye pupil dilation
• Controls male ejaculation
• Its axons release norepinephrine at their synapses
Parasympathetic Nervous System
• Its nerve cell bodies are located near the innervated organ
• Nerves exit the spinal chord near the cranial and sacral vertebra
• The vagus nerve is part of it
• Its axons release acetylcholine at their synapses
Enteric Nervous System
The intestines contain large numbers of interneurons, that is, neurons that connect via synapses only to other neurons, and not to sensory, muscle or gland cells. One of the main neurotransmitters used by these enteric interneurons is serotonin. Serotonin stimulates the peristalsis of the smooth muscles of intestines.
The colon is also known as the large intestine. It probably evolved to help land animals conserve water. The body moves water from inside the lumen of the colon into the bloodstream by removing salt from the lumen of the colon, which causes the water to follow by osmosis. There are lots of benign, symbiotic bacteria in the colon, but there are few bacteria in the small intestines. The purpose of diarrhea is to cleanse colon of pathogenic bacterial.
Development of the Enteric Nervous System
During embryonic development, the neural crest is formed from cells that migrate from the nearby neural tube. These neural crest cells later migrate to the intestines, where they become the enteric nervous system.
Defects of Intestinal Innervation
• Chagas disease (American trypanosomiasis), a tropical parasitic infection common in Latin America, kills enteric ganglia of Auerbach's myenteric plexus
• Hirschsprung’s Disease (congenital megacolon): babies lack enteric ganglia in the colon, due to a failure in the embryonic development of the enteric nervous system
• Neuronal Intestinal Dysplasia (NID): a congenital disease causing a lack of sympathetic or parasympathetic innervation of the intestines
• From Wikipedia I found that all newborns are kept in the hospital until they have their first bowel movement, in order to identify babies that have intestinal problems, and that in the United Kingdom there is a charity for NID called the Adele Chapman Foundation
Gastric Intrinsic Factor
Gastric glands in the stomach secrete a glycoprotein called gastric intrinsic factor that helps the small intestine absorb vitamin B12.
Liver and Gall Bladder
The liver secretes bile into the duodenum to emulsify fat, which is then digested by the lipase enzyme secreted into the duodenum by the pancreas. Excess bile is stored in the gall bladder. Gall bladder ganglia are part of the enteric nervous system.
Pancreas and the Vagus Nerve
The vagus nerve of the parasympathetic system stimulates the pancreas to increase secretions when eating a meal.
Pancreas and Bicarbonate
• Brunner’s glands of the pancreas produce a bicarbonate alkaline fluid to neutralize the stomach acid in the food that enters the duodenum from the stomach.
• Hormonal regulation: The secretin hormone produced by the duodenal endocrine cells tells the pancreas now much bicarbonate to produce.
• Nerve regulation: The pancreas receives serotonin-releasing neurons from the duodenum which inhibit the release of the bicarbonate.
Pancreas and Digestive Enzymes
• Cholecystokinin is released by endocrine cells in the stomach and travels through the bloodstream to the pancreas, where it stimulates the release of digestive enzymes.
• Gastrin is released by endocrine cells in the duodenum and travels through the bloodstream to the pancreas, where it also stimulates the release of digestive enzymes.
Enterochromaffin cells are found in intestinal lining and were named for the fact that they stain well with chromium dyes, because they have an affinity for chromium. Enterochromaffin cells contain 95% of the body’s serotonin. As was first proposed by the late Edith Bülbring of Oxford University, Fellow of the Royal Society, and pioneer in the study of the physiology of smooth muscle, enterochromaffin cells are sensory receptors that respond to pressure in the intestines by releasing serotonin into the connective tissue of the intestines. The serotonin in the connective tissue then stimulates:
• Secretomotor neurons that in turn stimulate the crypt cells to secrete salt into the lumen, and water then follows the salt into the lumen, due to osmotic pressure
• Enteric nervous system interneurons causing peristalsis
• Neurons that connect to the CNS and cause nausea and vomiting
Serotonin Transporter Protein
Serotonin transporter protein is in the outer membrane of neighbors of the enterochromaffin cells. It removes the serotonin after it has spent enough time stimulating the serotonin receptors.
Interstitial Cells of Cajal
• They are named after are named after the Spaniard Santiago Ramón y Cajal
• They are pacemakers in the enteric nervous system
• They amplify nerve signals
• They originate not in the neural crest, but from mesenchymal precursor cells, from which smooth muscle cells also develop
• Because they are not neurons, the body can produce more of them in adulthood, if some of them become damaged
Very interesting, but a little too technical for my pea brain; fascinating stuff, none the less. Too bad he's mainly into figuring out drugs for the ailments rather than more natural stuff. But as he sees it-natural ain't so good-and he points out e-coli and botchulism as being natural too; good point-but still....
This amazing scientist using storytelling technique to disclose well-kept secrets of the nervous system in the gut. This essential information will hopefully eventually seep into mainstream medicine, where it will benefit the masses suffering from gut disturbances, many of which are an unwitting resultant from pharmaceuticals.