Slow, deep breathing has been shown to activate the vagus nerve - the longest of the cranial nerves which courses from the brainstem to the gastrointestinal tract, innervating multiple viscerae en-route. In a preliminary study, deep breathing has been shown to prevent the development of acid-induced oesophageal hypersensitivity in comparison with sham breathing. This effect was pharmacologically blocked with atropine, thus providing evidence that the parasympathetic nervous system (i.e. vagus nerve) influences the development of oesophageal pain hypersensitivity. In general, vagus nerve stimulation has been shown as a promising therapeutic tool in the management of pain, and is NICE approved for the management of cluster headache. The overall aim of this systematic review and meta-analysis would be to provide an overview of studies that have been published hitherto which look at the relationship between slow, deep breathing and gastrointestinal pain. Further reading / references: https://gut.bmj.com/content/64/4/611.abstract https://onlinelibrary.wiley.com/doi/full/10.1111/joa.13122 Update **Thank you to the very many people who signed up this project. We have been overwhelmed by the response and it is so encouraging to see medical students interested in neurogastroenterology. Unfortunately, the project aims have changed as I have been made aware that another group is already looking at the deep breathing and visceral pain landscape. Apparently, more papers addressing this field will be released later this year, so it wouldn't be worthwhile to pursue a systematic review at this particular time. However, I am liaising with our PI and we are thinking of other visceral pain systematic reviews, which will most likely be related to the relationship between personality / psychopathology and pain perception in functional gastrointestinal diseases, like IBS. If neuro/psychogastroenterology is a field you are interested to learn more about, please still sign up to this particular project and I will update you as soon as we have the new project aims. Keep safe during this period. My e-mail address is m.butt@qmul.ac.uk if you would like to get in touch directly. All the best.**
Mohsin Butt
Remarxs