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DWI HASTUTI
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Journal : Eksakta : Berkala Ilmiah Bidang MIPA

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Gastrointestinal Dysfunction after Traumatic Brain Injury: Mechanisms Linking The Gut, Inflammation, and the HPA Axis Dwi Hastuti; A Jusman, Sri Widia; Reni Paramita
EKSAKTA: Berkala Ilmiah Bidang MIPA Vol. 26 No. 04 (2025): Eksakta : Berkala Ilmiah Bidang MIPA (E-ISSN : 2549-7464) In Progress
Publisher : Faculty of Mathematics and Natural Sciences (FMIPA), Universitas Negeri Padang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24036/eksakta/vol26-iss04/601

Abstract

Traumatic brain injury (TBI) is a major global health problem that often leads to systemic complications beyond neurological damage, notably gastrointestinal (GI) dysfunction. The mechanisms linking TBI to GI complications remain inconclusive. We conducted a systematic review using current clinical evidence on the pathophysiological processes underlying post-TBI GI dysfunction, focusing on two principal mechanisms: inflammatory-oxidative processes and hypothalamic–pituitary–adrenal (HPA) axis alterations. A comprehensive search was conducted through PubMed, Cochrane Library, and Scopus to identify eligible studies. Evidence indicates that surges of proinflammatory mediators and chemokines, along with reduced anti-inflammatory mediators, drive systemic immune imbalance. Moreover, iNOS upregulation and gut microbiota dysbiosis contribute to mucosal injury. Concurrently, HPA axis dysregulation exerts a bidirectional impact. Elevated ACTH and cortisol reflect an intact stress response that may stabilise metabolism if combined with early enteral nutrition, whereas critical illness-related corticosteroid insufficiency (CIRCI) and hypergastrinemia are strongly associated with gastrointestinal bleeding and mortality. Together, these findings underscore the synergistic role of inflammatory and endocrine disturbances in driving gastrointestinal vulnerability after TBI. Understanding these mechanisms is crucial for developing biomarker-based monitoring and targeted interventions to improve prognosis and reduce GI-related complications in TBI patients.
Co-Authors . Hartoyo A Jusman, Sri Widia Abdullah Osman Afif Nuril Musthofa Akbar Kurniawan Alfiasari Arini Siti Sundari Aroma Elmina Martha Asdi Agustar Astia Aprina Aulia Rahma, Fadilla M. Avanti Vera Risti Pramudyani BUDI SETIAWAN Dian Nur Afriyani Diyah Dwi Lestari Dodik Briawan Dwi Kurniati Putri Ega Asnatasia Maharani Emilia Emilia Ety Riyani Febritesna Nuraini Fitri Wulandari Hadi Mulyono Hadiyah Hadiyah Happy Primariasari Helen Parkhurst Hendriyaldi Henik Puji Rahayu Heriberta Heriberta Herien Puspitawati Humairoh Habibatul Karimah , Siti Husna Azizaturrahmah Husnurijal Idris Mohd Noor Ifdal Ikeu Tanziha Ilham Solihin Indah Rahmawati Indriyani, Novi Irni Rahmayani Johan Iyan Sofyan Juhriyansyah Dalle Junita Dwi Wardhani Kartika Andi Karya Pamungkas, Teguh Laksmi Indiati Leni Novita Lia Eliana Lilik N Yuliati Lilik Noor Yuliati Mariana Wahyu Listyati May Kristiani Simarmata Maya Eliana Melly Latifah Mohammad Nur Indro Muhammad Ridwansyah Mustamin, Syarifa Nadhrah Parmadi Rachmawati Hadori Rafiqi Rahma Nurjanah Rasyida Shabihah Zukro Aini Ratna Megawangi Reni Paramita Rety Puspitasari Ridhatul Aisy Rika Hardani Riski Hernando Sagita Rochman Santo Mugi Prayitno Siti Hodijah Solly Aryza Syaparuddin Syaparuddin Titik Purwati Widowati Titik Sumarti Titik Sumarti Tri Muji Ermayanti Triana Setyawardani Veriati Siregar Widiastuti, Fitri Wiwik Mulyani Yiyin Bayinah Yulina Eva Riany Yulmardi Yulmardi Zulkarnain Lubis