Abstract
Gastrointestinal (GI) complications are seen in over 50% of ischemic stroke survivors;
the most common complications are dysphagia, constipation, and GI bleeding. The bidirectional
relationship of the gut–brain axis and stroke has recently gained traction, wherein
stroke contributes to gut dysbiosis (alterations in the normal host intestinal microbiome)
and gut dysbiosis perpetuates poor functional neurologic outcomes in stroke. It is
postulated that the propagation of proinflammatory cells and gut metabolites (including
trimethylamine N-oxide and short-chain fatty acids) from the GI tract to the central
nervous system play a central role in gut–brain axis dysfunction. In this review,
we discuss the known GI complications in acute ischemic stroke, our current knowledge
from experimental stroke models for gut–brain axis dysfunction in stroke, and emerging
therapeutics that target the gut–brain axis.
Keywords
ischemic stroke - gastrointestinal - microbiome - complications - gut–brain axis
