What do we know about the connection between gut microbiota and pain?

Introduction and objective The relationship between gut microbiota and pain is crucial. Several studies demonstrate the evidence that gut microbiota play a key role in visceral, neuropathic and inflammatory pain. The proper profile of microbiota is also important in patients after surgeries and injuries who suffer from postoperative pain. In the present review study we assessed a comprehensive range of relevant literature to present the role of gut microbiota as the key factor in maintaining the structural integrity of the intestinal mucosal barrier, pain perception and modulation of the immune system. Review methods We conducted a literature review in February, 2023 searching for terms “Gut microbiome and pain", “Probiotic supplementation”, “Fecal microbial transplantation in patients with pain”. This publication includes the analysis of several case reports, which describe patients who were successfully treated with modification of gut microbiota composition. Brief description of the state of knowledge The gut microbiota is a diversity of many different microorganisms. They inhabit our gut and are the key to many aspects of human health. To understand how important the gut microbiome is we have to be aware of a bidirectional connection between the gut and the brain. The gut microbiota has an impact on the nervous system via the microbiome-gut-brain axis and the hypothalamic-pituitary-adrenal axis. Summary We propose novel therapeutic methods like probiotics or prebiotics or fecal microbiota transplantation as the new strategy for the management of pain. To reach this goal we need more clinical evidence to implement our theoretical knowledge to clinical practice.