Glucocorticoid-enhanced extinction-based exposure therapy in Irritable Bowel Syndrome

We have previously demonstrated that experimental lowering of serotonergic activity by means of Acute Tryptophan Depletion (ATD) leads to an increased visceral pain perception following a rectal stimulus by means of fMRI, including the activity of the brain emotional arousal network. We demonstrated an ATD-induced loss of negative feedback inhibition of the amygdala during visceral stimulation and showed a similar response in IBS patients. This loss of negative feedback from the amygdala leads to an increased activity of the emotional arousal network, resulting in an increased perception of visceral pain.