The Brain–Gut Axis in Traumatic Brain Injury: Implications for Nutrition Support

Abstract Purpose of Review Early enteral nutrition improves outcomes following traumatic brain injury (TBI). This can prove difficult due to TBI-induced feeding intolerance secondary disruption the brain-gut axis, a network composed central nervous system (CNS) input, autonomic signaling, and immunologic regulation that controls gut CNS homeostasis. Here, we discuss pathophysiology brain–gut axis dysregulation outline strategies in patients with TBI. Recent Findings Feeding TBI is multifactorial; complex signaling between CNS, sympathetic system, parasympathetic enteric homeostasis disrupted within hours post-injury. has profound effects on immune microbiome, further complicating post-TBI recovery. Despite this disruption, calorie protein requirements increase considerably TBI, early nutritional supplementation survival Enteral proven more efficacious than parenteral should be initiated 48 admission. Immune-fortified reduces inflammation may improve patients. Summary Although results paramount importance. enhances function. When feasible, injury.