Circadian rhythms: a regulator of gastrointestinal health and dysfunction

ABSTRACT

Introduction: Circadian rhythms regulate much of gastrointestinal physiology including cell proliferation, motility, digestion, absorption, and electrolyte balance. Disruption of circadian rhythms can have adverse consequences including the promotion of and/or exacerbation of a wide variety of gastrointestinal disorders and diseases.

Areas covered: In this review, we evaluate some of the many gastrointestinal functions that are regulated by circadian rhythms and how dysregulation of these functions may contribute to disease. This review also discusses some common gastrointestinal disorders that are known to be influenced by circadian rhythms as well as speculation about the mechanisms by which circadian rhythm disruption promotes dysfunction and disease pathogenesis. We discuss how knowledge of circadian rhythms and the advent of chrono-nutrition, chrono-pharmacology, and chrono-therapeutics might influence clinical practice.

Expert opinion: As our knowledge of circadian biology increases, it may be possible to incorporate strategies that take advantage of circadian rhythms and chronotherapy to prevent and/or treat disease.

KEYWORDS:

• Circadian rhythm
• diurnal fluctuation
• clock genes
• shift work
• circadian rhythm disruption
• social jet lag
• chronotype
• intestine
• gastrointestinal tract
• gastrointestinal disease

Article highlights

• Circadian rhythms are 24-hour fluctuations in biology and behavior that are driven by a molecular circadian clock that is present in nearly every cell in the mammalian body including in the intestine

• Circadian rhythms govern much of gastrointestinal physiology including cell proliferation, motility, secretion, electrolyte balance, and the digestion and absorption of proteins, carbohydrates, and lipids

• Disruption of circadian rhythms may be a risk factor that promotes a wide variety of gastrointestinal conditions and diseases including traveler’s diarrhea, peptic ulcer, gastroesophageal reflux disease, inflammatory bowel disease, and colorectal cancer

• Circadian-directed approaches may improve gastrointestinal symptoms and treatment (e.g. chrono-nutrition, chrono-pharmacology, chrono-therapeutics).

Increased awareness of the important role of circadian rhythms in gastrointestinal health and disease may lead to innovative approaches to manage gastrointestinal health and mitigate disease

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was supported, in part, by the U.S. Department of Health and Human Services, National Institutes of Health, National Institute on Alcohol Abuse and Alcoholism: AA023417.