Magnesium orotate has been cited in the medical literature for the past three years as a possible adjuvant in some pediatric and adult gastroenterological disorders associated with dysbiosis. Studies also focus on the possibility of adding magnesium orotate in psychiatric disorders’ treatment, such as major depression and anxiety. The most relevant element in these studies is the efficiency of magnesium orotate therapy in cases with both gastroenterological and psychiatric symptoms. This article proposes a literature review, focused on the studies published in the last three years, targeting magnesium orotate treatment and probiotic supplementation in patients with both digestive and psychiatric symptoms. Moreover, this review will compare the efficiency of magnesium orotate and probiotics within both the pediatric and adult communities, focusing on the possibility of gut–brain axis modulation and its involvement in the clinical evolution of these patients.

Background: A healthy sleep–wake cycle is fundamental for regulating immune function. Sleepiness and fatigue are often manifestations of chronic inflammatory disorders, such as inflammatory bowel disease (IBD), potentially influencing the course of the disease. Our aim was to characterize sleep impairment in patients with IBD and to identify potential associated factors. Methods: We conducted a single-center prospective case control study including IBD patients and healthy controls. We evaluated clinical and biochemical parameters, sleep impairment through Pittsburgh Sleep Quality Index (PSQI) and anxiety and depression through Hospital Anxiety and Depression Scale (HADS) questionnaires. Results: In total, 110 patients with IBD and 66 healthy controls were included. Patients with IBD had a significantly altered sleep quality compared to the control group (p < 0.001), with sleep impairment also occurring for patients in remission (median PSQI = 7), but without significant differences between ulcerative colitis and Crohn’s disease. However, PSQI was correlated with disease activity scores only for ulcerative colitis and not for Crohn’s disease. Among patients with increased PSQI, only 30.19% used sleep medication. Sleep impairment was significantly correlated with altered psychological status (p < 0.01) and the presence of extraintestinal manifestations (p = 0.0172). Conclusions: Sleep impairment is frequent among patients with IBD, is associated with psychological distress and several disease-related parameters and should be routinely evaluated, at least in several IBD patient subgroups, to improve disease management.

Functional Gastrointestinal Disorders have been an important cause of poor life quality in affected populations. The unclear etiology and pathophysiological mechanism alter the clinical evolution of the patient. Although a strong connection with psychological stress has been observed, it was not until recently that the gut–brain axis involvement has been revealed. Furthermore, the current literature not only promotes the gut–brain axis modulation as a therapeutical target for functional digestive disorders but also states that the gut microbiome has a main role in this bi-directional mechanism. Psychiatric symptoms are currently recognized as an equally important aspect of the clinical manifestation and modulation of both the digestive and central nervous systems and could be the best approach in restoring the balance. As such, this article proposes a detailed description of the physiology of the microbiome–gut–brain axis, the pathophysiology of the functional gastrointestinal disorders with psychiatric symptoms and current perspectives for therapeutical management, as revealed by the latest studies in the scientific literature.

Inflammatory bowel disease represents one of the most life-altering gastrointestinal pathologies, with its multifactorial nature and unclear physiopathology. The most relevant clinical forms, ulcerative colitis and Crohn’s disease, clinically manifest with mild to severe flares and remission periods that alter the patient’s social, familial and professional integration. The chronic inflammatory activity of the intestinal wall determines severe modifications of the local environment, such as dysbiosis, enteric endocrine, nervous and immune system disruptions and intestinal wall permeability changes. These features are part of the gastrointestinal ecosystem that modulates the bottom-to-top signaling to the central nervous system, leading to a neurobiologic imbalance and clinical affective and/or behavioral symptoms. The gut-brain link is a bidirectional pathway and psychological distress can also affect the central nervous system, which will alter the top-to-bottom regulation, leading to possible functional digestive symptoms and local inflammatory responses. In the middle of this neuro-gastrointestinal system, the microbiome is a key player, as its activities offer basic functional support for both relays. The present article presents current scientific information that links the pathophysiology and clinical aspects of inflammatory bowel disease and psychiatric symptomatology through the complex mechanism of the gut-brain axis and the modulatory effects of the gut microbiota.

Although the therapeutic potential of virtual reality has been foreseen since over half a century ago, the lack of graphical processing power made it impossible to apply in medical therapeutic sciences until last decade; nowadays, the hardware required for virtual reality is even 100 times more affordable. A head-mounted display induces immersivity engulfing the subject’s eyesight perception in a stereoscopic manner. The same tool that may aid better self understanding and bonding can also trigger psychopathological mechanisms through which the user becomes alienated from the real world. As virtual reality became even more popular during SARS-COV2 pandemic, users worldwide have spent more time into a virtual world. Depersonalization/derealization syndrome can occur if virtual reality is abused. The greater the person’s involvement in virtual reality, the greater the chance of a lack of bodily self (depersonalization). Controllers that mimic hands could prevent the subject from acknowledging the real world as true – derealization. Virtual reality’s dissociative potential is related to individual psychological traits and prolonged exposure. Children are the most prone to develop behavioral changes. Adults may develop behavioral problems related to virtual reality gaming, gambling, pornography and also social networking through created avatars. Blue light wavelength could harm sleep architecture and circadian rhythm by disrupting melatonin, therefore making virtual reality exposure problematic after sunset. State of the art reveals that using virtual reality in a therapeutic manner, actually facilitates the fight against addictions with cue therapy intended to extinguish conditioned response. The exposure to a substance (nicotine, alcohol, or any other psychoactive recreational abuse potential substances) can trigger craving in a controlled environment, that is malleable in the hands of the therapist. Virtual reality can offer an exposure perspective that is both vivid enough to be a challenge, but also safe enough to ensure patient involvement and to amplify the therapeutic alliance.

Modern medicine tends to evolve towards interdiciplinary collaboration and case management. A strong example in that direction is represented by neurogastroenterology, a field that developed arround the concept of gut-brain axis. Still, research in this field determend the multisystemic role of the gut microbiome, beyond it's regulatory function within the gut-brain axis. The purpose of this review is to focus on the current knowledge in medical literature regarding gut microbiome and its possible invovlvement in medical areas, such as cardiology, rheumatology, pneumology, neurology and psychiatry, bringing these domains closer then ever. We researched Google Scholar, Scopus, PubMed and Wiley Library for articles containing the following key words: “microbiota”, “intestinal bacteria”, “disbiosis”, “probiotics”, “prebiotics”, “rheumatology”, “cardiology”, “diabetes”, “metabolic disease”, “clinical medicine” “cardiology”, “cardiovascular”. Articles were selected by number of acceses, citations, results and by being published between 2015 and 2023. Both animal and clinical studies were considered as well as literature reviews and systematic reviews. Although many studies are still in preclinical phase, and some of them still have uneven results, the road for research has contured theories, especially regarding physiologic and pathophysiologic functions that involve the microbiome and have multisystemic consequences. Conclusions. The gut microbiome may be the key of understanding multi-organic pathophysiologic