Bridging the gap from mechanism to clinic: a translational perspective on taVNS for gastrointestinal disorders

In recent years, multiple clinical and translational studies have investigated the application and mechanisms of transcutaneous auricular vagus nerve stimulation (taVNS) in gastrointestinal disorders (GIDs), with consideration given to pathophysiology, stimulation parameters, and patient-specific factors. In this review, we systematically synthesize recent evidence from clinical trials and preclinical models published in leading gastroenterology and neurology journals. Our focus is on taVNS-mediated modulation of the brain, gut axis, particularly its role in improving autonomic balance, reducing visceral sensitivity, and attenuating inflammatory responses, with the aim of enhancing therapeutic outcomes in functional and inflammatory GIDs. There is a need to optimize stimulation protocols through mechanistic insights and to promote the use of this non-invasive, well-tolerated neuromodulation approach. These advances are essential for expanding taVNS accessibility in clinical practice, especially for patients with refractory symptoms, comorbid psychological conditions, and in settings where conventional treatments are limited or contraindicated. Personalized taVNS strategies and biomarker-guided dosing represent emerging trends in neuromodulation therapy. However, standardized protocols and predictive models have yet to be established for widespread clinical implementation.