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Accumulating evidence links the microbiota, mucosal immunity, and the enteric nervous system (ENS); their mechanistic integration remains incomplete. In this narrative review, we propose a Trigger\u2013Gateway\u2013Hub\u2013Effector framework as a heuristic and hypothesis-generating model to organize fragmented evidence on microbial-to-immune\u2013neural interactions. Within this framework, dysbiosis-associated microbial metabolites, including short-chain fatty acids, bile acids, methane-related pathways, and lipopolysaccharide, are considered potential upstream \u201cTriggers\u201d that may modulate epithelial and immune homeostasis. \u201cGateway\u201d processes refer to epithelial barrier vulnerability and mucosal immune changes that may permit microbial or inflammatory signals to affect deeper intestinal compartments. At the \u201cHub\u201d level, interactions among muscularis macrophages, mast cells, enteric glia cells, and neurons are proposed to integrate these signals and contribute to ENS-adjacent neuroimmune stress. These processes may converge on downstream \u201cEffector\u201d alterations, including neuronal vulnerability, maladaptive plasticity, and disruption of the interstitial cells of Cajal network, particularly in severe or refractory STC. However, there is currently limited direct evidence to support a continuous causal chain linking microbiome-derived signals to dysfunction of the enteroneural system. Many of the proposed mechanisms are inferred from preclinical studies or related gastrointestinal disorders. Therefore, this framework should be interpreted as a testable conceptual model rather than a confirmed pathogenic sequence. We further discuss the translational implications from a systems biology perspective, emphasizing evidence-weighted therapeutic interpretation, mechanism-guided stratification, and integrated microbial-immune-ENS assessment. Future human-centered studies combining multi-omic profiling, spatial tissue analysis, and objective neuromuscular readouts are needed to refine this model and inform precision-oriented therapeutic strategies for FC\/STC.<\/jats:p>","DOI":"10.3389\/fimmu.2026.1851825","type":"journal-article","created":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T04:24:13Z","timestamp":1782966253000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Microbiota\u2013immune\u2013enteric nervous system interactions in functional constipation: a narrative review and hypothesis-generating framework"],"prefix":"10.3389","volume":"17","author":[{"given":"Dingzuo","family":"Ge","sequence":"first","affiliation":[{"name":"Hospital of Chengdu University of Traditional Chinese Medicine","place":["Chengdu, 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