{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T14:02:54Z","timestamp":1776261774812,"version":"3.50.1"},"reference-count":34,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T00:00:00Z","timestamp":1776211200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Physiol."],"abstract":"<jats:p>For decades, disorders of gut-brain interaction (DGBI) have been ensnared in an epistemological bottleneck, clinically managed as diagnoses of exclusion despite the absence of structural pathology on conventional endoscopy. Traditional bottom-up models of visceral hypersensitivity fail to explain the profound subjective-objective symptom mismatches observed in clinical practice. This Perspective proposes a radical paradigm shift: leveraging the Predictive Processing (PP) framework to reconceptualize DGBI as a hierarchical computational dysfunction termed \u201cinteroceptive overfitting\u201d. We postulate that rigid, high-precision threat priors force the salience network (dACC and aIns) to misallocate pathologically high precision weighting to baseline physiological noise, such as healthy 3-cycles-per-minute (cpm) gastric slow waves. This top-down failure synthesizes illusory pain and triggers genuine autonomic disruption via active inference, creating a self-fulfilling loop of GI micro-sabotage. We present a clinical roadmap utilizing high-resolution body surface gastric mapping (BSGM) and Ecological Momentary Assessment (EMA) to identify \u201cProbabilistic Mismatch Points\u201d within a multimodal diagnostic matrix that accounts for non-rhythmic peripheral modulators. To resolve therapeutic stagnation, we propose closed-loop digital therapeutics (DTx) designed to recalibrate the brain\u2019s predictive engine through validation-correction loops, targeted extinction learning, and dual-stream telemetry. This computational framework provides a rigorously scientific blueprint to resolve therapeutic stagnation in DGBI.<\/jats:p>","DOI":"10.3389\/fphys.2026.1817832","type":"journal-article","created":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T13:09:13Z","timestamp":1776258553000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Assessment of gut-brain interactions: reframing DGBI symptoms from visceral hypersensitivity to computational interoceptive overfitting"],"prefix":"10.3389","volume":"17","author":[{"given":"Dakai","family":"Zeng","sequence":"first","affiliation":[{"name":"Third Affiliated Hospital of Wenzhou Medical University","place":["Wenzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"He","family":"Zeng","sequence":"additional","affiliation":[{"name":"Third Affiliated Hospital of Wenzhou Medical University","place":["Wenzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zi","family":"Lin","sequence":"additional","affiliation":[{"name":"Third Affiliated Hospital of Wenzhou Medical University","place":["Wenzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wen-Jing","family":"Yan","sequence":"additional","affiliation":[{"name":"The Affiliated Kangning Hospital of Wenzhou Medical University","place":["Wenzhou, China"]},{"name":"Zhejiang Provincial Clinical Research Center for Mental Health, The Affiliated Wenzhou Kangning Hospital, Wenzhou Medical University","place":["Wenzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,15]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"61","DOI":"10.5056\/jnm25094","article-title":"Combined gastric Alimetry and gastric emptying scintigraphy testing increases clinician certainty in the diagnosis and management of suspected gastroparesis","volume":"32","author":"Abraham","year":"2026","journal-title":"J. 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