OBJECTIVE: To investigate the biological mechanisms underlying the associations of psychological stress and intestinal inflammation in inflammatory bowel disease (IBD). DESIGN: Experimental mouse models and large human cohorts have been used. METHOD: Consecutive mouse models with chemically induced colitis were used to investigate biological pathways though which psychological stress leads to gut inflammation. These results were validated in three human cohorts with patients with IBD. RESULTS: Stress induced elevated levels of glucocorticoids drive the generation of an inflammatory subset of enteric glia cells. These enteric glia cells produce the protein CSF1, that promotes monocyte accumulation in the intestinal mucosa and TNF-mediated intestinal inflammation. CONCLUSION: A pivotal role for the enteric nervous system (ENS) has been discovered in mediating the aggravating effect of psychological stress on intestinal inflammation.