Attenuation of the colorectal tonic reflex in female patients with irritable bowel syndrome

2005 ◽  
Vol 289 (3) ◽  
pp. G489-G494 ◽  
Author(s):  
Clinton Ng ◽  
Mark Danta ◽  
John Kellow ◽  
Caro-Anne Badcock ◽  
Ross Hansen ◽  
...  
Keyword(s):  
Irritable Bowel Syndrome ◽  
Healthy Subjects ◽  
Rectal Balloon ◽  
Tonic Response ◽  
Rectal Tone ◽  
Colonic Distension ◽  
Normal Increase ◽  
Irritable Bowel ◽  
Tonic Reflex ◽  
Healthy Females

Alterations in normal intestinointestinal reflexes may be important contributors to the pathophysiology of irritable bowel syndrome (IBS). Our aims were to compare the rectal tonic responses to colonic distension in female IBS patients with predominant constipation (IBS-C) and with predominant diarrhea (IBS-D) to those in healthy females, both fasting and postprandially. Using a dual barostat assembly, 2-min colonic phasic distensions were performed during fasting and postprandially. Rectal tone was recorded before, during, and after the phasic distension. Colonic compliance and colonic sensitivity in response to the distension were also evaluated fasting and postprandially. Eight IBS-C patients, 8 IBS-D patients, and 8 age- and sex-matched healthy subjects ( group N) participated. The fasting increments in rectal tone in response to colonic distension in both IBS-C (rectal balloon volume change −4.6 ± 6.1 ml) and IBS-D (−7.9 ± 4.9 ml) were significantly reduced compared with group N (−34 ± 9.7 ml, P = 0.01). Similar findings were observed postprandially ( P = 0.02). When adjusted for the colonic compliance of individual subjects, the degree of attenuation in the rectal tonic response in IBS compared with group N was maintained (fasting P = 0.007; postprandial P = 0.03). When adjusted for colonic sensitivity there was a trend for the attenuation in the rectal tonic response in IBS patients compared with group N to be maintained (fasting P = 0.07, postprandial P = 0.08). IBS patients display a definite attenuation of the normal increase in rectal tone in response to colonic distension (colorectal reflex), fasting and postprandially. Alterations in colonic compliance and sensitivity in IBS are not likely to contribute to such attenuation.

scholarly journals On the Pathogenesis of the Irritable Bowel Syndrome: The Irritable Bowel or the Irritable Patient?

1990 ◽  
Vol 4 (1) ◽  
pp. 33-38
Author(s):  
Stephen M Collins
Keyword(s):  
Irritable Bowel Syndrome ◽  
Healthy Subjects ◽  
Behavioural Problem ◽  
Pain Tolerance ◽  
Organic Disease ◽  
Gastrointestinal Dysfunction ◽  
Traditional Philosophy ◽  
Irritable Bowel ◽  
Experience Pain

The traditional perspective of irritable bowel syndrome (IBS) as a behavioural problem has tended to downplay the role of gastrointestinal dysfunction. Contrary to predictions based on the traditional philosophy, a recent study has shown that IBS patients have increased pain tolerance compared to healthy subjects. This profile of pain tolerance is similar to that seen in chronic organic disease of the gut (eg, Crohn's disease), raising the possibility that IBS patients may experience pain resulting from gastrointestinal dysfunction. The recent finding of increased airway responsiveness to inhaled methacholine in certain IBS patients provides an objective and quantifiable measurement of tissue dysfunction in that syndrome, and focuses attention on possible mechanisms underlying the altered responsiveness of hollow organs in patients with IBS; these mechanisms are discussed.

Su2047 Fecal and Mucosal Intestinal Microbiota in Postinfectious Irritable Bowel Syndrome (IBS) Patients Differs From General IBS Patients As Well As Healthy Subjects

2015 ◽  
Vol 148 (4) ◽  
pp. S-584
Author(s):  
Johanna Sundin ◽  
Ignacio Rangel ◽  
susana fuentes ◽  
Elisabeth Hultgren Hörnquist ◽  
Willem M. de Vos ◽  
...  
Keyword(s):  
Irritable Bowel Syndrome ◽  
Intestinal Microbiota ◽  
Healthy Subjects ◽  
Irritable Bowel ◽  
Postinfectious Irritable Bowel Syndrome

scholarly journals Rectal Visceral Sensitivity in Women with Irritable Bowel Syndrome without Psychiatric Comorbidity Compared with Healthy Volunteers

2009 ◽  
Vol 2009 ◽  
pp. 1-8 ◽  
Author(s):  
Signe Spetalen ◽  
Leiv Sandvik ◽  
Svein Blomhoff ◽  
Morten B. Jacobsen
Keyword(s):  
Irritable Bowel Syndrome ◽  
Healthy Volunteers ◽  
Psychiatric Disorders ◽  
Psychiatric Comorbidity ◽  
Normal Pressure ◽  
Visceral Sensitivity ◽  
Staircase Method ◽  
Phobic Anxiety ◽  
Rectal Tone ◽  
Irritable Bowel

Background.Psychiatric comorbidity and visceral hypersensitivity are common in patients with irritable bowel syndrome (IBS), but little is known about visceral sensitivity in IBS patients without psychiatric disorders.Aim.We wanted to examine rectal visceral sensitivity in IBS patients without comorbid psychiatric disorders, IBS patients with phobic anxiety and healthy volunteers.Methods.A total of thirty-eight female, non-constipated IBS patients without psychiatric disorders and eleven female IBS patients with phobic anxiety were compared to nine healthy women using a barostat double random staircase method. The non-psychiatric patients were divided into those with diarrhoea predominant symptoms and those with alternating stool habits.Results.The IBS patients without psychiatric disorders had normal visceral pressure thresholds. However, in the diarrhoea predominant subgroup, the volume discomfort threshold was reduced while it was unchanged in those with alternating stool habits. The phobic IBS patients had similar thresholds to the healthy volunteers. The rectal tone was increased in the non-psychiatric IBS patients with diarrhoea predominant symptoms and in the IBS patients with phobic anxiety.Conclusions.Non-constipated IBS patients without psychiatric disorders had increased visceral sensitivity regarding volume thresholds but normal pressure thresholds. Our study suggests that the lowered volume threshold was due to increased rectal tone.

Viscerosensory-cardiovascular reflexes: altered baroreflex sensitivity in irritable bowel syndrome

2005 ◽  
Vol 289 (4) ◽  
pp. R970-R976 ◽  
Author(s):  
Patrick P. J. van der Veek ◽  
Cees A. Swenne ◽  
Hedde van de Vooren ◽  
Annelies L. Schoneveld ◽  
Roberto Maestri ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Irritable Bowel Syndrome ◽  
Baroreflex Sensitivity ◽  
Cardiovascular Reflexes ◽  
Healthy Controls ◽  
Rectal Balloon ◽  
Arterial Blood ◽  
Cardiovascular Reflex ◽  
Irritable Bowel ◽  
Intense Stimulation

Animal studies have demonstrated that visceral afferent stimulation alters autonomic cardiovascular reflexes. This mechanism might play an important role in the pathophysiology of conditions associated with visceral hypersensitivity, such as irritable bowel syndrome (IBS). As such, studies in humans are lacking, we measured viscerosensory-cardiovascular reflex interactions in IBS patients and healthy controls. Systolic blood pressure (SBP), heart rate (HR), and arterial baroreflex sensitivity (BRS) were studied in 87 IBS patients and 36 healthy controls under baseline conditions and during mild (15 mmHg) and intense (35 mmHg) visceral stimulation by rectal balloon distension. BRS was computed from continuous ECG and arterial blood pressure signals (Finapres-method) during 5-min periods of 15-min metronome respiration. Baseline SBP and HR were not different between patients and controls. In both groups, SBP increased similarly during rectal stimulation, whereas HR decreased during mild and increased intense stimulation. BRS was significantly higher in patients compared with controls at baseline (7.9 ± 5.4 vs. 5.7 ± 3.7 ms/mmHg, P = 0.03) and increased significantly in both groups during mild stimulation. This increase persisted in controls during intense stimulation, but BRS returned to baseline in patients. BRS was not significantly different between groups during rectal distension. This study demonstrates the presence of a viscerosensory-cardiovascular reflex in healthy individuals and in IBS patients. The increased BRS in IBS patients at baseline may either be a training-effect (frequent challenging of the reflex) or reflects altered viscerosensory processing at the nucleus tractus solitarii.

scholarly journals High Prevalence of Ultrasound Verified Enthesitis in Patients With Inflammatory Bowel Disease With or Without Spondylarthritis

2021 ◽  
Vol 8 ◽  
Author(s):  
Rusmir Husic ◽  
Angelika Lackner ◽  
Patrizia Katharina Kump ◽  
Christoph Högenauer ◽  
Winfried Graninger ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Irritable Bowel Syndrome ◽  
Bowel Disease ◽  
Healthy Subjects ◽  
Ultrasound Examination ◽  
Clinical Signs ◽  
Extraintestinal Manifestation ◽  
High Prevalence ◽  
Inflammatory Bowel ◽  
Irritable Bowel

Background: Inflammatory bowel disease (IBD) is closely associated with spondylarthritis (SpA) and enthesitis, as an important feature of SpA, is a common extraintestinal manifestation of IBD. Enthesitis may be clinically silent in a high proportion of patients with IBD without clinical signs or a diagnosis of SpA.Objectives: The aim of this study was to compare the prevalence of ultrasound (US) verified enthesitis in IBD patients with and without SpA, with patients with irritable bowel syndrome (IBS) and healthy subjects (HC) serving as controls.Methods: IBD patients with or without SpA, patients with IBS and HC were prospectively recruited and clinically assessed. Ultrasound examination was performed at 14 entheses. The ultrasound abnormalities were scored according to the Madrid Ankylosing Spondylitis Enthesitis Index (MASEI).Results: We included 33 IBD patients without SpA, 14 IBD patients with SpA, 26 IBS patients and 18 HC. Higher MASEI scores were found in patients with IBD without SpA [median 21.0 range (8.0–53.0)] and IBD associated SpA [33.0 (8–50)] than in IBS patients [10.5 (0–42.0)-p < 0.001 for both comparison] and HC [12.0 (2.0–38.0)-p < 0.01]. PD, enthesophytes and erosions were more common in patients with IBD with or without SpA as compared to IBS patients and HC. IBD patients with SpA compared to IBD without SpA demonstrated significant higher prevalence of erosion and structural irregularity and consequently significant higher MASEI (p < 0.05 for all comparison).Conclusions: Ultrasound verified enthesitis is more common in patients with IBD with or without SpA as compared to patients with IBS or HC.

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