Ambulatory small intestinal motility in 'diarrhoea' predominant irritable bowel syndrome.

Abstract

Dysmotility of the duodenum and proximal jejunum has been reported in patients with irritable bowel syndrome. This study extended these findings by recording fasting ambulatory motility from electronic strain gauge sensors sited in the jejunum and ileum of eight diarrhoea predominant irritable bowel syndrome patients and 12 healthy controls. During the day, periodicity of migrating motor complexes mean (SEM) did not differ between patients (92 (10) min) and controls (85 (7) min). At night, periodicity was shorter in both patients and controls, and the daytime dominance of phase II was replaced by phase I. In both groups, aboral progression of phase III fronts was associated with a slowing of propagation velocity and maximum contractile rate, but an increase in mean amplitude of contraction. Discrete clustered contractions were seen in seven patients and 10 controls occupying 14 and 16% of daytime phase II activity, respectively. Pain episodes were not associated with any specific motility patterns. Despite the lack ofmotility differences between the two groups, orocaecal transit time in the irritable bowel syndrome patients was shorter at 57 (9) min than in the controls, 82 (6) min (p<0 05). This ambulant study has failed to show any abnormalities of fasting small intestinal motility that might distinguish diarrhoea predomiiant irritable bowel syndrome patients from healthy controls. (Gut 1994; 35: 203-210) complex (MMC Abdominal symptoms in IBS may originate from organs other than the colon.34 The small intestine has been studied as a site of possible dysmotility. In contrast with the colon, normal patterns of motility are more clearly defined in the small intestine,5" although there is considerable variability in health.'"0' During fasting the small intestine exhibits a distally migrating cycle of motility, the interdigestive migrating motor SUBJECTS Eight patients (four men, four women, mean age 36 years, range 24-53) attending the gastroenterology clinic with a diagnosis of IBS22 23 were studied. All complained of 'diarrhoea' as their predominant bowel habit and were selected because of the severity of their symptoms. These

Motility in Irritable-Bowel Syndrome

“…They can be induced by cholecvstokinin or prostigmine in a proportion of both IBS patients and controls to a similar extent [2], A temporal relation of prolonged propagated contractions to abdominal pain was reported in 61% of IBS patients, but in only 17% of controls [1]. Again, this finding could not be corroborated in a subsequent careful study [5], Clustered contractions are groups of propagated smallintestinal contractions of approximately 1 min duration, occurring every other minute. Therefore they are also called 'minute rhythm'.…”

Effects of oral cisapride on small bowel motility in irritable bowel syndrome

“…5±7 This is also relevant in view of the altered patterns of motility which can be observed in patients with irritable bowel syndrome during prolonged recordings from the small intestine, 8±10 although other studies have not observed such alterations. 11,12 The aims of this study were therefore to compare, utilizing an ambulant recording technique, the effects of a 24-h oral dose regimen of cisapride on interdigestive and post-prandial motor activity of the proximal small intestine in irritable bowel syndrome patients with predominant constipation, irritable bowel syndrome patients with predominant diarrhoea and healthy subjects. In each group a control (placebo) period of recording was undertaken, while separate groups of healthy subjects and of irritable bowel syndrome patients, who were studied in similar fashion but without the drug, acted as additional control groups.…”

Cognitive behavioural therapy in addition to antispasmodic therapy for irritable bowel syndrome in primary care: randomised controlled trial

“…There is a lack of agreement regarding the aetiology and physiology of IBS, but theories include abnormal gastrointestinal motor function, [24][25][26] enhanced visceral perception, 27-29 the influence of psychosocial factors such as a history of childhood abuse, 30 genetic predisposition [31][32][33] and a possible role for enteric mucosal inflammation 34 such as that precipitated by acute bacterial gastroenteritis. 35 To date, studies on the aetiology of IBS have been descriptive or retrospective and longitudinal studies are needed to clarify matters.…”