Autonomic cardiovascular regulation in quiescent ulcerative colitis and Crohn's disease

Abstract

Cardiac vagal control is impaired in quiescent ulcerative colitis only, and not in Crohn's disease, while in both bowel diseases vascular control appears preserved. Since cardiovagal modulation seems related to anti-inflammatory mechanisms, the reduced parasympathetic cardiac regulation in apparently quiescent ulcerative colitis suggests that such systemic derangement is accompanied by local subclinical inflammations, even in the absence of clinically active inflammatory processes.

Mechanisms of gastric emptying disturbances in chronic and acute inflammation of the distal gastrointestinal tract

“…There is increasing evidence that patients with IBD have altered autonomic and enteric neural functions (10,16,40,45,54). Such neural disturbances have not been addressed by our study protocol but may contribute to gastric emptying disturbances in IBD patients (29) and deserve further investigation.…”

“…Second, hyperglycemia is associated with delayed gastric emptying (15,37,53), and, hence, increased blood glucose levels might cause gastric dysmotility in IBD patients receiving corticosteroid therapy. Third, autonomic neuropathy (10,16,54) and alterations of intramural neurons (9,28,40,45) have been observed in IBD and might disturb gastrointestinal motility. Finally, there is evidence that release of several gastrointestinal neurohormonal mediators that regulate gastric functions may be altered in IBD (1,7,49,58,59); however, these results were conflicting, and roles of key regulators, particularly CCK, peptide YY (PYY), and glucagon-like peptide-1 (GLP-1) (51) have remained unclear.…”

Prevalence of QT interval prolongation in inflammatory bowel disease

“…Cardiovascular autonomic dysregulation (cardiac vagal modulation) results in heart rate variability (HRV), prolonged QT interval, and lower baroreflex sensitivity and baroreflex effectiveness (26,27). Similar autonomic imbalance may have a bearing on the pathogenesis of QT interval prolongation in patients with IBD.…”

“…Recent studies suggest underlying chronic inflammation leads to interaction between gastrointestinal and cardiovascular autonomic regulation (parasympathetic system) in patients with IBD, particularly during its active phase (26,27). Cardiovascular autonomic dysregulation (cardiac vagal modulation) results in heart rate variability (HRV), prolonged QT interval, and lower baroreflex sensitivity and baroreflex effectiveness (26,27).…”

Diagnosis and management of functional symptoms in inflammatory bowel disease in remission

“…Subtle changes in antroduodenal motility in quiescent CD have also been described [65] . These alterations in intestinal motility could be related to autonomic nerve system dysfunction that has been described in IBD patients in remission [66][67][68][69] .…”