Colonic Motility Abnormality in Patients With Irritable Bowel Syndrome Exhibiting Abdominal Pain and Diarrhea

Chey, William Y.; Jin, H.; Lee, Mun Ho; Sun, Sung Wu; Lee, Kae Yol

doi:10.1111/j.1572-0241.2001.03804.x

Cited by 297 publications

(108 citation statements)

References 17 publications

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“…The most prevalent forms of motility-related diarrheas are autonomic neuropathy 106 or IBS-D, associated with either accelerated colonic transit 107 or increased numbers of high-amplitude propagated contractions. 108 …”

Section: Secretory or Osmotic Diarrheamentioning

confidence: 99%

Pathophysiology, Evaluation, and Management of Chronic Watery Diarrhea

2017

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Chronic watery diarrhea poses a diagnostic and therapeutic challenge and is often a disabling condition for patients. Although acute diarrhea is likely to be caused by infection, the causes of chronic diarrhea (more than 4 weeks in duration) are more elusive. We review on the pathophysiology, diagnosis, and treatment of chronic diarrhea. Drawing on recent insights into the molecular mechanisms of intestinal epithelial transport and barrier function, we discuss how diarrhea can result from a decrease in luminal solute absorption, an increase in secretion, or both, as well as derangements in barrier properties. We also describe the various extra-epithelial factors that activate diarrheal mechanisms. Finally, clinical evaluation and tests used in assessment of patients presenting with chronic diarrhea are reviewed, and an algorithm guiding therapeutic decisions and pharmacotherapy is presented.

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Section: Secretory or Osmotic Diarrheamentioning

confidence: 99%

Pathophysiology, Evaluation, and Management of Chronic Watery Diarrhea

2017

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“…Although motor abnormalities of the large bowel have been described in both conditions [3, 4, 5, 6], especially for IBS, unequivocal data have not been reported consistently. Recent evidence, however, seems to suggest that an abnormal colonic motility may actually be documented in IBS patients [7, 8, 9, 10]. …”

Section: Introductionmentioning

confidence: 99%

Abnormal Colonic Propagated Activity in Patients with Slow Transit Constipation and Constipation-Predominant Irritable Bowel Syndrome

Bassotti

Chistolini²,

Marinozzi³

et al. 2003

Digestion

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Background: The pathophysiological basis of constipation is still unclear, and the role of colonic dysfunction is debated, especially in irritable bowel syndrome. Objective data are quite scarce, especially concerning colonic propulsive activity. Aims: To evaluate high- and low-amplitude colonic propulsive activity in constipated patients (slow-transit type and irritable bowel syndrome) in comparison with normal controls. Patients and Methods: Forty-five constipated patients (35 with slow-transit constipation and 10 with constipation-predominant irritable bowel syndrome) were recruited, and their data compared to those of 18 healthy subjects. Twenty-four-hour colonic manometric recordings were obtained in the three groups of subjects, and data concerning high- and low-amplitude colonic propulsive activity were then compared. Results: High-amplitude propagated contractions were significantly (p < 0.05) decreased in patients with slow-transit constipation and constipation-predominant irritable bowel syndrome with respect to controls (1.5 ± 0.4, 3.7 ± 2, and 6 ± 1 events/subject/day, respectively). In slow-transit constipation, a significant decrease of contractions’ amplitude was also observed. Concerning low-amplitude propagated contractions, patients with slow-transit constipation had significantly less events with respect to patients with constipation-predominant irritable bowel syndrome (46 ± 7 vs. 87.4 ± 19, p = 0.015); no differences were found between patients with slow-transit constipation and controls and between patients with constipation-predominant irritable bowel syndrome and controls. All three groups displayed a significant increase of low-amplitude propagated contractions after meals (6.3 ± 2 vs. 18.2 ± 5 for controls, p < 0.005; 6.4 ± 1.4 vs. 16.3 ± 2.4 for slow-transit constipation, p < 0.005; 10.5 ± 3.2 vs. 32.6 ± 7 for constipation-predominant irritable bowel syndrome, p = 0.001). Conclusions: Low-amplitude propagated contractions may represent an important physiologic motor event in constipated patients, reducing the severity of constipation in patients with irritable bowel syndrome and preserving a residual colonic propulsive activity in patients with slow-transit constipation.

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“…CCK-33 can decompose several fractions, one of which is CCK-8. It has been reported that the use of CCK-8 intravenously can lead to abdominal pain in human [6]. As we all know, CCK can cause gastrointestinal smooth muscle contraction and improve gastrointestinal motility after binding the CCK receptor.…”

Section: Discussionmentioning

confidence: 99%

“…In particular, enhanced visceral perception is considered to be important as it has been reported that up to 94% of patients are hypersensitive to rectal balloon distension [5]. There is also evidence pointing to altered gut motility in IBS [6]. …”

Section: Introductionmentioning

confidence: 99%

Correlation of Gut Hormones with Irritable Bowel Syndrome

et al. 2008

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Background: Irritable bowel syndrome (IBS) is a functional bowel disorder which is characterized by abdominal pain and disturbed bowel habits. The pathophysiological mechanism is complex and still remains incompletely clear. Alterations at both the central and the peripheral level are thought to contribute to the symptoms of IBS, including psychosocial factors, visceral hypersensitivity and abnormal gastrointestinal motility and secretion. Several gut peptides contribute to the regulation of gastrointestinal function, but little is known about gut hormone secretion in IBS. Methods: We evaluated the concentrations of cholecystokinin (CCK), vasoactive intestinal peptide (VIP), somatostatin, substance P, neuropeptide Y (NPY) in plasma and in sigmoid tissue in 40 patients with IBS and 15 age- and gender-matched controls by using radioimmunoassay. Results: IBS patients had higher plasma level of CCK (p < 0.01), and the level of CCK in the sigmoid was also increased compared with controls (p < 0.05). The levels of somatostatin and substance P in fasting plasma and in the sigmoid were not different between IBS patients and control subjects (p > 0.05), but the levels of VIP in sigmoid tissue or in plasma were higher in IBS patients than in control group (p < 0.01). The NPY levels in both plasma and the sigmoid were significantly lower in IBS patients than in controls (p < 0.05). Plasma NPY level in patients with IBS with diarrhea as a predominant bowel pattern was lower than in patients with IBS with constipation as a predominant bowel pattern. Conclusion: IBS patients have increased levels of CCK and VIP and decreased NPY levels in fasting plasma and sigmoid tissue. These alterations of VIP, CCK and NPY may play a role in the pathogenesis of IBS.

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Colonic Motility Abnormality in Patients With Irritable Bowel Syndrome Exhibiting Abdominal Pain and Diarrhea

Cited by 297 publications

References 17 publications

Pathophysiology, Evaluation, and Management of Chronic Watery Diarrhea

Pathophysiology, Evaluation, and Management of Chronic Watery Diarrhea

Abnormal Colonic Propagated Activity in Patients with Slow Transit Constipation and Constipation-Predominant Irritable Bowel Syndrome

Correlation of Gut Hormones with Irritable Bowel Syndrome

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