Compliance, tone and sensitivity of the rectum in different subtypes of irritable bowel syndrome

Steens, Jeroen; Schaar, Peter; Penning, Corine; Brussee, Jessica; Masclee, Ad

doi:10.1046/j.1365-2982.2002.00332.x

Cited by 76 publications

(55 citation statements)

References 23 publications

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“…Although both colonic and rectal compliance were not significantly altered after the meal, we found that, as in animal studies, rectal sensitivity as determined by the rectal ASS was increased postprandially (Table 1). Although other studies have reported an increased ASS with rectal distension in irritable bowel syndrome patients postprandially (3,17), our data indicate that even healthy subjects can exhibit an increased ASS with rectal distension postprandially. This postprandial hypersensitivity may explain the lack of correlation between rectal volume response and pain in the postprandial period.…”

Section: Discussioncontrasting

confidence: 90%

Modulatory influences on antegrade and retrograde tonic reflexes in the colon and rectum

Danta

Prott

et al. 2004

American Journal of Physiology-Gastrointestinal and Liver Physi

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influences on antegrade and retrograde tonic reflexes in the colon and rectum. Am J Physiol Gastrointest Liver Physiol 287: G962-G966, 2004. First published July 1, 2004; doi:10.1152/ajpgi.00460.2003.-Tonic reflexes in the colon and rectum are likely to be important in health and in disorders of gastrointestinal function. The aim of this study was to evaluate the fasting and postprandial "colorectal" and "rectocolic" reflexes in response to 2-min isobaric distensions of the colon and rectum, accounting for enteric sensation, compliance, and distending balloon volume. In 14 healthy fasting subjects, a dual barostat assembly was positioned (descending colon and rectum). A 2-min phasic distension was performed in the colon and rectum in random order while the opposing balloon volume was recorded. Sensation (phasic distension) and compliance (ramp distension) were also determined. The experiment was repeated postprandially. Colonic distension resulted in significant rectal tonic contraction in the fasting (rectal volume change: Ϫ35.4 Ϯ 8.4 ml, P Ͻ 0.01) and postprandial (Ϫ22.2 Ϯ 8.4 ml, P Ͻ 0.01) states. After adjustment for colonic sensitivity, for compliance, and for distending balloon volume, the rectal volume change remained significant; the extent of the tonic response, however, correlated significantly with increasing pain score (P Ͻ 0.01). In contrast, rectal distension did not produce a significant tonic response in the colon (fasting: Ϫ6.5 Ϯ 7.3 ml; postprandial: 2.7 Ϯ 7.3 ml), either unadjusted or adjusted for rectal sensitivity, compliance, and distending balloon volume. In conclusion, the colorectal reflex, but not the rectocolic reflex, can be readily demonstrated both before and after a meal in response to a 2-min isobaric distension in the colon and rectum, respectively. Although the presence of the colorectal reflex does not depend on colonic sensitivity or the volume of the distending colonic balloon, these factors modulate the reflex, especially in the fasting state.

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Section: Discussioncontrasting

confidence: 90%

Modulatory influences on antegrade and retrograde tonic reflexes in the colon and rectum

Danta

Prott

et al. 2004

American Journal of Physiology-Gastrointestinal and Liver Physi

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“…For example, IBS-C patients experienced decreased sensations of urge during rectal distension compared with IBS-D patients. 19 However in the present study, differences in bowel habit were not associated with the presence or absence of hypersensitivity to rectal distension. In addition, hypersensitivity has been linked to certain individual IBS symptoms, such as the feeling of incomplete evacuation and urgency.…”

Section: Discussioncontrasting

confidence: 69%

Relationship between symptoms and hypersensitivity to rectal distension in patients with irritable bowel syndrome

Kuiken¹,

Lindeboom

Tytgat³

et al. 2005

Aliment Pharmacol Ther

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SUMMARYBackground: Visceral hypersensitivity is considered an important pathophysiological mechanism in irritable bowel syndrome, yet its relationship to symptoms is unclear. Aim: To detect possible associations between symptoms and the presence of hypersensitivity to rectal distension in patients with irritable bowel syndrome. Methods: Ninety-two irritable bowel syndrome patients and 17 healthy volunteers underwent a rectal barostat study. The association between specific irritable bowel syndrome symptoms and the presence of hypersensitivity was examined using Area under the Receiver Operating Characteristic curves. Results: Irritable bowel syndrome patients had significantly lower thresholds for discomfort/pain than healthy volunteers: 24 (18-30) and 30 (27-45) mmHg above minimal distending pressure, respectively. Forty-

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“…Apart from disturbances in rectal sensitivity, significant alterations in rectal compliance may be observed in IBS patients. Although previous studies have shown controversial results on compliance of the rectum in IBS patients, decreased rectal compliance appears to be more frequently observed than increased rectal compliance [12, 13, 16]. Rectal hypocompliance has been identified, both in D-IBS patients and in C-IBS patients.…”

Section: Discussionmentioning

confidence: 99%

“…Studies in C-IBS patients have produced conflicting results on that. Although C-IBS patients were thought to be predominantly hyposensitive, rectal hypersensitivity has been observed in a considerable number of C-IBS patients [12, 13]. Apart from disturbances in rectal sensitivity, significant alterations in rectal compliance may be observed in IBS patients.…”

Section: Discussionmentioning

confidence: 99%

“…An alteration in rectal compliance is also known to be a pathogenic mechanism in IBS. Rectal compliance was reported to be lower in IBS patients in some studies [10,11,12,13], but not in others [4, 5,14,15,16]. Given that IBS symptoms commonly occur after eating and are often aggravated by meals [17,18,19], it is conceivable that postprandial abnormalities in rectal physiology might be associated with IBS symptoms.…”

Section: Introductionmentioning

confidence: 99%

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Relationship of Underlying Abnormalities in Rectal Sensitivity and Compliance to Distension with Symptoms in Irritable Bowel Syndrome

Lee

Kim²,

Cho³

2006

Digestion

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Background/Aims: Abnormalities in rectal physiology play an important role in the genesis of symptoms in irritable bowel syndrome (IBS). However, their relationship to symptoms is unclear. Our aim was to investigate the association of abnormalities in rectal sensitivity and compliance to specific symptoms in IBS. Methods: Fifty-six IBS patients and 14 healthy controls participated in this study. The intensities of individual IBS symptoms in the past 4 weeks were scored on a graded 5-point Likert scale. Using a barostat, isobaric rectal distensions were performed before and after a meal. Results: Rectal hypersensitivity and hypocompliance in the fasting state were observed in 68 and 52% of IBS patients, respectively. Postprandial hypersensitivity of the rectum was significantly more prevalent in the diarrhea-predominant IBS (D-IBS) group compared to the constipation-predominant IBS (C-IBS) group. The D-IBS group showed a significant postprandial decrease in rectal compliance, but the C-IBS group did not. A significant correlation was observed between a sense of incomplete evacuation and increased bowel movements with postprandial rectal hypersensitivity or hypocompliance. Conclusion: A sense of incomplete evacuation and increased bowel movements are related to postprandial abnormalities in rectal sensitivity and compliance to distension. The other IBS symptoms do not seem to predict such abnormalities.

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Compliance, tone and sensitivity of the rectum in different subtypes of irritable bowel syndrome

Cited by 76 publications

References 23 publications

Modulatory influences on antegrade and retrograde tonic reflexes in the colon and rectum

Modulatory influences on antegrade and retrograde tonic reflexes in the colon and rectum

Relationship between symptoms and hypersensitivity to rectal distension in patients with irritable bowel syndrome

Relationship of Underlying Abnormalities in Rectal Sensitivity and Compliance to Distension with Symptoms in Irritable Bowel Syndrome

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