Current insights in to the pathophysiology of Irritable Bowel Syndrome

Karantanos, Theodoros; Markoutsaki, Theofano; Gazouli, Maria; Anagnou, Nicholas P.; Karamanolis, Dimitrios G.

doi:10.1186/1757-4749-2-3

Cited by 81 publications

(59 citation statements)

References 64 publications

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“…Lack of differences among the subtypes of IBS patients may be due to predominance of autonomic enteric nervous system activity. 3 Different investigators explained various mechanisms for involvement of autonomic nerve function activity in IBS patients. Increased release of corticotrophin releasing factor (CRF) from hypothalamus affect directly or through locus ceruleus.…”

Section: Discussionmentioning

confidence: 99%

“…2 On the basis of abdominal and bowel symptoms IBS was diagnosed and classified by revised Rome-II criteria. 3 The criteria for diagnosis of IBS include abdominal discomfort or pain where at studies reported that autonomic nervous system may be affected by inflammatory reaction at the level of enteric mucosa. 6 Heart rate variability (HRV) is a measure which reflects autonomic nervous control.…”

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confidence: 99%

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Assessment of Autonomic Nerve Function In Patients With Irritable Bowel Syndrome

Nayem

Begum

Ferdousi

2012

J Bangladesh Soc Physiol

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Introductionleast two of the features are to be present which is relieved by defecation, onset is associated with a change in frequency and form of stool. The symptom must persist at least 12 weeks, in the preceding one year. 2 According to literature, IBS is multifactorial in origin. Several environmental factors, psycho social stressors, altered gut flora contribute to pathophysiology of IBS. It is now largely considered as a disorder of the brain-gut axis, involving abnormal function in the enteric, autonomic and central nervous system. 4 Autonomic nervous system regulates the visceral sensitivity of the body and coordinates gastrointestinal motility and secretion. Background: Autonomic nerve function impairment is related to development of Irritable Bowel Syndrome (IBS). Heart rate variability (HRV) is a useful tool to measure autonomic nerve function activity and also sympatho-vagal balance. Objective: To assess autonomic nerve function activity by heart rate variability analysis in patients with Irritable Bowel Syndrome. Methods: This cross sectional study was conducted in the Department of Physiology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka from 1 st July 2010 to 30 th June 2011. Ninety patients aged 20-50 years of both sexes with Irritable bowel syndrome were included in the study group. They were enrolled from the OPD of Gastroenterology in BSMMU. For comparison age and sex matched 30 apparently healthy subjects were also studied as control. The power spectral HRV parameters were recorded by a digital Polyrite. For statistical analysis ANOVA, independent sample t-test were performed. Results: Mean resting pulse rate, mean HR, SBP, DBP, LF, LF norm and LF/HF were significantly higher(P<0.001) and total power, HF, HF norm were significantly lower(P<0.001) in IBS group compared to those of control. Conclusion: This study concludes markedly lower parasympathetic with concomitant higher sympathetic activity and shifting of sympathovagal balance towards sympathetic predominance in patients of IBS.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Assessment of Autonomic Nerve Function In Patients With Irritable Bowel Syndrome

Nayem

Begum

Ferdousi

2012

J Bangladesh Soc Physiol

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“…IBS is an important health problem throughout the world (21,22). Despite many years of research, the disorder continues to have an uncertain etiology and is often associated with noncolonic symptoms (23,24). The burden of IBS is significant enough to contribute to considerable impairment of quality of life.…”

Section: Discussionmentioning

confidence: 99%

A Meta-analysis of the Therapeutic Effects of Amitriptyline for Treating Irritable Bowel Syndrome

Chao

Zhang

2013

Intern. Med.

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Objective We aimed to evaluate the efficacy of amitriptyline as a therapeutic option for irritable bowel syndrome (IBS) through a meta-analysis of randomized controlled trials. Methods For the years from 1966 until May 2012, PubMed, Scopus, Web of Science and the Cochrane Central Register of Controlled Trials were searched for double-blind, placebo-controlled trials investigating the efficacy of amitriptyline in the management of IBS. Results Four randomized, placebo-controlled clinical trials met our criteria and were included in the metaanalysis. The pooled relative risk for clinical improvement with amitriptyline therapy was 4.18 (95% CI: 2.00 to 8.77, p=0.0001). Conclusion It was thus concluded that amitriptyline exhibits a clinically and statistically significant control of IBS symptoms.

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“…Compared with normal subjects, they have an increased vagal response to rectal distension, decreased vagal response to sigmoid distension, a blunted adrenocorticotropic hormone response and lower plasma cortisol levels, suggesting abnormalities in the central control mechanisms that are involved in autonomic and neuroendocrinal response to visceral stimulation [5]. Central mechanisms include anxiety, depression and somatisation; peripheral dysfunction is characterized by gut motility and secretion changes and visceral hypersensitivity [6,7]. IBS is associated with structural changes in grey matter density involving key areas in attention, emotion regulation, pain inhibition and visceral information processing [8].…”

Section: Introductionmentioning

confidence: 99%

Osteopathic manipulative treatment and nutrition: An alternative approach to the irritable bowel syndrome

Collebrusco¹,

Lombardini²

2013

Health

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A simple treatment plan for manual therapists is presented based on current evidence-based literature, it is designed to lessen chronic pain and inflammation in the Irritable Bowel Syndrome (IBS). A chronic continuous or intermittent gastrointestinal tract dysfunction, IBS appears due to dysregulation of brain-gut-microbe communication. An overview of its management using Osteopathic Manipulative Treatment (OMT) is described. In IBS OMT focuses on the nervous and circulatory systems, spine, viscera, thoracic and pelvic diaphragms in order to restore homeostatic balance, normalize autonomic activity in the intestine, promote lymphatic flow and address somatic dysfunction. Lymphatic and venous congestion is treated by the Lymphatic Pump Techniques and stimulation of Chapman's Reflex Points. The food itself, food allergies and intolerance could contribute to symptom onset or even cause IBS. Furthermore the "microbiota" greatly impacts on the bi-directional braingut axis communication. This paper also provides appropriate dietary modifications for patients with IBS.

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Current insights in to the pathophysiology of Irritable Bowel Syndrome

Cited by 81 publications

References 64 publications

Assessment of Autonomic Nerve Function In Patients With Irritable Bowel Syndrome

Assessment of Autonomic Nerve Function In Patients With Irritable Bowel Syndrome

A Meta-analysis of the Therapeutic Effects of Amitriptyline for Treating Irritable Bowel Syndrome

Osteopathic manipulative treatment and nutrition: An alternative approach to the irritable bowel syndrome

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