Increased Postprandial Colonic Motility and Autonomic Nervous System Activity in Patients With Irritable Bowel Syndrome: A Prospective Study

Abstract

Background/AimsThe prevalence and severity of irritable bowel syndrome (IBS) declines with age, but the cause of this is unknown. This study tested 2 hypotheses: (1) autonomic nervous system responses to eating and bowel distention, measured by heart rate variability (HRV), differs by age in IBS patients and (2) HRV is correlated with colonic motility and IBS symptoms. MethodsOne hundred and fifty-six Rome III positive IBS patients and 31 healthy controls underwent colonic manometry with bag distention in the descending colon, followed by ingestion of an 810-kcal meal. HRV, evaluated by low frequency (%LF; 0.04-0.15 Hz) component, high frequency (%HF; 0.15-0.40 Hz) component, and the LF/HF ratio, was measured during colonic distention and after the meal. Motility index and subjective symptom scores were simultaneously quantified. ResultsBoth colonic distention and eating decreased %HF and increased the LF/HF ratio, and both indices of autonomic nervous system correlated with age. In IBS patients, %HF negatively correlated with the postprandial motility index after adjusting for age. The %HF and LF/HF ratios also correlated with psychological symptoms but not bowel symptoms in IBS patients. ConclusionDecreased vagal activity is associated with increase in age and greater postprandial colonic motility in patients with IBS, which may contribute to postprandial symptoms. (J Neurogastroenterol Motil 2018;24:87-95)

Regulation of the Autonomic Nervous System on Intestine

“…The abnormality of the autonomic nerve is an objective physiological factor of IBS (Cheng et al, 2013). The results from clinical studies demonstrated the impaired parasympathetic activity and enhanced sympathetic tone in patients (Pellissier et al, 2010;Chalaye et al, 2012;Mazur et al, 2012;Tanaka et al, 2018). Mood regulation can alter autonomic dysfunction in IBDs patients, whereas autonomic dysfunction persists regardless of mood regulation in IBS patients (Pellissier et al, 2010).…”

The Relationship Between Daytime Salivary Melatonin and Gastrointestinal Symptoms in Young Adults Seeking Psychiatric Care

“…IBS is a functional bowel disorder in which the main symptoms consist of abdominal pain and altered stool consistency and frequency. IBS patients often exhibit greater postprandial abdominal pain, discomfort, urge, and greater colonic motility (gastrocolic reflex), as well as increased stress response and visceral hypersensitivity compared with healthy controls (14). Functional imaging of IBS patients has shown abnormalities in areas of the brain involved in pain and arousal states (anterior cingulate cortex and the amygdalae) (15).…”

Effects of Alkaline‐Reduced Drinking Water on Irritable Bowel Syndrome with Diarrhea: A Randomized Double‐Blind, Placebo‐Controlled Pilot Study

“…However, the cause and mechanisms underlying the various symptoms are not entirely understood. Many hypotheses have been proposed, including small bowel bacterial overgrowth syndrome, genetic factors, food hypersensitivities, gastrointestinal motility disorders, gut-brain axis alterations, hypersensitivity of the intestine, and psychosocial factors [ 7 – 10 ]. Recent studies indicate that the intestinal microbiota is one of the important factors affecting the onset of IBS [ 11 , 12 ].…”