Pathophysiology underlying irritable bowel syndrome -From the viewpoint of dysfunction of autonomic nervous system activity-

Abstract

Although irritable bowel syndrome (IBS) is the most common gastrointestinal disease and is found in up to 50% of patients referred to gastroenterologists, its pathogenesis remains unexplained. Lately most attention has been focused on visceral hypersensitivity related to dysfunction of the autonomic nervous system. Although there have been many reports regarding the autonomic nervous system in IBS patients, the results have not always been consistent. In many studies, increased sympathetic nervous system activity and decreased parasympathetic nervous system activity have been the most frequently noted differences when IBS patients are compared with healthy controls. There are also some differences among IBS symptom subgroups and some differences between men and women. Data from previous studies have been inconsistent, with complicating factors resulting in difficulties in classification and the possibility of multiple physiological pathways for a similar symptom picture. Further studies based on the Rome III criteria are required to evaluate whether or not autonomic functions significantly differ from each other. However, although there are many methods of measurement for evaluation of the autonomic nervous system, there are few of these methods that are not only accurate but also cost-effective, non-invasive, and easy to perform. Recently, we developed a new method with the abovementioned advantages for measuring fingertip blood flow in evaluating the autonomic nervous system by continuous-wave Doppler sonography. Using this method, we found that abnormal fingertip blood flow responses suggested the presence of excess sympathetic activity.

A sustained hypothalamic–pituitary–adrenal axis response to acute psychosocial stress in irritable bowel syndrome

“…Although autonomic pathways are considered key in maintaining normal brain-gut interactions (Manabe et al 2009), our results suggest that, in response to acute psychosocial stress, the sympathetic branch of the autonomic nervous system is functioning normally in IBS. Furthermore, when comparing the methodological approach between studies, it seems that the SNS response in IBS is dependent on the type of stressor used.…”

Maternal separation as a model of brain–gut axis dysfunction

“…Noradrenaline is a neurotransmitter of the autonomic nervous system which is known to be altered in IBS (Manabe et al 2009). …”

Serotonin Transporter and G Protein Beta 3 Subunit Gene Polymorphisms in Greeks with Irritable Bowel Syndrome

“…Despite the fact that the pathophysiology of IBS is poorly understood, it has been recently reported that the main pathophysiological mechanisms involve altered visceral sensitivity, abnormal gut motility and dysfunction of autonomic nervous system [3,4]. Serotonin, secreted by enterochromaffin cells and mast cells at the level of gut mucosa, is believed to modify the visceral sensitivity and regulate the gut motility and secretion [4,5].…”