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

Kuiken, SD; Lindeboom, Robert; Tytgat, G. N. J.; Boeckxstaens, Guy E.

doi:10.1111/j.1365-2036.2005.02524.x

Cited by 85 publications

(80 citation statements)

References 25 publications

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“…It has recently been demonstrated that hypersensitive and normosensitive IBS patients present with comparable, heterogeneous symptomatology and none of the specific IBS symptoms can distinguish hypersensitive from normosensitive patients [9]. In that study, sensitivity to rectal distension was determined only in the fasting state.…”

Section: Discussionmentioning

confidence: 99%

“…Rectal compliance was defined as the slope of the linear part of each pressure-volume curve [9, 10]. It was approximated by calculating the difference in the intrabag volume divided by the difference in the intrabag pressure in the linear part of each pressure-volume curve, which is expressed in ml/mm Hg.…”

Section: Methodsmentioning

confidence: 99%

“…Although visceral hypersensitivity is one of the main hypotheses explaining the origin of symptoms in IBS, its relation to subjective symptoms has not been proven. It has recently been reported that hypersensitive and normosensitive IBS patients present with comparable, heterogeneous symptomatology [9]. However, in that study, the presence of rectal hypersensitivity was determined only in the fasting state, and rectal compliance was not measured.…”

Section: Introductionmentioning

confidence: 95%

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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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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 95%

See 1 more Smart Citation

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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“…[4][5][6][7] No known structural or anatomical explanation accounts for the pathophysiology of IBS, although several mechanisms have been proposed, including low-grade mucosal inflammation, visceral hypersensitivity, alterations in fecal flora, and bacterial overgrowth. [8][9][10][11] Management guidelines for IBS recommend that a positive diagnosis is made using symptom-based diagnostic criteria, 12,13 in an attempt to minimize fruitless and repeated invasive investigation. The current gold-standard for diagnosing IBS are the Rome III criteria, 1 but their accuracy has only been assessed in one study to date, 14 and their performance in predicting IBS was modest.…”

Section: Introductionmentioning

confidence: 99%

Irritable Bowel Syndrome and Microscopic Colitis: A Systematic Review and Meta-analysis

Kamp

Kane

Ford

2016

Clinical Gastroenterology and Hepatology

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“…Th is novel fi nding has particular clinical resonance given the prevalence of visceral hypersensitivity and / or hyperalgesia as clinical manifestations of IBS ( 20 ). In this regard, it is curious that supernatants from subjects with IBS-C had no such eff ect yet this subgroup has also been shown to exhibit enhanced visceral sensation ( 21 ). Th ey also suggest that cysteine as well as serine proteases may be involved in this process -an interesting fi nding given the presence of cysteine proteases in intestinal cells other than mast cells, the dominant source of serine proteases.…”

mentioning

confidence: 99%

Editorial: PARs for the Course: Roles of Proteases and PAR Receptors in Subtly Inflamed Irritable Bowel Syndrome

Quigley

2013

American Journal of Gastroenterology

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Although the etiology of irritable bowel syndrome (IBS) remains unknown, clinical and laboratory observations suggest that within the broad and varying phenotype, that is, IBS, there may exist subgroups, which can be defi ned on the basis of a distinctive pathophysiological basis. Of these, postinfectious IBS is the best characterized; in IBS, in general, studies of infl ammatory mediators and substances elaborated by cells involved in the intestinal immune response, such as proteases, suggest that some IBS sufferers can be differentiated on the basis of an aberrant immune response. Valdez-Morales and colleagues extend this concept by demonstrating the ability of supernatants of biopsy cultures from individuals with diarrheapredominant IBS to enhance neuronal excitabilityan effect that could well contribute to a clinical hallmark of IBS, namely, visceral hypersensitivity. Am J Gastroenterol 2013; 108:1644 -1646 doi: 10.1038/ajg.2013 Irritable bowel syndrome (IBS) is a common and, at times, disabling condition whose etiology, despite the best eff orts of clinicians and scientists, remains unclear. As a consequence, reliable biomarkers for the syndrome have yet to emerge, and its diagnosis, therefore, continues to rest on clinical features and the exclusion of disorders that have the potential to present in a similar manner ( 1 ). Much of the diffi culties related to unraveling the enigma that is IBS revolve around its heterogeneity, which may originate from any one or a combination of the following: dominant symptom (pain, discomfort, bloating, distension, and altered bowel habit), predominant bowel habit (diarrhea, constipation, or mixed pattern), comorbidity (be it psychological or somatic), severity (including impact on the quality of life), natural history, and prognosis. To frustrate the clinician scientist further, those IBS subtypes that can be defi ned with some degree of accuracy, at least using Rome III criteria (2), including diarrhea-predominant IBS, constipationpredominant IBS and mixed IBS, do not appear to be immutable, and suff erers can move from one stool pattern to another over time, thus emphasizing the importance of longitudinal studies of this disorder ( 3,4 ).However, in this rather gloomy scenario, shines an unexpected beam of light that has illuminated (or, to be accurate, reignited) a new perspective on the etiology of IBS -postinfectious IBS (PI-IBS) ( 5 ). Although PI-IBS had been well described decades beforehand ( 6 ), more recent studies based on the consequences of large-scale outbreaks of bacterial, viral, and amebic gastroenteritis have firmly brought the concept of host -microbiome interactions into play in IBS research, in general ( 7 ). Observations in relation to PI-IBS, such as the description of correlations between the initial inflammatory response to the infection and the subsequent development of IBS ( 8 ), as well as the identification of polymorphisms in genes coding for components of the mucosal immune response and intestinal barrier integrity as risk factor...

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

Cited by 85 publications

References 25 publications

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

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

Irritable Bowel Syndrome and Microscopic Colitis: A Systematic Review and Meta-analysis

Editorial: PARs for the Course: Roles of Proteases and PAR Receptors in Subtly Inflamed Irritable Bowel Syndrome

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