Susceptibility to diarrhea is related to hemodynamic markers of sympathetic activation in the general population

Abstract

Objectives: Functional gastrointestinal (GI) symptoms, such as IBS (irritable bowel syndrome), have been suggested to be associated with autonomic neuropathy. We therefore examined associations between hemodynamic indices of autonomic control, functional GI symptoms and stress in a population-based cohort. Methods and materials: The study included 2094 participants of the Malm€ o Offspring Study (mean age 40.6 ± 13.8 years, 53.9% women). 509 (24.3%) reported having GI symptoms the last 2 weeks, without having organic GI disease, and 347 subjects (16.6%) reported IBS. Office and ambulatory 24-h systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate were measured. Associations between hemodynamic parameters and abdominal pain, diarrhea, constipation, bloating and flatulence, vomiting and nausea and psychological well-being according to the visual analog scale for IBS (VAS-IBS), and stress, were performed by Spearman's correlation test and linear regression models. Results: Subjects who reported GI symptoms had lower office supine and standing DBP and lower 24 h SBP and DBP compared with those without GI symptoms. Regarding specific symptoms, diarrhea was correlated with 24-h measurements of SBP (rs ¼ 0.197), DBP (rs ¼ 0.173) and heart rate (rs ¼ 0.134). Subjects with the most severe diarrhea had higher 24-h SBP (125.2 vs. 119.0 mmHg; p ¼ .038), DBP (74.0 vs. 69.0 mmHg; p ¼ .033) and heart rate (74.5 vs 71.1 beats/minute; p ¼ .048), after adjustments for confounders, compared to the other. There were no associations between other GI symptoms, IBS, stress and hemodynamic alterations. Conclusion: Functional diarrhea was associated with hemodynamic indices of sympathetic activation, supporting a possible role of the autonomic nervous system in diarrhea. ARTICLE HISTORY

Associations Between Endometriosis and Gut Microbiota

“…The controls were recruited from 2644 individuals who had previously been extracted from the MOS [ 19 ], which consists of descendants to participants in the Malmö Diet and Cancer Cardiovascular Cohort (MDC-CC). The recruitment of participants to the MDC-CC and the MOS took place in the 1990s and 2010s, respectively [ 20 , 21 ].…”

A possible association between early life factors and burden of functional bowel symptoms in adulthood

“…This is a population-based study combining data collected from the Swedish Medical Birth Registry (MBR) with the Malmö Offspring Study (MOS) ( Figure 1 ) [ 18 , 19 ]. Participants in MOS completed questionnaires regarding bowel symptoms in the form of the visual analog scale for irritable bowel syndrome (VAS-IBS) as well as information concerning their socioeconomic background, lifestyle habits, and health-related questions.…”

“…The MOS is an ongoing population-based cohort ( n = 2644), with the single inclusion criteria of being either the adult children or grandchildren of the participants in the Malmö Diet and Cancer – Cardiovascular (MDC-CV) cohort [ 18 ]. The MDC-CV itself was formed by 6103 randomly selected individuals from the original study called the Malmö Diet and Cancer Study (MDCS).…”

“…MDCS was formed between 1991 and 1996, and its 28,098 participants were born between the years of 1923 and 1950 [ 19 ]. The MOS data for this study were attained between 2013 and 2017 [ 18 ]. At inclusion in MOS, age, sex, and body mass index (BMI) were registered.…”

“…A questionnaire regarding educational level, occupation, marital status, smoking habits, alcohol habits, physical activity, stress level, and medical history was completed. To assess self-reported IBS related to the Rome III criteria [ 18 , 21 ], the participants had to answer the question ‘Have you several times during a month suffered from abdominal pain related to irregular bowel habits, which is called IBS?’ If they answered yes, they were referred to as having self-reported IBS.…”