Interaction between preprandial and postprandial rectal sensory and motor abnormalities in IBS

Abstract

Meal intake affects rectal sensorimotor function in IBS and health. Importantly, the rectal tone responses to a high-caloric meal are different between patients with IBS and controls, as well as between hypersensitive and normosensitive patients with IBS.

Visceral hypersensitivity is associated with GI symptom severity in functional GI disorders: consistent findings from five different patient cohorts

“…All patients gave verbal and written informed consent before any study-related procedures were undertaken. A proportion of the subjects included in this study have been included in previous publications using these cohorts, but not including the analyses performed in this study 8 33–37…”

“…The details of the protocols used can be found elsewhere,8 18 34 38 but are also described in the online supplementary methods and summarised in figure 1. In the two US IBS cohorts, the same protocol was used; phasic distensions, 30 s distensions, 30 s rest at the operating pressure, 2 mm Hg increments, but in cohort 1 the investigation was performed in the descending colon and in cohort 2 in the rectum (figure 1A).…”

“…Despite being very common and extensively studied, the pathophysiology of FGIDs is still incompletely understood and considered to be complex and multifactorial. Abnormal brain–gut interactions,5 psychological factors,5 6 altered GI motor function7 8 and visceral hypersensitivity7 8 are considered to be of relevance for FGIDs in general, but also other factors such as bacteria in the GI tract,9 10 immune function,11 gut permeability12 and nutrients13 have been implicated in the complex pathophysiology of FGIDs.…”

“…Since then numerous studies have verified the presence of visceral hypersensitivity in IBS,15–17 and also in other FGIDs such as FD18 and functional chest pain 19 20. However, not all patients with FGIDs demonstrate visceral hypersensitivity, and in large-scale studies approximately one-third of patients with FGIDs seem to demonstrate visceral hypersensitivity based on normal values in healthy individuals 7 8 19 21. Moreover, the presence of hypersensitivity to balloon distension provides no information about the underlying mechanism and its anatomical location since peripheral as well as central factors may be responsible for visceral hypersensitivity 22…”

Modern Management of Irritable Bowel Syndrome: More Than Motility

“…Guidelines for management have been published by a number of bodies [6,7,8]. The pathophysiology underlying IBS is heterogeneous and involves an interplay between altered intestinal motility, visceral hypersensitivity, dietary factors, the intestinal microbiota, impaired mucosal barrier function, low-grade inflammatory changes in the gastrointestinal wall and altered brain-gut axis interactions [9,10,11]. In the current review, we will focus on current and emerging treatment options for IBS.…”