Colonic motility, autonomic function, and gastrointestinal hormones under psychological stress on irritable bowel syndrome.

Fukudo, Shin; Suzuki, Jinichi

doi:10.1620/tjem.151.373

Cited by 96 publications

(70 citation statements)

References 28 publications

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“…By contrast, a consistent change in GI symptoms, including colonic motility (Fukudo & Suzuki, 1987) and enhanced perception of visceral pain (Murray et al 2004), has been found in response to cognitive or physical stressors in IBS.…”

Section: Introductionmentioning

confidence: 90%

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

et al. 2014

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Background. Despite stress being considered a key factor in the pathophysiology of the functional gastrointestinal (GI) disorder irritable bowel syndrome (IBS), there is a paucity of information regarding the ability of IBS patients to respond to acute experimental stress. Insights into the stress response in IBS could open the way to novel therapeutic interventions. To this end, we assessed the response of a range of physiological and psychological parameters to the Trier Social Stress Test (TSST) in IBS.Method. Thirteen female patients with IBS and 15 healthy female age-matched control participants underwent a single exposure to the TSST. Salivary cortisol, salivary C-reactive protein (CRP), skin conductance level (SCL), GI symptoms, mood and self-reported stress were measured pre-and post-exposure to the TSST.Results. The hypothalamic-pituitary-adrenal (HPA) axis response to the TSST was sustained in IBS, as shown by a greater total cortisol output throughout (p = 0.035) and higher cortisol levels measured by an area under the curve with respect to ground (AUC G ) analysis (p = 0.044). In IBS patients, GI symptoms increased significantly during the recovery period following exposure to the TSST (p = 0.045). Salivary CRP and SCL activity showed significant changes in relation to stress but with no differential effect between experimental groups.Conclusions. Patients with IBS exhibit sustained HPA axis activity, and an increase in problematic GI symptoms in response to acute experimental psychosocial stress. These data pave the way for future interventional studies aimed at identifying novel therapeutic approaches to modulate the HPA axis and GI symptom response to acute psychosocial stress in IBS.

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Section: Introductionmentioning

confidence: 90%

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

et al. 2014

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“…As for human subjects, it has been reported that psychological stress induced an increase in colonic activity (Naruducci et al, 1985;Rao et al, 1998;Welgan et al, 1985;Welgan et al, 1988). MDT-stress, in particular, induced a significant increase in the colonic motility of patients with irritable bowel syndrome, with an increase in heart rate variability, but not in healthy controls (Fukudo and Suzuki, 1987). Psychological stressors producing anger and anxiety increased the colonic motility in normal healthy controls and irritable bowel syndrome patients (Welgan et al, 1988).…”

Section: Correlation Of Both Anxiety and Depression Scores And The Lfmentioning

confidence: 98%

Correlations between the responses of electrogastrograms, heart rate and respiratory rate to the stress of the mirror drawing test in human subjects

Homma

2006

J. Smooth Muscle Res.

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Original C o r r e l a t i o n s b e t w e e n t h e r e s p o n s e s o felectrogastrograms, heart rate and respiratory rate to the stress of the mirror drawing test in human subjects AbstractAn electrogastrogram (EGG) recorded on the skin is believed to reflect the electrical activity of the gastrointestinal tract. In this study, linear correlations were calculated for the EGG spectral frequencies and the power ratios, changes in heart and respiratory rate before and during mirror drawing test (MDT) stress and after having meals, with the changes in the sympathetic tone indicator (LF/HF) and HADS anxiety and depression scores in human subjects (n=48). Depression scores had a negative linear correlation with the EGG resting frequencies of the epigastric and supraumbilical 6 cpm groups (5.0-7.4 cpm). Anxiety scores had a positive linear correlation with the EGG area power ratio of the resting to MDT stress responses of the epigastric and infraumbilical 6 cpm groups (6 cpm area during MDT/that during fasting rest). The resting LF/HF had a positive linear correlation with the EGG area power ratio of the resting to MDT stress responses of the epigastric and infraumbilical 3 cpm groups (2.5-4.9 cpm). The resting LF/HF ratio had a negative correlation with the area power ratio of the resting to postprandial responses (postprandial power/resting power) in the epigatric, supraumbilical and infraumbilical 6 cpm groups. The resting LF/HF ratio had a positive linear correlation with the heart rate at rest and during MDT-stress. In contrast, the resting LF/HF ratio had a negative linear correlation with the respiratory rate at rest and during MDT-stress. EGGs of the surface electrical activities of the gastrointestinal tract were influenced by acute MDT-stress and their frequencies and their response power ratios were correlated linearly with anxiety scores, depression scores and the sympathetic tone indicator, the LF/HF ratio.

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“…Previous research showed that the correlation coefficient between stress loading and exacerbation of gastrointestinal symptoms is high for IBS patients compared with that for healthy individuals [11]. When psychosocial stress is loaded on IBS patients in an examination room, bowel movement is activated, as determined by measurements of colonic manometry [12]. In IBS patients, stimulation of the gastrointestinal system enhances the response of the central nervous system (CNS), to varying degrees between the sexes, with the activation of brain areas that regulate the stress responses (i.e., the amygdala, anterior cingulate cortex and insula) [13].…”

Section: Pathophysiologymentioning

confidence: 99%

“…Some patients require careful clinical observation for a certain duration to detect a profound psychopathology. In some cases, GI motility examination of the digestive system [12,41,52] is indicated to judge compatible pathophysiology of IBS, such as mild dysmotility of the lower GI tract or visceral hypersensitivity and/or to rule out severe GI motility disorders depending on the clinical situation. A majority of IBS patients usually have stressrelated pathophysiology [9][10][11][12][13][14].…”

Section: Therapeutic Algorithm In Japanese Ibs Guidelinementioning

confidence: 99%

Evidence-based clinical practice guidelines for irritable bowel syndrome

et al. 2014

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New strategies for the care of irritable bowel syndrome (IBS) are developing and several novel treatments have been globally produced. New methods of care should be customized geographically because each country has a specific medical system, life style, eating habit, gut microbiota, genes and so on. Several clinical guidelines for IBS have been proposed and the Japanese Society of Gastroenterology (JSGE) subsequently developed evidence-based clinical practice guidelines for IBS. Sixty-two clinical questions (CQs) comprising 1 definition, 6 epidemiology, 6 pathophysiology, 10 diagnosis, 30 treatment, 4 prognosis, and 5 complications were proposed and statements were made to answer to CQs. A diagnosis algorithm and a three-step treatment was provided for patients with chronic abdominal pain or abdominal discomfort and/or abnormal bowel movement. If more than one alarm symptom/sign, risk factor and/or routine examination is positive, colonoscopy is indicated. If all of them, or the subsequent colonoscopy, are/is negative, Rome III or compatible criteria is applied. After IBS diagnosis, step 1 therapy consisting of diet therapy, behavioral modification and guttargeted pharmacotherapy is indicated for four weeks. Nonresponders to step 1 therapy proceed to the second step that includes psychopharmacological agents and simple psychotherapy for four weeks. In the third step, for patients nonresponsive to step 2 therapy, a combination of gut-targeted pharmacotherapy, psychopharmacological treatments and/or specific psychotherapy is/are indicated. Clinical guidelines and consensus for IBS treatment in Japan are well suited for Japanese IBS patients; as such, they may provide useful insight for IBS treatment in other countries around the world.

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Colonic motility, autonomic function, and gastrointestinal hormones under psychological stress on irritable bowel syndrome.

Cited by 96 publications

References 28 publications

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

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

Correlations between the responses of electrogastrograms, heart rate and respiratory rate to the stress of the mirror drawing test in human subjects

Evidence-based clinical practice guidelines for irritable bowel syndrome

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