Functional gastrointestinal disorders and visceral hypersensitivity in children and adolescents suffering from Crohnʼs disease

Fauré, Christophe; Giguère, Lyse

doi:10.1002/ibd.20506

Cited by 58 publications

(34 citation statements)

References 47 publications

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“…There may be other pathophysiological mechanisms involved in the genesis of dyspeptic symptoms in Crohn's disease such as visceral hypersensitivity, impaired accommodation and disturbed antral-duodenum contractility [22]. In accordance, Faure and Giguère already showed that in children with Crohn's disease in remission suffering from chronic functional abdominal pain, the rectal sensory threshold for pain, measured by barostat, was significantly lower compared to normal subjects [5]; if this is true for visceral hypersensitivity, this might be a possible explanation for the presence of dyspeptic symptoms in our patients.…”

Section: Discussionmentioning

confidence: 74%

“…Disorders in gastrointestinal motility have been observed in patients and in experimental models of Crohn's diseases [4][5][6][7][8]. However, the association between gastric dysmotility and the presence of dyspeptic symptoms in these patients had not been previously investigated.…”

Section: Discussionmentioning

confidence: 99%

“…Although not primarily a motility disorder, some of the symptoms of Crohn's disease could be explained by the presence of inflammatory mucosal changes, tissue swelling and occasional obstruction, which may have important effects on gastrointestinal motility [3]. Disordered motility patterns, including delayed gastric emptying, visceral hypersensitivity and upper intestinal hypomotility, have been observed in patients and animals with inflammatory bowel diseases [4][5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

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Dyspeptic Symptoms and Delayed Gastric Emptying of Solids in Patients With Inactive Crohn's Disease

Nóbrega¹,

Ferreira²,

Oliveira³

et al. 2011

Gastroenterology

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Background: Patients with Crohn's disease (CD) have been shown to present dyspeptic symptoms more frequently than the general population. Some of these symptoms could be related to motility disorders to some degree. Then, we propose to investigate whether gastric emptying of solids in patients with inactive CD is delayed and to determine the relationships between gastric emptying and dyspeptic symptoms in inactive CD. Methods: Twenty-six patients with inactive Crohn's disease, as defined by a Crohn's Disease Activity Index (CDAI) < 150, underwent a gastric emptying test by breath test using 13 C octanoic acid coupled to a solid meal and answered a validated questionnaire (The Porto Alegre Dyspeptic Symptoms Questionnaire) to assess dyspeptic symptoms. Patients with scores ≥ 6 were considered to have dyspepsia. The control group was composed by 19 age-and sex-matched healthy volunteers. Results: Patients with CD had a significantly longer t 1/2 and t lag (p<0.05) than the controls. CD patients with dyspepsia had significantly (p<0.05) prolonged gastric emptying when compared to patients without dyspeptic symptoms. When the individual symptom patterns were analyzed, only vomiting was significantly associated with delayed gastric emptying (p<0.05). There was no difference between the subgroups of patients with respect to gender, CDAI scores, disease location, clinical behavior (obstructive/obstructive) or previous gastrointestinal surgery. Conclusion: Delayed gastric emptying in inactive Crohn's disease patients seems to be associated with dyspeptic symptoms, particularly vomiting, even without any evidence of gastrointestinal obstruction.

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Section: Discussionmentioning

confidence: 74%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Dyspeptic Symptoms and Delayed Gastric Emptying of Solids in Patients With Inactive Crohn's Disease

Nóbrega¹,

Ferreira²,

Oliveira³

et al. 2011

Gastroenterology

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“…41 Age greater than 40 years and anxiety independently predicted functional GI symptoms and both functional symptoms and depression were associated with impaired HRQOL and increased use of health services. In children with inactive IBD, these IBS symptoms have been associated with visceral hyperalgesia and anxiety, 42 but there are no studies to date assessing the effects on HRQOL.…”

Section: Comorbid Irritable Bowel Syndrome (Ibs)mentioning

confidence: 99%

Strategies to improve quality of life in adolescents with inflammatory bowel disease

Karwowski

Keljo

Szigethy

2009

Inflammatory Bowel Diseases

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Inflammatory bowel disease (IBD), which encompasses Crohn's disease (CD) and ulcerative colitis (UC), are chronic and debilitating conditions with unpredictable courses and complicated treatment. Pediatric IBD carries implications that extend beyond the health of the gastrointestinal tract. When these lifelong illnesses are diagnosed during adolescence, a critical developmental period, the transition to adulthood can be even more turbulent. Like other chronic diseases of childhood, patients with IBD are at risk for depression, anxiety, social isolation, and altered self-image, which can all negatively affect health-related quality of life (HRQOL). The review will draw from pertinent adult and pediatric literature about HRQOL over the past 10 years using a PubMed literature search to summarize instruments with which HRQOL is measured, and address factors that affect HRQOL in adolescents and young adults with IBD. Psychosocial interventions that have been utilized to improve quality of life in this population will also be covered. Identifying patients with impaired quality of life is of paramount importance, as is implementing strategies that may improve HRQOL, so that they may have an easier transition to adulthood while living with IBD.

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“…A study in pediatric IBD patients in remission with residual abdominal pain observed that they presented rectal pain thresholds lower than those of healthy volunteers and similar to those of patients with functional digestive diseases [73] . Further on, two studies measured in rectosigmoid junction biopsies the density of nerve fibers that presented the transient potential vanilloid receptor type 1 (TRPV1), implicated in nociception and in IBS visceral hypersensitivity [74,75] .…”

Section: Ibd Induces Hypersensitivitymentioning

confidence: 81%

Diagnosis and management of functional symptoms in inflammatory bowel disease in remission

Teruel

Garrido

Mesonero

2016

WJGPT

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it in the present work. We describe a problematic that comprises physiopathological uncertainties, diagnostic difficulties, as IBS-like symptoms are very similar to those produced by an inflammatory flare, and the necessity of appropriate management of these patients, who, although in remission, have impaired quality of life. Ultimately, from almost a philosophical point of view, the presence of IBS-like symptoms in IBD patients in remission supposes a challenge to the traditional functional-organic dichotomy, suggesting the need for a change of paradigm. Core tip: Many inflammatory bowel disease patients in remission suffer from ongoing gastrointestinal symptoms that resemble those of irritable bowel syndrome and that hinder their quality of life. We review the pathogenesis of these symptoms, their prevalence and the best management strategies. Author contributions: All authors contributed equally to this work. Conflict-of-interest statement:The authors declare no conflicts of interest. AbstractInflammatory bowel disease (IBD) patients in remission may suffer from gastrointestinal symptoms that resemble irritable bowel syndrome (IBS). Knowledge on this issue has increased considerably in the last decade, and it is our intention to review and summarize REVIEWSubmit a

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Functional gastrointestinal disorders and visceral hypersensitivity in children and adolescents suffering from Crohnʼs disease

Cited by 58 publications

References 47 publications

Dyspeptic Symptoms and Delayed Gastric Emptying of Solids in Patients With Inactive Crohn's Disease

Dyspeptic Symptoms and Delayed Gastric Emptying of Solids in Patients With Inactive Crohn's Disease

Strategies to improve quality of life in adolescents with inflammatory bowel disease

Diagnosis and management of functional symptoms in inflammatory bowel disease in remission

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