Increased β-Adrenergic Sensitivity Correlates with Visceral Hypersensitivity in Patients with Constipation-Predominant Irritable Bowel Syndrome

Park, Jung Ho; Rhee, Poong‐Lyul; Kim, Hyun Seo; Lee, Jun Haeng; Kim, Young‐Ho; Kim, Jae Jun; Rhee, Jong Chul; Kang, Eun-Jin; Yu, Bum-Hee

doi:10.1007/s10620-005-2932-y

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“…[2][3][4][5] Numerous studies have been undertaken to assess autonomic imbalance as a factor underlying the pathogenesis of IBS, considering that experimental stress increases sympathetic activity and also alters gastrointestinal motor responses. [6][7][8] At present, laser Doppler flowmetry (LDF), which assesses microcirculatory blood flow in the skin to a depth of about 1 mm, is the most commonly used method for assessment of peripheral autonomic dysfunction. [9][10][11] Carried out at the fingertips, this technique can be used under resting conditions and also during phasic sympathetic activation by means of deep inspiratory gasps and brief electrical stimuli as well as during tonic activation by sustained painful stimuli (cold pressor test) or by mental arithmetic.…”

Section: Introductionmentioning

confidence: 99%

Characterization of autonomic dysfunction in patients with irritable bowel syndrome using fingertip blood flow

Tanaka

Manabe

Hata

et al. 2008

Neurogastroenterology Motil

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Fingertip blood flow (FTBF) as measured by laser Doppler flowmetry (LDF) measurement is considered an indicator of sympathetic nerve function. We evaluated autonomic function in patients with irritable bowel syndrome (IBS) by assessing FTBF with both LDF and continuous-wave (cw) Doppler sonography. Firstly, the two methods were compared in 40 healthy volunteers. Next, 59 patients with IBS as well as 118 healthy volunteer controls were studied. In the supine position, FTBF in the right index finger was measured with cw Doppler sonography, whereas FTBF in the left index finger was assessed with LDF. After baseline measurement for at least 5 min, the volunteers received sympathetic stimulation from cold stress applied without notification in the form of an icebag (0 degrees C) upon the left forearm for 1 min. The new cw Doppler sonography method can be used in place of the old LDF method for clinical purposes. FTBF velocity before stimulation (V(pre)) was significantly lower in the IBS group than that in the healthy volunteers (P < 0.01). In addition, the time required for FTBF to return to V(pre) after stimulation was significantly longer in the IBS group than that in the control group. (P = 0.02). Thus, measurement of FTBF with cw Doppler sonography can be useful in the assessment of sympathetic nerve function. The IBS patients showed an abnormal FTBF response suggesting the presence of excess sympathetic activity.

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