Oesophageal motility in the irritable bowel syndrome.

Whorwell, Peter J.; Clouter, C; Smith, Carl C.

doi:10.1136/bmj.282.6270.1101

Cited by 99 publications

(19 citation statements)

References 10 publications

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“…Abnormal gastrointestinal motility and visceral hypersenstivity have been reported in IBS patients (115)(116)(117)(118)(119)(120)(121)(122)(123)(124)(125)(126)(127)(128). It has been speculated that this abnormality is caused by genetic, psychosocial factors and stress.…”

Section: The Neuroendocrine System (Nes) Of the Gutmentioning

confidence: 99%

The role of diet in the pathogenesis and management of irritable bowel syndrome (Review)

El‐Salhy

Østgaard

Gundersen³

et al. 2012

Int J Mol Med

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Abstract. Most patients with irritable bowel syndrome (IBS) believe that diet plays a significant role in inducing IBS symptoms and desire to know what foods to avoid. It has been found that the intake of calories, carbohydrates, proteins and fat by IBS patients does not differ from that of the background population. IBS patients were found to avoid certain food items that are rich in fermentable oligo-, di-and monosacharides and polyols (FODMAPs), but they did have a high consumption of many other FODMAP-rich food items. The diet of IBS patients was found to consist of a low calcium, magnesium, phosphorus, vitamin B2 and vitamin A content. There is no consistent evidence that IBS patients suffer from food allergy, nor is there documented evidence that food intolerance plays a role in IBS symptoms. Abnormalities in gut hormones have been reported in IBS patients. As gut hormones control and regulate gastrointestinal motility and sensation, this may explain the abnormal gastrointestinal motility and visceral hypersensitivity reported in these patients. Guidance concerning food management which includes individually based restrictions of FODMAP-rich food items and individual evaluation of the effects of protein-, fat-and carbohydrate-rich/poor diets may reduce IBS symptoms.

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Section: The Neuroendocrine System (Nes) Of the Gutmentioning

confidence: 99%

The role of diet in the pathogenesis and management of irritable bowel syndrome (Review)

El‐Salhy

Østgaard

Gundersen³

et al. 2012

Int J Mol Med

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“…Besides the increased morbidity caused by IBS, it represents an economic burden to the society in different indirect forms such as increased sick leave and over consumption of healthcare resources (2,3). General disturbances in gastrointestinal motility have been reported in patients with IBS (4)(5)(6)(7)(8)(9)(10). The cause of gastrointestinal dysmotility has been speculated to be a result of genetic, psychosocial factors and stress (1)(2)(3).…”

Section: Introductionmentioning

confidence: 99%

Ghrelin in patients with irritable bowel syndrome

El‐Salhy

Lillebø²,

Reinemo³

et al. 2009

Int J Mol Med

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Abstract. General gastrointestinal dysmotility occurs in patients with irritable bowel syndrome (IBS). Ghrelin seems to play an important role in regulating gastrointestinal motility. The present study was undertaken, therefore, to establish the possible role of ghrelin in the pathophysiology of IBS. Thirty-seven patients with IBS (19 had IBS-constipation and 18 IBS-diarrhoea) were included in this study. Ten healthy volunteers served as controls. After overnight fast, blood samples were drawn from patients and controls, and a gastroduodenal endoscopy was performed. Biopsies were taken from oxyntic mucosa and duodenum. Ghrelin cell density was determined by computer image analysis after immunohistochemical staining of the tissues. Total and active ghrelin were detected in tissue extracts and plasma by commercially available RIA and ELISA Kits. The density of ghrelinimmunoreactive cells in the oxyntic mucosa was significantly lower in IBS-constipation and significantly higher in IBSdiarrhoea patients than healthy controls (P<0.0001 and <0.0001, respectively). There was no statistical difference in total or active ghrelin between IBS patients and controls, regarding tissue extracts or plasma. In order to compensate for the increase and decrease in the ghrelin cell density, the synthesis and release of ghrelin may be decreased and increased in IBS-diarrhoea and IBS-constipation patients, respectively. It has been speculated that this compensatory mechanism may be subjected from time to time to fatigue with the subsequent increased and decreased synthesis and release of ghrelin in IBS-diarrhoea and IBS-constipation with a subsequent intermittent diarrhoea or constipation seen in these patients, respectively.

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“…Thus, the present findings reinforce the concept of the existence of a functional relationship between colic area and upper gastrointestinal on the LES motility. In fact, previous clinical and experimental works indicate that RD might be responsible in eliciting LES relaxation (13,19) . Moreover, mechanisms of TLESR differ from those of neural-mediated LES relaxation due to deglutition.…”

Section: Discussionmentioning

confidence: 99%

“…Some investigations utilizing animal models characterized a neural-mediated reflex of LES relaxation during intra-gastric distention or intramural neuronal stimulation (10) . Moreover, either clinical or experimental reports indicate that the intestinal segment induces esophageal relaxation, which are permissive for dysphagic symptoms (15,19) . In fact, in their work on 21 patients who had intestinal disorders such as constipation and irritable bowel syndrome (IBS), the authors detected that 54% had GERD (12) .…”

Section: Introductionmentioning

confidence: 99%

The Participation of the Nitrergic Pathway in Increased Rate of Transitory Relaxation of Lower Esophageal Sphincter Induced by Rectal Distension in Dogs

Palheta

Graça

Santos

et al. 2014

Arq. Gastroenterol.

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ContextThe rectal distension in dogs increases the rate of transitory lower esophageal sphincter relaxation considered the main factor causing gastroesophageal reflux.ObjectivesThe aim of this study was evaluate the participation of the nitrergic pathway in the increased transitory lower esophageal sphincter relaxation rate induced by rectal distension in anesthetized dogs.MethodsMale mongrel dogs (n = 21), weighing 10-15 kg, were fasted for 12 hours, with water ad libitum. Thereafter, they were anesthetized (ketamine 10 mg.Kg-1+ xylazine 20 mg.Kg-1), so as to carry out the esophageal motility evaluation protocol during 120 min. After a 30-minute basal period, the animals were randomly intravenous treated whith: saline solution 0.15M (1ml.Kg-1), L-NAME (3 mg.Kg-1), L-NAME (3 mg.Kg-1) + L-Arginine (200 mg.Kg-1), glibenclamide (1 mg.Kg-1) or methylene blue (3 mg.Kg-1). Forty-five min after these pre-treatments, the rectum was distended (rectal distension, 5 mL.Kg-1) or not (control) with a latex balloon, with changes in the esophageal motility recorded over 45 min. Data were analyzed using ANOVA followed by Student Newman-Keuls test.ResultsIn comparison to the respective control group, rectal distension induces an increase in transitory lower esophageal sphincter relaxation. Pre-treatment with L-NAME or methylene blue prevents (P<0.05) this phenomenon, which is reversible by L-Arginine plus L-NAME. However, pretreating with glibenclamide failed to abolish this process.ConclusionsTherefore, these experiments suggested, that rectal distension increases transitory lower esophageal sphincter relaxation in dogs via through nitrergic pathways.

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Oesophageal motility in the irritable bowel syndrome.

Cited by 99 publications

References 10 publications

The role of diet in the pathogenesis and management of irritable bowel syndrome (Review)

The role of diet in the pathogenesis and management of irritable bowel syndrome (Review)

Ghrelin in patients with irritable bowel syndrome

The Participation of the Nitrergic Pathway in Increased Rate of Transitory Relaxation of Lower Esophageal Sphincter Induced by Rectal Distension in Dogs

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