Abstract
Abnormal gut-brain interactions are common in irritable bowel syndrome (IBS), but the associations between neurophysiological measures and their relation to gastrointestinal (GI) symptoms are poorly understood. Our aim was to explore these relationships and define the most relevant neurophysiology measures for GI symptom severity in IBS. IBS patients underwent small intestinal motility (manometry; fasted and fed contraction frequency, phase III time) and secretion (transmural potential difference), rectal sensorimotor (barostat; sensory thresholds, tone response, compliance), autonomic nervous system (baroreceptor sensitivity and effectiveness), and colonic motor function (transit time) examinations. GI symptom severity (GSRS-IBS), and anxiety and depression (HAD) as a proxy measure of central nervous system (CNS) dysfunction, were assessed. In total 281 IBS patients (Rome II criteria) were included (74% females, median age 36 [interquartile range 28–50] years). Significant correlations between neurophysiology measures were stronger within, rather than between, different neurophysiological examinations. The strongest neurophysiology-symptom correlations occurred between a combination of CNS and visceral sensitivity parameters, and GSRS-IBS total score and pain domain (ρ = 0.40, p < 0.001, and ρ = 0.38, p < 0.001). Associations between GI symptoms in IBS and individual and combinations of neurophysiological factors occurred, primarily in CNS and visceral sensitivity measures, providing new insights into the clinical presentation of IBS.
Highlights
Abnormal gut-brain interactions are common in irritable bowel syndrome (IBS), but the associations between neurophysiological measures and their relation to gastrointestinal (GI) symptoms are poorly understood
Some individual neurophysiological factors used in this study have been linked to elevated symptom severity, to the best of our knowledge, GI motility, secretion, sensitivity and autonomic nervous system (ANS) and central nervous system (CNS) function have not been analysed simultaneously in IBS patients before
There is a study that has demonstrated a link between rectal compliance and colonic transit time in IBS patients with urgency[35]
Summary
Abnormal gut-brain interactions are common in irritable bowel syndrome (IBS), but the associations between neurophysiological measures and their relation to gastrointestinal (GI) symptoms are poorly understood. IBS patients have been reported to have increased psychological distress[10,11], visceral hypersensitivity[12], altered colonic motility[13], aberrant autonomic nervous system (ANS) function[14,15], rectal sensorimotor dysfunction[16,17], and dysfunction of motility[18,19,20] and secretion[21] of the small intestine, in comparison with healthy controls These abnormalities have been described individually in IBS, the associations among these aberrant measures, and the interactions between these parameters and the patient reported IBS symptom severity, have to this date not been thoroughly studied. For the other neurophysiological factors, the association with symptom severity in IBS is even less clear
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