Background. Increased visceroperception is considered a hallmark of irritable bowel syndrome (1BS). However poor data are available about the rectal sensorimotor patterns in diarrhoea and constipation prevalent-lBS subjects respectively. Aims. To investigate whether sensitivity, compliance and tone of the rectum are different between diarrhoea and constipation predominam-IBS subjects. Metbods: 5evemeen patients who fulfilled the Rome ll Criteria for IBS were enrolled; 9 patients (6 males; range 19-34 },ears) with diarrhoea predominant IBS (IBS-D) and 8 patients (4 males; range 24-37 years) with constipation predominant IBS (IBS-C) were respectively selected to undergo a rectal barostat study. After bag placement, minintal distending pressure (MDP) was firstly measured as the pressure that allows one to detect respiratory movements. Rectal compliance and sensitivity" were then assessed by isobaric distensinn with stepwise pressure increases fi'om 0 to 30 mmHg. During the distensions, subjects were asked to report: first perception, feeling of stool and urgency to detkcate. After a 30 min adaptation period, rectal tone was measured as average volume over 30 min at a level of MDP + 2mmHg. Results: In the IBS-D patients, rectal volmnes required to pemeive the sensation of stool and urgency were significantly- lower than in IBS-C patients (101 -+ 37 vs 206-+ 36 ml and 193 -+ 50 vs 326 -+ 59 ml, respectively, p<0.01 ). Any significant difference was observed when sensitivity was expressed as pressnre levels. Rectal compliance was also significamly lower in IBS-D patients than in IBS-C patients (64 +_ 1.5 vs 12.3 • 1.9 ml/mmHg, p<0.05). Average bag volume at MDP + 2 during 30 rain was significantly higher in IBS-C than IBS-D patients (119 _+ 6 ml vs 69 -+ 2, p<0.05). Conclusion: IBS-D patients are characterized by- increased rectal sensinvity, and by decreased compliance and adaptative relaxation compared to IBS-C subjects. Rectal hamstat studies help to distinguish groups of patients with different subtypes of IBS and support new hypothesis about IBS patbogenesis

Rectal motor and sensory functions in irritable bowel syndrome subtypes.

CUOMO, ROSARIO;SARNELLI, GIOVANNI;
2003

Abstract

Background. Increased visceroperception is considered a hallmark of irritable bowel syndrome (1BS). However poor data are available about the rectal sensorimotor patterns in diarrhoea and constipation prevalent-lBS subjects respectively. Aims. To investigate whether sensitivity, compliance and tone of the rectum are different between diarrhoea and constipation predominam-IBS subjects. Metbods: 5evemeen patients who fulfilled the Rome ll Criteria for IBS were enrolled; 9 patients (6 males; range 19-34 },ears) with diarrhoea predominant IBS (IBS-D) and 8 patients (4 males; range 24-37 years) with constipation predominant IBS (IBS-C) were respectively selected to undergo a rectal barostat study. After bag placement, minintal distending pressure (MDP) was firstly measured as the pressure that allows one to detect respiratory movements. Rectal compliance and sensitivity" were then assessed by isobaric distensinn with stepwise pressure increases fi'om 0 to 30 mmHg. During the distensions, subjects were asked to report: first perception, feeling of stool and urgency to detkcate. After a 30 min adaptation period, rectal tone was measured as average volume over 30 min at a level of MDP + 2mmHg. Results: In the IBS-D patients, rectal volmnes required to pemeive the sensation of stool and urgency were significantly- lower than in IBS-C patients (101 -+ 37 vs 206-+ 36 ml and 193 -+ 50 vs 326 -+ 59 ml, respectively, p<0.01 ). Any significant difference was observed when sensitivity was expressed as pressnre levels. Rectal compliance was also significamly lower in IBS-D patients than in IBS-C patients (64 +_ 1.5 vs 12.3 • 1.9 ml/mmHg, p<0.05). Average bag volume at MDP + 2 during 30 rain was significantly higher in IBS-C than IBS-D patients (119 _+ 6 ml vs 69 -+ 2, p<0.05). Conclusion: IBS-D patients are characterized by- increased rectal sensinvity, and by decreased compliance and adaptative relaxation compared to IBS-C subjects. Rectal hamstat studies help to distinguish groups of patients with different subtypes of IBS and support new hypothesis about IBS patbogenesis
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11588/181414
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