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Correlation of symptom criteria with perception thresholds during rectosigmoid distension in irritable bowel syndrome patients.
Am J Gastroenterol. 2000 Jan; 95(1):152-6.AJ

Abstract

OBJECTIVE

Due to a lack of reliable biological markers, the diagnosis of irritable bowel syndrome (IBS) is based on symptom criteria. The possible physiological correlates of these criteria are not known. Our aims were to identify correlations of currently used IBS symptom criteria with distinct alterations in visceral perception.

METHODS

Forty-two IBS patients (51% women) with a mean age of 39.5+/-1.4 yr, were included; 64% of patients were recruited from advertisement and 36% were clinic referrals. Patients completed a bowel symptom questionnaire, which included the Rome criteria and symptom severity ratings. Rectal discomfort thresholds were evaluated in all patients and in 19 controls, using a nonbiased tracking protocol consisting of phasic rectal balloon distensions before (PreTh) and after (PostTh) repetitive, high-pressure sigmoid distensions. We assessed the effect of each Rome criteria and symptom severity on PreTh and PostTh.

RESULTS

IBS symptom severity was reported as moderate in 38.1% and as severe in 61.9% of patients. Overall, lower thresholds were observed in IBS patients than in controls (PreTh: 28.2+/-1.7 vs. 36.3+/-2.8 mm Hg, p<0.05; PostTh: 25.3+/-1.5 vs. 34.2+/-2.7 mm Hg, p<0.01). When assessing the effect of Rome criteria on rectal thresholds, we found that patients with hard/lumpy stools had lower thresholds than those without them, whereas patients with loose watery stools had higher thresholds than those who lacked them (both p<0.05). The lowering of rectal discomfort thresholds after sigmoid stimulation was observed regardless of the presence or absence of any Rome criteria or symptom severity.

CONCLUSION

Although a decrease in rectal discomfort thresholds after sigmoid stimulation is seen in IBS regardless of specific symptoms, baseline and postsigmoid stimulation thresholds are lower in IBS patients with constipation-related symptoms.

Authors+Show Affiliations

UCLA/CURE Neuroenteric Disease Program, Department of Medicine and Physiology, UCLA School of Medicine, Los Angeles, California, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

10638575

Citation

Schmulson, M, et al. "Correlation of Symptom Criteria With Perception Thresholds During Rectosigmoid Distension in Irritable Bowel Syndrome Patients." The American Journal of Gastroenterology, vol. 95, no. 1, 2000, pp. 152-6.
Schmulson M, Chang L, Naliboff B, et al. Correlation of symptom criteria with perception thresholds during rectosigmoid distension in irritable bowel syndrome patients. Am J Gastroenterol. 2000;95(1):152-6.
Schmulson, M., Chang, L., Naliboff, B., Lee, O. Y., & Mayer, E. A. (2000). Correlation of symptom criteria with perception thresholds during rectosigmoid distension in irritable bowel syndrome patients. The American Journal of Gastroenterology, 95(1), 152-6.
Schmulson M, et al. Correlation of Symptom Criteria With Perception Thresholds During Rectosigmoid Distension in Irritable Bowel Syndrome Patients. Am J Gastroenterol. 2000;95(1):152-6. PubMed PMID: 10638575.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Correlation of symptom criteria with perception thresholds during rectosigmoid distension in irritable bowel syndrome patients. AU - Schmulson,M, AU - Chang,L, AU - Naliboff,B, AU - Lee,O Y, AU - Mayer,E A, PY - 2000/1/19/pubmed PY - 2000/1/19/medline PY - 2000/1/19/entrez SP - 152 EP - 6 JF - The American journal of gastroenterology JO - Am J Gastroenterol VL - 95 IS - 1 N2 - OBJECTIVE: Due to a lack of reliable biological markers, the diagnosis of irritable bowel syndrome (IBS) is based on symptom criteria. The possible physiological correlates of these criteria are not known. Our aims were to identify correlations of currently used IBS symptom criteria with distinct alterations in visceral perception. METHODS: Forty-two IBS patients (51% women) with a mean age of 39.5+/-1.4 yr, were included; 64% of patients were recruited from advertisement and 36% were clinic referrals. Patients completed a bowel symptom questionnaire, which included the Rome criteria and symptom severity ratings. Rectal discomfort thresholds were evaluated in all patients and in 19 controls, using a nonbiased tracking protocol consisting of phasic rectal balloon distensions before (PreTh) and after (PostTh) repetitive, high-pressure sigmoid distensions. We assessed the effect of each Rome criteria and symptom severity on PreTh and PostTh. RESULTS: IBS symptom severity was reported as moderate in 38.1% and as severe in 61.9% of patients. Overall, lower thresholds were observed in IBS patients than in controls (PreTh: 28.2+/-1.7 vs. 36.3+/-2.8 mm Hg, p<0.05; PostTh: 25.3+/-1.5 vs. 34.2+/-2.7 mm Hg, p<0.01). When assessing the effect of Rome criteria on rectal thresholds, we found that patients with hard/lumpy stools had lower thresholds than those without them, whereas patients with loose watery stools had higher thresholds than those who lacked them (both p<0.05). The lowering of rectal discomfort thresholds after sigmoid stimulation was observed regardless of the presence or absence of any Rome criteria or symptom severity. CONCLUSION: Although a decrease in rectal discomfort thresholds after sigmoid stimulation is seen in IBS regardless of specific symptoms, baseline and postsigmoid stimulation thresholds are lower in IBS patients with constipation-related symptoms. SN - 0002-9270 UR - https://www.unboundmedicine.com/medline/citation/10638575/Correlation_of_symptom_criteria_with_perception_thresholds_during_rectosigmoid_distension_in_irritable_bowel_syndrome_patients_ L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&amp;sid=nlm:pubmed&amp;issn=0002-9270&amp;date=2000&amp;volume=95&amp;issue=1&amp;spage=152 DB - PRIME DP - Unbound Medicine ER -