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Visceral sensitivity and symptoms in patients with constipation- or diarrhea-predominant irritable bowel syndrome (IBS): effect of a low-fat intraduodenal infusion.
Am J Gastroenterol. 2005 Feb; 100(2):383-9.AJ

Abstract

BACKGROUND

Visceral hypersensitivity is common in Irritable Bowel Syndrome (IBS) patients, and symptoms exacerbate postprandially. Yet the effects of nutrients on visceral sensitivity and symptoms in these patients have not been fully explored.

AIMS

To evaluate the differences of visceral sensitivity and symptoms in healthy subjects and IBS patients during fasting and intraduodenal lipids infusion.

METHODS

Graded rectal distensions at fixed tension levels were performed in 16 IBS patients (8 IBS-C and 8 IBS-D) and 6 healthy subjects before and during intraduodenal lipids infusion at 0.5 kcal/min. Tension levels were increased in 4 gr increments up to 64 gr or discomfort during both conditions. At each step, perception and symptoms were measured by means of a validated questionnaire.

RESULTS

In basal conditions, perception thresholds in IBS patients and health were, respectively, 8 +/- 2 gr versus 32 +/- 9 gr (p < 0.001) with no changes during lipids. Intraduodenal lipids infusion significantly lowered threshold of discomfort in IBS patients in comparison to fasting (24 +/- 6 gr vs 34 +/- 4 gr; p < 0.05), while health tolerated all distension without discomfort. No differences of compliance, perception, or discomfort were observed between the two subgroups of patients at each tension step. The predominant symptom elicited in patients with IBS-C was abdominal pain (54%), while patients with IBS-D exhibited urgency (63%, p < 0.005); this pattern was maintained during lipids.

CONCLUSIONS

Intraduodenal lipids increase visceral sensitivity in both IBS-C and IBS-D; symptoms specificity in response to rectal distension is maintained in the postprandial period. Lipids may be responsible for the postprandial symptoms exacerbation in IBS.

Authors+Show Affiliations

Department of Medicine and Ageing Sciences, Section of Internal Medicine and Gastroenterology, Gabriele D'Annunzio University and Foundation, 66100 Chieti, Italy.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

15667496

Citation

Caldarella, Maria Pia, et al. "Visceral Sensitivity and Symptoms in Patients With Constipation- or Diarrhea-predominant Irritable Bowel Syndrome (IBS): Effect of a Low-fat Intraduodenal Infusion." The American Journal of Gastroenterology, vol. 100, no. 2, 2005, pp. 383-9.
Caldarella MP, Milano A, Laterza F, et al. Visceral sensitivity and symptoms in patients with constipation- or diarrhea-predominant irritable bowel syndrome (IBS): effect of a low-fat intraduodenal infusion. Am J Gastroenterol. 2005;100(2):383-9.
Caldarella, M. P., Milano, A., Laterza, F., Sacco, F., Balatsinou, C., Lapenna, D., Pierdomenico, S. D., Cuccurullo, F., & Neri, M. (2005). Visceral sensitivity and symptoms in patients with constipation- or diarrhea-predominant irritable bowel syndrome (IBS): effect of a low-fat intraduodenal infusion. The American Journal of Gastroenterology, 100(2), 383-9.
Caldarella MP, et al. Visceral Sensitivity and Symptoms in Patients With Constipation- or Diarrhea-predominant Irritable Bowel Syndrome (IBS): Effect of a Low-fat Intraduodenal Infusion. Am J Gastroenterol. 2005;100(2):383-9. PubMed PMID: 15667496.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Visceral sensitivity and symptoms in patients with constipation- or diarrhea-predominant irritable bowel syndrome (IBS): effect of a low-fat intraduodenal infusion. AU - Caldarella,Maria Pia, AU - Milano,Angelo, AU - Laterza,Francesco, AU - Sacco,Flora, AU - Balatsinou,Crysanthi, AU - Lapenna,Domenico, AU - Pierdomenico,Sante Donato, AU - Cuccurullo,Franco, AU - Neri,Matteo, PY - 2005/1/26/pubmed PY - 2005/3/2/medline PY - 2005/1/26/entrez SP - 383 EP - 9 JF - The American journal of gastroenterology JO - Am J Gastroenterol VL - 100 IS - 2 N2 - BACKGROUND: Visceral hypersensitivity is common in Irritable Bowel Syndrome (IBS) patients, and symptoms exacerbate postprandially. Yet the effects of nutrients on visceral sensitivity and symptoms in these patients have not been fully explored. AIMS: To evaluate the differences of visceral sensitivity and symptoms in healthy subjects and IBS patients during fasting and intraduodenal lipids infusion. METHODS: Graded rectal distensions at fixed tension levels were performed in 16 IBS patients (8 IBS-C and 8 IBS-D) and 6 healthy subjects before and during intraduodenal lipids infusion at 0.5 kcal/min. Tension levels were increased in 4 gr increments up to 64 gr or discomfort during both conditions. At each step, perception and symptoms were measured by means of a validated questionnaire. RESULTS: In basal conditions, perception thresholds in IBS patients and health were, respectively, 8 +/- 2 gr versus 32 +/- 9 gr (p < 0.001) with no changes during lipids. Intraduodenal lipids infusion significantly lowered threshold of discomfort in IBS patients in comparison to fasting (24 +/- 6 gr vs 34 +/- 4 gr; p < 0.05), while health tolerated all distension without discomfort. No differences of compliance, perception, or discomfort were observed between the two subgroups of patients at each tension step. The predominant symptom elicited in patients with IBS-C was abdominal pain (54%), while patients with IBS-D exhibited urgency (63%, p < 0.005); this pattern was maintained during lipids. CONCLUSIONS: Intraduodenal lipids increase visceral sensitivity in both IBS-C and IBS-D; symptoms specificity in response to rectal distension is maintained in the postprandial period. Lipids may be responsible for the postprandial symptoms exacerbation in IBS. SN - 0002-9270 UR - https://www.unboundmedicine.com/medline/citation/15667496/Visceral_sensitivity_and_symptoms_in_patients_with_constipation__or_diarrhea_predominant_irritable_bowel_syndrome__IBS_:_effect_of_a_low_fat_intraduodenal_infusion_ DB - PRIME DP - Unbound Medicine ER -