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Relationship between symptoms and hypersensitivity to rectal distension in patients with irritable bowel syndrome.
Aliment Pharmacol Ther. 2005 Jul 15; 22(2):157-64.AP

Abstract

BACKGROUND

Visceral hypersensitivity is considered an important pathophysiological mechanism in irritable bowel syndrome, yet its relationship to symptoms is unclear.

AIM

To detect possible associations between symptoms and the presence of hypersensitivity to rectal distension in patients with irritable bowel syndrome.

METHODS

Ninety-two irritable bowel syndrome patients and 17 healthy volunteers underwent a rectal barostat study. The association between specific irritable bowel syndrome symptoms and the presence of hypersensitivity was examined using Area under the Receiver Operating Characteristic curves.

RESULTS

Irritable bowel syndrome patients had significantly lower thresholds for discomfort/pain than healthy volunteers: 24 (18-30) and 30 (27-45) mmHg above minimal distending pressure, respectively. Forty-one patients (45%) showed hypersensitivity to rectal distension. Proportions of patients with different predominant bowel habits were similar in hypersensitive and normosensitive subgroups (diarrhoea predominant: 39 and 41%, respectively; alternating type: 27 and 28%, respectively; constipation predominant: 34 and 31%, respectively). Severe abdominal pain was more frequent in hypersensitive, compared with normosensitive patients (88% vs. 67%, P = 0.02), but none of the individual irritable bowel syndrome symptoms could accurately predict the presence of hypersensitivity, as assessed by Area under the Receiver Operating Characteristic curve analysis.

CONCLUSIONS

Hypersensitive and normosensitive irritable bowel syndrome patients present with comparable, heterogeneous symptomatology. Therefore, selection based on clinical parameters is unlikely to discriminate individual irritable bowel syndrome patients with visceral hypersensitivity from those with normal visceral sensitivity.

Authors+Show Affiliations

Department of Gastroenterology and Hepatology, Academic Medical Centre, Amsterdam, The Netherlands.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16011674

Citation

Kuiken, S D., et al. "Relationship Between Symptoms and Hypersensitivity to Rectal Distension in Patients With Irritable Bowel Syndrome." Alimentary Pharmacology & Therapeutics, vol. 22, no. 2, 2005, pp. 157-64.
Kuiken SD, Lindeboom R, Tytgat GN, et al. Relationship between symptoms and hypersensitivity to rectal distension in patients with irritable bowel syndrome. Aliment Pharmacol Ther. 2005;22(2):157-64.
Kuiken, S. D., Lindeboom, R., Tytgat, G. N., & Boeckxstaens, G. E. (2005). Relationship between symptoms and hypersensitivity to rectal distension in patients with irritable bowel syndrome. Alimentary Pharmacology & Therapeutics, 22(2), 157-64.
Kuiken SD, et al. Relationship Between Symptoms and Hypersensitivity to Rectal Distension in Patients With Irritable Bowel Syndrome. Aliment Pharmacol Ther. 2005 Jul 15;22(2):157-64. PubMed PMID: 16011674.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Relationship between symptoms and hypersensitivity to rectal distension in patients with irritable bowel syndrome. AU - Kuiken,S D, AU - Lindeboom,R, AU - Tytgat,G N, AU - Boeckxstaens,G E, PY - 2005/7/14/pubmed PY - 2005/9/30/medline PY - 2005/7/14/entrez SP - 157 EP - 64 JF - Alimentary pharmacology & therapeutics JO - Aliment Pharmacol Ther VL - 22 IS - 2 N2 - BACKGROUND: Visceral hypersensitivity is considered an important pathophysiological mechanism in irritable bowel syndrome, yet its relationship to symptoms is unclear. AIM: To detect possible associations between symptoms and the presence of hypersensitivity to rectal distension in patients with irritable bowel syndrome. METHODS: Ninety-two irritable bowel syndrome patients and 17 healthy volunteers underwent a rectal barostat study. The association between specific irritable bowel syndrome symptoms and the presence of hypersensitivity was examined using Area under the Receiver Operating Characteristic curves. RESULTS: Irritable bowel syndrome patients had significantly lower thresholds for discomfort/pain than healthy volunteers: 24 (18-30) and 30 (27-45) mmHg above minimal distending pressure, respectively. Forty-one patients (45%) showed hypersensitivity to rectal distension. Proportions of patients with different predominant bowel habits were similar in hypersensitive and normosensitive subgroups (diarrhoea predominant: 39 and 41%, respectively; alternating type: 27 and 28%, respectively; constipation predominant: 34 and 31%, respectively). Severe abdominal pain was more frequent in hypersensitive, compared with normosensitive patients (88% vs. 67%, P = 0.02), but none of the individual irritable bowel syndrome symptoms could accurately predict the presence of hypersensitivity, as assessed by Area under the Receiver Operating Characteristic curve analysis. CONCLUSIONS: Hypersensitive and normosensitive irritable bowel syndrome patients present with comparable, heterogeneous symptomatology. Therefore, selection based on clinical parameters is unlikely to discriminate individual irritable bowel syndrome patients with visceral hypersensitivity from those with normal visceral sensitivity. SN - 0269-2813 UR - https://www.unboundmedicine.com/medline/citation/16011674/Relationship_between_symptoms_and_hypersensitivity_to_rectal_distension_in_patients_with_irritable_bowel_syndrome_ L2 - https://doi.org/10.1111/j.1365-2036.2005.02524.x DB - PRIME DP - Unbound Medicine ER -