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Altered rectal perception in irritable bowel syndrome is associated with symptom severity.
Gastroenterology. 2007 Oct; 133(4):1113-23.G

Abstract

BACKGROUND & AIMS

Diverging results exist regarding the connection between altered visceral perception and gastrointestinal (GI) symptoms, as well as the effects of psychological status on visceral sensitivity. We sought to investigate different aspects of rectal perception in irritable bowel syndrome (IBS) and the association with GI and psychological symptoms.

METHODS

We included 109 patients with IBS meeting Rome II criteria (77 women; age range, 20-71 years) and 29 healthy controls (21 women; age range, 20-68 years). They underwent rectal balloon distentions determining sensory thresholds for discomfort and pain, the perceived intensity of unpleasantness, and the viscerosomatic referral area. The fifth percentile (thresholds) and 95th percentile (unpleasantness and referral area) in controls were used to define altered perception. Questionnaires were used to assess severity of IBS-related GI symptoms and psychological symptoms.

RESULTS

When combining the 3 aspects of perception, 67 patients (61%) had altered rectal perception. These patients, compared with normosensitive patients, more frequently reported moderate or severe pain (73% vs 44%; P < .01), bloating (73% vs 36%; P < .0001), diarrhea (47% vs 21%; P < .01), satiety (39% vs 13%; P < .01), and clinically significant anxiety (31% vs 12%; P < .05). In a multivariate analysis, only pain and bloating remained associated with altered rectal perception.

CONCLUSIONS

Altered rectal perception is common in IBS and seems to be one important pathophysiologic factor associated with GI symptom severity in general and pain and bloating in particular. It is not just a reflection of the psychological state of the patient.

Authors+Show Affiliations

Department of Internal Medicine, Sahlgrenska University Hospital, Göteborg, Sweden.No affiliation info availableNo affiliation info availableNo 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

17919487

Citation

Posserud, Iris, et al. "Altered Rectal Perception in Irritable Bowel Syndrome Is Associated With Symptom Severity." Gastroenterology, vol. 133, no. 4, 2007, pp. 1113-23.
Posserud I, Syrous A, Lindström L, et al. Altered rectal perception in irritable bowel syndrome is associated with symptom severity. Gastroenterology. 2007;133(4):1113-23.
Posserud, I., Syrous, A., Lindström, L., Tack, J., Abrahamsson, H., & Simrén, M. (2007). Altered rectal perception in irritable bowel syndrome is associated with symptom severity. Gastroenterology, 133(4), 1113-23.
Posserud I, et al. Altered Rectal Perception in Irritable Bowel Syndrome Is Associated With Symptom Severity. Gastroenterology. 2007;133(4):1113-23. PubMed PMID: 17919487.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Altered rectal perception in irritable bowel syndrome is associated with symptom severity. AU - Posserud,Iris, AU - Syrous,Alma, AU - Lindström,Lina, AU - Tack,Jan, AU - Abrahamsson,Hasse, AU - Simrén,Magnus, Y1 - 2007/07/25/ PY - 2007/03/01/received PY - 2007/06/14/accepted PY - 2007/10/9/pubmed PY - 2007/10/27/medline PY - 2007/10/9/entrez SP - 1113 EP - 23 JF - Gastroenterology JO - Gastroenterology VL - 133 IS - 4 N2 - BACKGROUND & AIMS: Diverging results exist regarding the connection between altered visceral perception and gastrointestinal (GI) symptoms, as well as the effects of psychological status on visceral sensitivity. We sought to investigate different aspects of rectal perception in irritable bowel syndrome (IBS) and the association with GI and psychological symptoms. METHODS: We included 109 patients with IBS meeting Rome II criteria (77 women; age range, 20-71 years) and 29 healthy controls (21 women; age range, 20-68 years). They underwent rectal balloon distentions determining sensory thresholds for discomfort and pain, the perceived intensity of unpleasantness, and the viscerosomatic referral area. The fifth percentile (thresholds) and 95th percentile (unpleasantness and referral area) in controls were used to define altered perception. Questionnaires were used to assess severity of IBS-related GI symptoms and psychological symptoms. RESULTS: When combining the 3 aspects of perception, 67 patients (61%) had altered rectal perception. These patients, compared with normosensitive patients, more frequently reported moderate or severe pain (73% vs 44%; P < .01), bloating (73% vs 36%; P < .0001), diarrhea (47% vs 21%; P < .01), satiety (39% vs 13%; P < .01), and clinically significant anxiety (31% vs 12%; P < .05). In a multivariate analysis, only pain and bloating remained associated with altered rectal perception. CONCLUSIONS: Altered rectal perception is common in IBS and seems to be one important pathophysiologic factor associated with GI symptom severity in general and pain and bloating in particular. It is not just a reflection of the psychological state of the patient. SN - 0016-5085 UR - https://www.unboundmedicine.com/medline/citation/17919487/Altered_rectal_perception_in_irritable_bowel_syndrome_is_associated_with_symptom_severity_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0016-5085(07)01404-7 DB - PRIME DP - Unbound Medicine ER -