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Autonomic response to a visceral stressor is dysregulated in irritable bowel syndrome and correlates with duration of disease
Author(s) -
Cheng P.,
Shih W.,
Alberto M.,
Presson A. P.,
Licudine A.,
Mayer E. A.,
Naliboff B. D.,
Chang L.
Publication year - 2013
Publication title -
neurogastroenterology and motility
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.489
H-Index - 105
eISSN - 1365-2982
pISSN - 1350-1925
DOI - 10.1111/nmo.12177
Subject(s) - medicine , irritable bowel syndrome , heart rate variability , autonomic nervous system , heart rate , cardiology , gastroenterology , blood pressure
Background Previous studies reported altered autonomic nervous system ( ANS ) responses in irritable bowel syndrome ( IBS ) at baseline and to colonic balloon distension. This study examined heart rate variability ( HRV ) and plasma catecholamines as an index of ANS responsiveness in IBS during flexible sigmoidoscopy ( FS ) and explored associations of HRV with clinical measures. Methods Rome III‐positive IBS patients and healthy controls completed questionnaires measuring gastrointestinal and psychological symptoms. Heart rate variability measures were calculated using electrocardiogram ( ECG ) data at rest and during FS . Plasma catecholamines were measured before and after the FS . Linear mixed effects models were used to compare HRV with IBS status and IBS duration across six time points. Significance was assessed at the 0.05 level. Key Results Thirty‐six IBS patients (53% F, mean age 37.89) and 31 controls (58% F, mean age 37.26) participated. After adjusting for age, sex, body mass index, and current anxiety symptoms, IBS patients had a non‐significant lower cardiovagal tone (P = 0.436) and higher cardiosympathetic balance (P = 0.316) at rest. During FS , controls showed a transient increase in cardiosympathetic balance and decrease in cardiovagal tone. However, IBS patients had significantly less cardiosympathetic and cardiovagal responsiveness both leading up to (P = 0.003, P = 0.005) and following (P = 0.001) this stimulus. Those with longer duration of disease had less cardiosympathetic (P = 0.014) and cardiovagal (P = 0.009) responsiveness than those with shorter duration. No differences in catecholamines between IBS and controls were found. Conclusions & Inferences Irritable bowel syndrome demonstrated dysregulated ANS responses to a visceral stressor which could be related to disease duration. Therefore, autonomic dysregulation is an objective physiologic correlate of IBS .