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Motility response to colonic distention is increased in postinfectious irritable bowel syndrome ( PI ‐ IBS )
Author(s) -
Kanazawa M.,
Palsson O. S.,
Tilburg M. A. L.,
Gangarosa L. M.,
Fukudo S.,
Whitehead W. E.
Publication year - 2014
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.12318
Subject(s) - barostat , irritable bowel syndrome , medicine , gastroenterology , diarrhea
Background Acute intestinal infection leads to persistent intestinal smooth muscle hypercontractility and pain hypersensitivity after resolution of the infection in animal models. We investigated whether postinfectious irritable bowel syndrome ( PI ‐ IBS ) is associated with abnormalities in phasic contractions of the colon, smooth muscle tone, and pain sensitivity compared to non‐ PI ‐ IBS ( NI ‐ IBS ) or healthy controls ( HC ). Methods Two hundred and eighteen Rome III‐positive IBS patients and 43 HC participated. IBS patients were designated PI ‐ IBS , if their IBS symptoms began following an episode of gastroenteritis characterized by two or more of: fever, vomiting, or diarrhea. Pain threshold to phasic distentions of the descending colon was assessed using a barostat. Colonic motility was assessed with the barostat bag minimally inflated to the individual operating pressure ( IOP ), at 20 mmHg above the IOP , and following a test meal. IBS symptom severity and psychological symptoms were assessed by the IBS Severity Scale ( IBS ‐ SS ) and the Brief Symptom Inventory‐18 ( BSI ‐18). Key Results Twenty two (10.1%) met criteria for PI ‐ IBS . Both IBS and HC groups showed a significant increase in motility index during intraluminal distention and following meals. The magnitude of the response to distention above (orad to) the balloon was significantly greater in PI ‐ IBS compared with NI ‐ IBS ( p < 0.05) or HC ( p < 0.01). Differences between PI ‐ IBS and NI ‐ IBS were not significant for IBS symptom severity, pain threshold, barostat bag volumes, or any psychological score on the BSI ‐18. Conclusions & Inferences Patients with PI ‐ IBS have greater colonic hypercontractility than NI ‐ IBS . We speculate that sustained mild mucosal inflammation may cause this colonic irritability.