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. 2005 Oct;54(10):1396-401.
doi: 10.1136/gut.2004.058685. Epub 2005 May 28.

Sex specific alterations in autonomic function among patients with irritable bowel syndrome

K Tillisch  1 , E A Mayer, J S Labus, J Stains, L Chang, B D Naliboff
Affiliations

Sex specific alterations in autonomic function among patients with irritable bowel syndrome

K Tillisch et al. Gut. 2005 Oct.

Abstract

Background: Irritable bowel syndrome (IBS) is associated with increased psychological symptoms, early life stressors, and alterations in visceral perception and brain responses to noxious visceral stimuli. The autonomic nervous system (ANS) is a likely mediator for these brain-gut interactions. The few studies directly examining ANS measures have been suggestive of alterations in some IBS patients, but no studies to date have examined the potentially critical variables of sex differences or response to visceral stimulation.

Aims: (1) To test differences in ANS function during rest and during a visceral stressor (rectosigmoid balloon distension) between IBS patients and healthy control subjects. (2) To examine the role of sex on the autonomic responses of IBS patients.

Methods: Baseline autonomic measures were evaluated from 130 Rome I positive IBS patients and 55 healthy control subjects. Data were also collected from a subset of 46 IBS patients and 16 healthy control subjects during a sigmoid balloon distension study. Heart rate variability measures of peak power ratio (PPR) and peak power high frequency (PPHF) were analysed to assess sympathetic balance and parasympathetic response, respectively. Peripheral sympathetic response was measured by skin conductance.

Results: IBS patients showed a greater skin conductance response to visceral distension than controls. IBS patients had higher PPR and lower PPHF across conditions. Male IBS patients had higher skin conductance and PPR than females and lower PPHF.

Conclusions: IBS patients have altered autonomic responsiveness to a visceral stressor, with increased sympathetic and decreased parasympathetic activity. These differences are predominantly seen in males.

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Figures

Figure 1
Figure 1
Skin conductance (SC) scores (with standard error bars) are shown at baseline, after balloon placement, and during sigmoid distension for control and irritable bowel syndrome (IBS) subjects, and for male and female IBS subjects. A significant condition × group interaction (p = 0.039) was seen, with higher SC in the IBS group versus the control group. A significant sex main effect (p = 0.010) was seen between male and female IBS patients, with higher SC in the male group.
Figure 2
Figure 2
Peak power ratio of low to high frequency (PPLF/ PPHF) scores (with standard error bars) are shown at baseline, after balloon placement, and during sigmoid distension for control and irritable bowel syndrome (IBS) subjects, and for male and female IBS subjects. A group main effect (p = 0.0068) was seen for the IBS versus the control group, with higher sympathetic balance in the IBS group. A sex main effect (p = 0.0031) was seen between male and female IBS patients, with higher sympathetic balance in the male group.
Figure 3
Figure 3
Peak power high frequency (PPHF) scores (with standard error bars) are shown at baseline, after balloon placement, and during sigmoid distension for control and irritable bowel syndrome (IBS) subjects, and for male and female IBS subjects. A group main effect (p = 0.044) was seen with lower parasympathetic tone in the IBS group compared with controls. A sex main effect (p = 0.008) was seen between male and female IBS patients, with lower parasympathetic tone in the male group.
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