Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2008 Jul;6(7):772-81.
doi: 10.1016/j.cgh.2008.02.060. Epub 2008 May 5.

Prospective study of motor, sensory, psychologic, and autonomic functions in patients with irritable bowel syndrome

Michael Camilleri  1 , Sanna McKinzie, Irene Busciglio, Phillip A Low, Seth Sweetser, Duane Burton, Kari Baxter, Michael Ryks, Alan R Zinsmeister
Affiliations

Prospective study of motor, sensory, psychologic, and autonomic functions in patients with irritable bowel syndrome

Michael Camilleri et al. Clin Gastroenterol Hepatol. 2008 Jul.

Abstract

Background & aims: The aim of this study was to assess pathophysiology in irritable bowel syndrome (IBS).

Methods: A total of 122 IBS patients (3 male) and 41 healthy females underwent the following: questionnaires (symptoms, psychology), autonomic function, gut transit, gastric volumes, satiation, rectal compliance, and sensation (thresholds and pain ratings) testing. Proportions of patients with abnormal (<10th and >90th percentiles) motor or sensory functions according to bowel symptoms (constipation [C], diarrhea [D], mixed [M),) pain/bloat, and number of primary symptoms were estimated.

Results: IBS subgroups (C, D, M) were similar in age, gastric and small-bowel transit, satiation, gastric volumes, rectal compliance, sensory thresholds, and pain ratings. IBS was associated with body mass index, somatic symptoms, and anxiety and depression scores. Significant associations were observed with colonic transit (IBS-C [P = .078] and IBS-D [P < .05] at 24 h; IBS-D [P < .01] and IBS-M [P = .056] at 48 h): 32% of IBS patients had abnormal colonic transit: 20.5% at 24 hours and 11.5% at 48 hours. Overall, 20.5% of IBS patients had increased sensation to distensions: hypersensitivity (<10th percentile thresholds) in 7.6%, and hyperalgesia (pain sensation ratings to distension >90th percentile for ratings in health) in 13%. Conversely, 16.5% of IBS patients had reduced rectal sensation. Pain greater than 6 times per year and bloating were not associated significantly with motor, satiation, or sensory functions. Endorsing 1 to 2 or 3 to 4 primary IBS symptoms were associated with abnormal transit and sensation in IBS.

Conclusions: In tertiary referral (predominantly female) patients with IBS, colonic transit (32%) is the most prevalent physiologic abnormality; 21% had increased and 17% had decreased rectal pain sensations. Comprehensive physiologic assessment may help optimize management in IBS.

PubMed Disclaimer

Conflict of interest statement

Disclosures: The authors have no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
SCL-90 mean T scores. Note there are statistically significant differences in anxiety, depression, somatization, general severity index (GSI), and positive symptom total (PST).
Figure 2
Figure 2
Comparison of colonic geometric center at 24 and 48 hours in healthy controls and IBS patients with different types of bowel dysfunction.
Figure 3
Figure 3
Percent of participants in each group reaching threshold for first sensation, gas, urgency and pain in response to step wise increase in intra-balloon pressure; note the significant overlap and lack of any significant differences in any group or any sensation relative to controls.
Figure 4
Figure 4
Sensory ratings of participants in each group for urgency and pain in response to random order, phasic increase in intra-balloon pressure; note the significant overlap for the sensation of pain and the lower sensory ratings for urgency in IBS-C (p=0.04 vs healthy controls).
Figure 5
Figure 5
Overlap of abnormal transit and increased sensation in patients with IBS.
See this image and copyright information in PMC

References

    1. Camilleri M. Mechanisms in IBS: something old, something new, something borrowed. Neurogastroenterol Motil. 2005;17:311–316. - PubMed
    1. Cann PA, Read NW, Brown C, Hobson N, Holdsworth CD. Irritable bowel syndrome: relationship of disorders in the transit of a single solid meal to symptom patterns. Gut. 1983;24:405–411. - PMC - PubMed
    1. Vassallo M, Camilleri M, Phillips SF, Brown ML, Chapman NJ, Thomforde GM. Transit through the proximal colon influences stool weight in the irritable bowel syndrome. Gastroenterology. 1992;102:102–108. - PubMed
    1. Stivland T, Camilleri M, Vassallo M, Proano M, Rath D, Brown M, Thomforde G, Pemberton J, Phillips S. Scintigraphic measurement of regional gut transit in idiopathic constipation. Gastroenterology. 1991;101:107–115. - PubMed
    1. Choi MG, Camilleri M, O’Brien MD, Kammer PP, Hanson RB. A pilot study of motility and tone of the left colon in patients with diarrhea due to functional disorders and dysautonomia. Am J Gastroenterol. 1997;92:297–302. - PubMed