TY - JOUR
T1 - Jejunal sensorimotor dysfunction in irritable bowel syndrome
T2 - Clinical and psychosocial features
AU - Evans, P. R.
AU - Bennett, E. J.
AU - Bak, Young-Tae
AU - Tennant, C. C.
AU - Kellow, J. E.
PY - 1996/1/1
Y1 - 1996/1/1
N2 - Background and Aims: The interrelationships between enteric hypersensitivity, dysmotility, and psychosocial factors in the pathogenesis of irritable bowel syndrome (IBS) are poorly understood. The aims of this study were to (1) compare the clinical, jejunal motor, and psychological features in patients with IBS who have heightened sensitivity and those who have normal sensitivity to jejunal balloon distention and (2) examine psychosocial correlates of sensory and/or motor dysfunction. Methods: Female patients with IBS (n = 24) and healthy controls (n = 9) underwent 24-hour ambulant duodenojejunal manometry, assessment of jejunal sensitivity by balloon distention, and comprehensive psychosocial assessment. Results: In 6 (25%) and 10 (42%) patients, hypersensitivity was present at the threshold for initial perception and at the threshold for pain, respectively. After ingestion of a high-energy standard meal, all patients with heightened sensitivity for perception had abnormalities in the postprandial motor pattern compared with one third of patients with normal sensitivity. In this subgroup with hypersensitivity and postprandial dysmotility, clinical features were not discriminative but an inherently ineffectual coping style featuring both anger hyperreactivity and defensive control of anger was highly characteristic. Conclusions: In IBS, abnormal postprandial jejunal motor activity is related to jejunal mechanoreceptor-related hypersensitivity, and such sensorimotor dysfunction has a specific psychological profile.
AB - Background and Aims: The interrelationships between enteric hypersensitivity, dysmotility, and psychosocial factors in the pathogenesis of irritable bowel syndrome (IBS) are poorly understood. The aims of this study were to (1) compare the clinical, jejunal motor, and psychological features in patients with IBS who have heightened sensitivity and those who have normal sensitivity to jejunal balloon distention and (2) examine psychosocial correlates of sensory and/or motor dysfunction. Methods: Female patients with IBS (n = 24) and healthy controls (n = 9) underwent 24-hour ambulant duodenojejunal manometry, assessment of jejunal sensitivity by balloon distention, and comprehensive psychosocial assessment. Results: In 6 (25%) and 10 (42%) patients, hypersensitivity was present at the threshold for initial perception and at the threshold for pain, respectively. After ingestion of a high-energy standard meal, all patients with heightened sensitivity for perception had abnormalities in the postprandial motor pattern compared with one third of patients with normal sensitivity. In this subgroup with hypersensitivity and postprandial dysmotility, clinical features were not discriminative but an inherently ineffectual coping style featuring both anger hyperreactivity and defensive control of anger was highly characteristic. Conclusions: In IBS, abnormal postprandial jejunal motor activity is related to jejunal mechanoreceptor-related hypersensitivity, and such sensorimotor dysfunction has a specific psychological profile.
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U2 - 10.1053/gast.1996.v110.pm8566585
DO - 10.1053/gast.1996.v110.pm8566585
M3 - Article
C2 - 8566585
AN - SCOPUS:0030063571
SN - 0016-5085
VL - 110
SP - 393
EP - 404
JO - Gastroenterology
JF - Gastroenterology
IS - 2
ER -