Spetalen Signe, Sandvik Leiv, Blomhoff Svein, Jacobsen Morten B
Department of Pathology, Ullevaal University Hospital, 0407 Oslo, Norway.
Gastroenterol Res Pract. 2009;2009:130684. doi: 10.1155/2009/130684. Epub 2009 Sep 17.
Psychiatric comorbidity and visceral hypersensitivity are common in patients with irritable bowel syndrome (IBS), but little is known about visceral sensitivity in IBS patients without psychiatric disorders.
We wanted to examine rectal visceral sensitivity in IBS patients without comorbid psychiatric disorders, IBS patients with phobic anxiety and healthy volunteers.
A total of thirty-eight female, non-constipated IBS patients without psychiatric disorders and eleven female IBS patients with phobic anxiety were compared to nine healthy women using a barostat double random staircase method. The non-psychiatric patients were divided into those with diarrhoea predominant symptoms and those with alternating stool habits.
The IBS patients without psychiatric disorders had normal visceral pressure thresholds. However, in the diarrhoea predominant subgroup, the volume discomfort threshold was reduced while it was unchanged in those with alternating stool habits. The phobic IBS patients had similar thresholds to the healthy volunteers. The rectal tone was increased in the non-psychiatric IBS patients with diarrhoea predominant symptoms and in the IBS patients with phobic anxiety.
Non-constipated IBS patients without psychiatric disorders had increased visceral sensitivity regarding volume thresholds but normal pressure thresholds. Our study suggests that the lowered volume threshold was due to increased rectal tone.
精神共病和内脏高敏感性在肠易激综合征(IBS)患者中很常见,但对于无精神障碍的IBS患者的内脏敏感性了解甚少。
我们想研究无精神共病的IBS患者、伴有恐惧焦虑的IBS患者以及健康志愿者的直肠内脏敏感性。
使用恒压器双随机阶梯法,将38名无精神障碍且无便秘的女性IBS患者和11名伴有恐惧焦虑的女性IBS患者与9名健康女性进行比较。无精神障碍的患者被分为以腹泻为主型症状患者和大便习惯交替型患者。
无精神障碍的IBS患者内脏压力阈值正常。然而,在以腹泻为主型亚组中,容量不适阈值降低,而在大便习惯交替型患者中则无变化。伴有恐惧的IBS患者与健康志愿者的阈值相似。以腹泻为主型症状的无精神障碍IBS患者和伴有恐惧焦虑的IBS患者直肠张力增加。
无精神障碍且无便秘的IBS患者在容量阈值方面内脏敏感性增加,但压力阈值正常。我们的研究表明,容量阈值降低是由于直肠张力增加所致。