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Visceral and somatic hypersensitivity,autonomic cardiovascular dysfunction and low-grade inflammation in a subset of irritable bowel syndrome patients
Authors:Liang Liu  Bei-ni Liu  Shuo Chen  Miao Wang  Yang Liu  Yan-li Zhang  Shu-kun Yao
Institution:1. Department of Gastroenterology, China-Japan Friendship Hospital, Beijing, 100029, China
2. Graduate School, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, 100730, China
3. Beijing University of Chinese Medicine, Beijing, 100029, China
Abstract:The pathophysiology of irritable bowel syndrome (IBS) is complex and not fully understood, so the aim of this study was to evaluate whether visceral and somatic hypersensitivity, autonomic cardiovascular dysfunction, and low-grade inflammation of the gut wall are associated with diarrhea-predominant IBS (D-IBS). Sixty-two patients with D-IBS and 20 control subjects participated in the study. Using the ascending method of limits (AML) protocol, we demonstrated that D-IBS patients had significantly lower sensory thresholds compared with healthy controls (P<0.001). Using diverse methods, especially the ischemic sensitivity test, for the first time in China, we confirmed that D-IBS patients have somatic hypersensitivity. They had a significantly higher systolic blood pressure and heart rate after a cold stimulus, indicative of autonomic cardiovascular dysfunction. Compared with the control group, D-IBS patients had a significantly higher level of calprotectin (P<0.001). We also found significant correlations between visceral and somatic hypersensitivity, visceral hypersensitivity and autonomic cardiovascular dysfunction, and somatic hypersensitivity and autonomic cardiovascular dysfunction. Our findings may provide valuable suggestions for the treatment of D-IBS.
Keywords:Irritable bowel syndrome (IBS)  Visceral hypersensitivity  Somatic hypersensitivity  Autonomic cardiovascular dysfunction  Low-grade inflammation
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