Document Detail


Intestinal membrane permeability and hypersensitivity in the irritable bowel syndrome.
MedLine Citation:
PMID:  19595511     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Irritable bowel syndrome (IBS) is a common gastrointestinal disorder in which the underlying pathophysiology is poorly understood; however, increased intestinal permeability in diarrhea-predominant IBS patients has been reported. Here we demonstrate that diarrhea-predominant IBS (D-IBS) patients display increased intestinal permeability. We have also found that increased intestinal membrane permeability is associated with visceral and thermal hypersensitivity in this subset of D-IBS patients. We evaluated 54 D-IBS patients and 22 controls for intestinal membrane permeability using the lactulose/mannitol method. All subjects ingested 5g of lactulose and 2g of mannitol in 100ml of water after which their urine was collected. We also evaluated the mean mechanical visual analogue scale (M-VAS) pain rating to nociceptive thermal and visceral stimulation in all subjects. All study participants also completed the FBDSI scale. Approximately 39% of diarrhea-predominant IBS patients had increased intestinal membrane permeability as measured by the lactulose/mannitol ratio. These IBS patients also demonstrated higher M-VAS pain intensity reading scale. Interestingly, the IBS patients with hypersensitivity and increased intestinal permeability had a higher FBDSI score (100.8 + or - 5.4) than IBS patients with normal membrane permeability and sensitivity (51.6 + or - 12.7) and controls (6.1 + or - 5.6) (p<0.001). A subset of D-IBS patients had increased intestinal membrane permeability that was associated with an increased FBDSI score and increased hypersensitivity to visceral and thermal nociceptive pain stimuli. Thus, increased intestinal membrane permeability in D-IBS patients may lead to more severe IBS symptoms and hypersensitivity to somatic and visceral stimuli.
Authors:
QiQi Zhou; Buyi Zhang; G Nicholas Verne
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, U.S. Gov't, Non-P.H.S.    
Journal Detail:
Title:  Pain     Volume:  146     ISSN:  1872-6623     ISO Abbreviation:  Pain     Publication Date:  2009 Nov 
Date Detail:
Created Date:  2009-10-12     Completed Date:  2009-12-30     Revised Date:  2014-09-20    
Medline Journal Info:
Nlm Unique ID:  7508686     Medline TA:  Pain     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  41-6     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Catheterization
Cell Membrane Permeability / physiology*
Diarrhea / etiology,  physiopathology
Female
Hot Temperature / diagnostic use
Humans
Hypersensitivity / etiology*,  physiopathology*
Intestinal Mucosa / physiology*
Irritable Bowel Syndrome / complications*,  physiopathology*
Male
Pain / etiology,  physiopathology
Pain Measurement
Physical Stimulation
Severity of Illness Index
Grant Support
ID/Acronym/Agency:
M01 RR000082/RR/NCRR NIH HHS; M01 RR000082-448592/RR/NCRR NIH HHS; M01 RR000082-457397/RR/NCRR NIH HHS; R01 NS053090/NS/NINDS NIH HHS; R01 NS053090-01/NS/NINDS NIH HHS; R01 NS053090-02/NS/NINDS NIH HHS; R01 NS053090-03/NS/NINDS NIH HHS; R01 NS053090-04/NS/NINDS NIH HHS; R01 NS053090-05/NS/NINDS NIH HHS; R01-NS053090/NS/NINDS NIH HHS
Comments/Corrections

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