Document Detail


Study of visceral hypersensitivity in irritable bowel syndrome.
MedLine Citation:
PMID:  15612244     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Visceral hypersensitivity is highly prevalent in most functional bowel disorders, such as irritable bowel syndrome (IBS), and activation of intestinal mast cells (MC) may play a role because they have been found in close proximity to gastrointestinal mucosal sensory nerve terminals containing neuropeptides and a bi-directional pathway connecting the central nervous system, gut, and MC has been demonstrated. The current study appraised the status of rectal visceral perception, as well as the changes in the MC and substance P (SP) in the intestinal mucosa of patients with IBS. METHODS: The study group comprised 42 patients with IBS and 19 healthy subjects who underwent anorectal manometry and rectal perception thresholds to balloon distension. The MC and the SP-ergic terminals in the mucosa were stained for respective histochemical and immunohistochemical investigations. The results were presented both qualitatively and quantitatively by color image analyzer, based on analysis of the intensity and area of stained fibrils. The structural relationship between the MC and nerve terminals was studied by electron microscopy, using an in situ embedding technique. RESULTS: The anorectal resting pressure, squeezing pressure and relaxation pressure were normal in both groups. The sensation threshold, defecation threshold and pain threshold in diarrhea-predominant IBS and the pain thresholds in constipation-predominant IBS were much lower than in the controls. Rectal compliance decreased in IBS. The number of MC in the terminal ileum, the ileocecal junction and the ascending colon was significantly elevated in IBS (P < 0.01), and the MC showed great variation. A significantly increased concentration of SP was found in the colon of the IBS patients compared with the controls. There was a positive correlation between the profiles of mucosal MC and the SP-ergic terminals, and MC were closely adjacent to SP-ergic terminals in the lamina propria. CONCLUSION: As altered rectal perception is present in almost all patients with IBS, it might be a reliable biological characteristic of the disease. Alterations in the MC and SP of the intestinal mucosa may be important factors in visceral hypersensitivity.
Authors:
Wen Zhu Dong; Duo Wu Zou; Zhao Shen Li; Xiao Ping Zou; Ai Yong Zhu; Guo Ming Xu; Ning Yin; Yan Fang Gong; Zhen Xing Sun; Xiao Hua Man
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Chinese journal of digestive diseases     Volume:  5     ISSN:  1443-9611     ISO Abbreviation:  Chin J Dig Dis     Publication Date:  2004  
Date Detail:
Created Date:  2004-12-22     Completed Date:  2005-01-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101088612     Medline TA:  Chin J Dig Dis     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  103-9     Citation Subset:  IM    
Affiliation:
Department of Gastroenterology, Changhai Hospital, Second Military Medical University, Shanghai, China. wzhdong@yahoo.com.cn
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MeSH Terms
Descriptor/Qualifier:
Adult
Case-Control Studies
Defecation
Female
Humans
Intestinal Mucosa / physiology
Irritable Bowel Syndrome / physiopathology*
Male
Mast Cells / physiology
Middle Aged
Pain Threshold
Perception*
Pressure
Rectum / innervation,  physiology*
Substance P / analysis
Chemical
Reg. No./Substance:
33507-63-0/Substance P

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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