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Visceral sensitivity remains stable over time in patients with irritable bowel syndrome, but with individual fluctuations

Journal article
Authors Axel Josefsson
Amanda Rosendahl
Pernilla Jerlstad
Gunilla Näslin
Hans Törnblom
Magnus Simrén
Published in Neurogastroenterology and Motility
Volume 31
Issue 7
ISSN 1350-1925
Publication year 2019
Published at Institute of Medicine, Department of Internal Medicine and Clinical Nutrition
Language en
Links dx.doi.org/10.1111/nmo.13603
Keywords irritable bowel syndrome, quality of life, visceral hypersensitivity
Subject categories Internal medicine

Abstract

Background: Visceral hypersensitivity in irritable bowel syndrome (IBS), measured with rectal balloon distensions, using a barostat, has been suggested to be a phenomenon that is reduced due to habituation at repeated investigations. We investigated the stability of rectal sensitivity in patients with IBS who had undergone a previous rectal barostat study and assessed variations in symptom pattern and severity in relation to rectal sensory function. Method: Irritable bowel syndrome patients, who had previously been undergone a rectal barostat study, were included. All patients underwent a second study 8-12 years later. Symptoms were characterized by use of questionnaires. Key Results: We included 26 subjects (17 females, median age at the index investigation 44.5 (21-61) years). Pressure and volume sensory thresholds were unchanged at the follow-up compared with the index investigation (P > 0.05 for all). At the index investigation, 8/26 patients had rectal hypersensitivity of which four were reclassified as normosensitive, and sixfrom normo- to hypersensitive, meaning that 10/26 patients were hypersensitive at the follow-up investigation. IBS-QOL had improved significantly in six of nine domains at follow-up (P < 0.05 for all). There were no differences in anxiety, depression, IBS symptom severity, or somatization (P > 0.05) at follow-up. None of these were associated with change in rectal sensitivity at follow-up. Conclusions and Inferences: Rectal hypersensitivity and IBS symptoms remained stable at the group level over 8-12 years in IBS patients, even though individual fluctuations were noted. Our findings contradict previous findings indicating that visceral hypersensitivity is an unstable trait. © 2019 John Wiley & Sons Ltd

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