IRRITABLE-BOWEL-SYNDROME - DIFFERENCES BETWEEN PATIENTS WHO SHOW RECTAL SENSITIVITY AND THOSE WHO DO NOT

被引：72

作者：

PRIOR, A ^{[1
]}

SORIAL, E ^{[1
]}

SUN, WM ^{[1
]}

READ, NW ^{[1
]}

机构：

[1] UNIV SHEFFIELD,NO GEN HOSP,CTR HUMAN NUTR,HERRIES RD,SHEFFIELD S5 7AU,ENGLAND

来源：

EUROPEAN JOURNAL OF GASTROENTEROLOGY & HEPATOLOGY | 1993年 / 5卷 / 05期

关键词：

IRRITABLE BOWEL SYNDROME; SENSITIVITY; MOTILITY; RECTUM;

D O I：

10.1097/00042737-199305000-00008

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Objective: To investigate whether measurements of rectal sensitivity may be used to segregate patients with irritable bowel syndrome into different treatment categories, intermittent phasic distension of the rectum was carried out in 55 patients with irritable bowel syndrome and 20 matched normal volunteers. Threshold volumes for sensations were compared with anorectal motor responses and symptomatic presentation. Results: Of the patients with irritable bowel syndrome, 58% had an abnormally low threshold for desire to defecate. This group also had abnormally low thresholds for sensations of urgency and discomfort, abnormally low rectal compliances (P<0.05), and abnormally low threshold volumes for the induction of repetitive rectal contractions and internal anal sphincter relaxation. Values in patients who had a non-sensitive rectum were normal. The incidence of most symptoms were similar in both irritable bowel syndrome groups though a frequent desire to defecate was more common in the sensitive group (P<0.01). Anxiety was also more common in the sensitive compared with the non-sensitive group (P<0.05). Although most sensitive patients had diarrhoea, one-third of patients with constipation were sensitive and unlike other constipated patients, they had a frequent desire to defecate. Conclusion: These results suggest that tests of rectal sensitivity may segregate patients with irritable bowel syndrome into pathophysiologically distinct subgroups.

引用

页码：343 / 349

页数：7

共 22 条

[1]

Kellow J.E., Phillips S.F., Altered small bowel motility in irritable bowel syndrome is correlated with symptoms, Gas Troenteroloyy, 92, pp. 1885-1893, (1987)

[2]

Kumar D., Wingate D.L., The irritable bowel syndrome: A paroxysmal motor disorder, Lancet, 2, pp. 973-977, (1985)

[3]

Kellow J.E., Phillips S.F., Miller L.J., Zinsmeister A.R., Dysmotility of the small intestine in irritable bowel syndrome, Gut, 29, pp. 1236-1243, (1988)

[4]

Kellow J.E., Gill R.C., Wingate D.L., Prolonged ambulant recordings of small bowel motility demonstrate abnormalities in the irritable bowel syndrome, Gastroenterology, 98, pp. 1208-1218, (1990)

[5]

Harvey R.F., Read A.E., Effect of cholecystokinin on colonic motility and symptoms in patients with the irritable bowel syndrome, Lancet, pp. 1-3, (1973)

[6]

Chaudhary N.A., Truelove S.C., Human colonic motility: A comparative study of normal subjects, patients with ulcerative colitis and patients with the irritable colon syndrome. I. Resting patterns, Gastroenterology, 40, (1961)

[7]

Snape W.J., Carlson G.M., Matarazzo S.A., Cohen S., Evidence that abnormal myoelectrical activity produces colonic motor dysfunction in the irritable bowel syndrome, Gastroen Terology, 72, pp. 383-387, (1977)

[8]

Sullivan M.A., Cohen S., Snape W.J., Colonic myoelectrical activity in irritable bowel syndrome: Effect of eating and anticholinergics, N Engl J Med, 298, pp. 878-883, (1978)

[9]

Prior A., Maxton D.G., Whorwell P.J., Anorectal manometry in irritable bowel syndrome: Differences between diarrhoea and constipation predominant subjects, Gut, 31, pp. 458-462, (1990)

[10]

Whitehead W.E., Engel B.T., Schuster M.M., Irritable bowel syndrome. Physiological and psychological differences between diarrhoea-predominant and constipation-predominant patients, Dig Dis Sci, 25, pp. 404-413, (1980)

← 1 2 3 →