Key result
Irritable bowel syndrome was associated with altered autonomic responsiveness to a visceral stressor, showing increased sympathetic and decreased parasympathetic activity, predominantly in males.
Why the study?
Does autonomic function during rest and visceral stressor differ between IBS patients and healthy controls, and are there sex differences?
Case-Control (n=185)
Does autonomic function during rest and visceral stressor differ between IBS patients and healthy controls, and are there sex differences?
IBS patients, particularly males, exhibit altered autonomic responsiveness to visceral stressors characterized by increased sympathetic and decreased parasympathetic activity.
Answers are grounded in this paper and cite their sources.
Altered autonomic responses in IBS, especially males, should not yet change practice; leaves open sex-specific interventional trials.
BACKGROUND: Irritable bowel syndrome (IBS) is associated with increased psychological symptoms, early life stressors, and alterations in visceral perception and brain responses to noxious visceral stimuli. The autonomic nervous system (ANS) is a likely mediator for these brain-gut interactions. The few studies directly examining ANS measures have been suggestive of alterations in some IBS patients, but no studies to date have examined the potentially critical variables of sex differences or response to visceral stimulation. AIMS: (1) To test differences in ANS function during rest and during a visceral stressor (rectosigmoid balloon distension) between IBS patients and healthy control subjects. (2) To examine the role of sex on the autonomic responses of IBS patients. METHODS: Baseline autonomic measures were evaluated from 130 Rome I positive IBS patients and 55 healthy control subjects. Data were also collected from a subset of 46 IBS patients and 16 healthy control subjects during a sigmoid balloon distension study. Heart rate variability measures of peak power ratio (PPR) and peak power high frequency (PPHF) were analysed to assess sympathetic balance and parasympathetic response, respectively. Peripheral sympathetic response was measured by skin conductance. RESULTS: IBS patients showed a greater skin conductance response to visceral distension than controls. IBS patients had higher PPR and lower PPHF across conditions. Male IBS patients had higher skin conductance and PPR than females and lower PPHF. CONCLUSIONS: IBS patients have altered autonomic responsiveness to a visceral stressor, with increased sympathetic and decreased parasympathetic activity. These differences are predominantly seen in males.
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Kirsten Tillisch (2005) conducted a case-control in Irritable bowel syndrome (n=185). Irritable bowel syndrome vs. Healthy control subjects was evaluated on Autonomic function during rest and visceral stressor (skin conductance, peak power ratio, and peak power high frequency). Irritable bowel syndrome was associated with altered autonomic responsiveness to a visceral stressor, showing increased sympathetic and decreased parasympathetic activity, predominantly in males.
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