Visceral hypersensitivity following cold water intake in subjects with irritable bowel syndrome |
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Authors: | Xiu Li Zuo Yan Qing Li Lei Shi Guo Ping Lv Rong Guang Kuang Xue Feng Lu Jun Man Li Paul V Desmond |
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Institution: | (1) Department of Gastroenterology, Qilu Hospital, Shandong University, Jinan, 250012, China;(2) Department of Gastroenterology, St. Vincent's Hospital, Fitzroy, Australia |
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Abstract: | Background Visceral hypersensitivity has been shown to be present in irritable bowel syndrome (IBS). This study sought to investigate
rectal sensitivity and abdominal symptoms in IBS patients before and after 220 ml cold water intake.
Methods A total of 60 IBS patients and 18 healthy controls participated in this study. Both the perception thresholds and defecation
thresholds to rectal balloon distension were measured. Then, all subjects were asked to drink 220 ml 37°C warm water or 4°C
cold water, and these steps were repeated 20 min later. Symptoms including abdominal pain/discomfort, bloating, and diarrhea
were recorded during the study.
Results Compared with the controls, the thresholds of initial sensation to rectal balloon distention in IBS patients were significantly
lower while the defecation thresholds were higher in constipation-predominant IBS patients. After drinking cold water, the
perception thresholds in IBS patients and the defecation thresholds in diarrhea-predominant IBS patients were further decreased.
However, warm water intake did not change the perception thresholds significantly in either IBS patients or controls. A negative
linear correlation was found between the symptoms and the visceral perception thresholds in diarrhea-predominant IBS patients
who showed significant symptoms after cold water intake.
Conclusion The results indicated that cold water intake leads to lowered visceral perception thresholds in IBS patients that were inversely
relevant to the abdominal symptoms in symptomatic diarrhea-predominant IBS patients. The alteration of rectal sensitivity
and abdominal symptoms following cold water stimulation provided further objective evidence for visceral hypersensitivity
in IBS patients. |
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Keywords: | irritable bowel syndrome rectal balloon distension cold visceral hypersensitivity |
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