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Patients with irritable bowel syndrome (IBS) often report exacerbation of symptoms after eating. Previous studies that have suggested an increased reactivity in IBS used very substantial (1000 kcal) meals and studied the response within the rectum. This study differs because it used a much smaller meal (200 kcal) and a barostat balloon was positioned at least 12 cm from the anal margin. While healthy volunteers all showed a rapid increase in tone as shown by an average 38% reduction in the barostat balloon volume, IBS patients with constipation showed little response and those patients with IBS with diarrhoea actually showed a reduction in tone, with the balloon volume rising an average of 35%. A cut off of <28% increase in tone accurately distinguished patients with IBS from those with organic disease in a separate group of patients. However, when larger meals were used (400/1000 kcal) this difference between IBS and
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