Clinical-alimentary tractEffect of acute physical and psychological stress on gut autonomic innervation in irritable bowel syndrome
Section snippets
Patients and subjects
Twenty-four consecutive consenting patients (20 women and 4 men; mean age, 40 years; age range, 18–78 years) were recruited from the outpatient department of a secondary referral gastroenterological service. Ethnic background was as follows: 14 white, 7 Asian, and 3 black. All patients had constipation-predominant IBS as defined by the Rome II criteria19 and were not taking any regular medication. Subjects were interviewed and their case notes reviewed at recruitment to exclude psychiatric
Demographics
There were no statistical differences between the IBS and control groups in terms of age (P = .18), sex (P = .68), or ethnicity (P = .084).
HAD
There were no statistically significant differences between the groups in HAD scores for either anxiety (median of 7 [range, 1–15] vs 5 [range, 2–9], IBS vs controls; P = .257) or depression (median of 3 [range, 1–7] vs 3 [range, 1–5], IBS vs controls; P = .827). All patients and controls had normal HAD depression subscale scores. Three of 12 subjects in the
Discussion
We have shown for the first time that there is a direct and measurable alteration in hindgut autonomic innervation in response to acute physical and psychological stress in both healthy controls and patients with IBS. The magnitude of this alteration of level of activity of autonomic innervation (as measured by RMBF) was similar in patients with IBS and controls. This suggests that the acute autonomic efferent response to stress, both in initial nature and extent, is normal in patients with
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