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Abnormal vagal function in irritable bowel syndrome.

H L Smart, M Atkinson

    Lancet (London, England)
    |August 29, 1987
    PubMed
    Summary
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    Autonomic nervous system dysfunction is common in irritable bowel syndrome (IBS) patients, affecting both gut and heart functions. These nervous system abnormalities may explain common IBS symptoms like gastro-oesophageal reflux and motility issues.

    Area of Science:

    • Gastroenterology
    • Autonomic Neuroscience
    • Clinical Medicine

    Background:

    • Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder.
    • Autonomic nervous system (ANS) dysfunction is increasingly recognized as a potential contributor to IBS pathophysiology.
    • Understanding ANS involvement is crucial for developing targeted therapies.

    Purpose of the Study:

    • To investigate alimentary and cardiac autonomic nervous function in patients with IBS.
    • To determine the prevalence of autonomic dysfunction in IBS.
    • To explore the relationship between autonomic dysfunction and gastrointestinal symptoms or findings.

    Main Methods:

    • Assessed vagally mediated lower oesophageal sphincter pressure response to abdominal compression in 25 IBS patients and 25 controls.

    Related Experiment Videos

  • Evaluated efferent vagal function using insulin-induced hypoglycaemia and pentagastrin stimulation tests in 23 IBS patients.
  • Measured pulse rate variability during deep respiration in 23 IBS patients.
  • Correlated autonomic function test results with endoscopic findings (oesophagitis) and gastro-oesophageal reflux (pH monitoring).

    • Main Results:

    • 13 of 25 IBS patients showed a reduced vagally mediated increase in lower oesophageal sphincter pressure compared to controls.
    • Subnormal efferent vagal function was observed in 7 of 23 IBS patients.
    • Reduced pulse rate variability with deep respiration was found in 6 of 23 IBS patients.
    • Autonomic test abnormalities did not strongly correlate with oesophagitis or gastro-oesophageal reflux.

    Conclusions:

    • Abnormalities in autonomic nervous reflexes are prevalent in IBS patients.
    • These autonomic dysfunctions may contribute to the frequent occurrence of gastro-oesophageal reflux in IBS.
    • Autonomic nervous system dysfunction may play a role in the disordered gastrointestinal motility characteristic of IBS.