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Autonomic vagal nerve dysfunction in patients with ulcerative colitis
S Lindgren1, J Stewenius, K Sjölund
1Dept. of Medicine, Malmö General Hospital, Lund University, Sweden.
Scandinavian Journal of Gastroenterology
|July 1, 1993
Summary
Autonomic neuropathy (AN) is common in ulcerative colitis, primarily affecting vagal nerve function. This contrasts with Crohn's disease, where sympathetic dysfunction is more prevalent. Irritable bowel syndrome patients also showed significant AN rates.
Area of Science:
- Gastroenterology
- Neurology
- Clinical Medicine
Background:
- Autonomic nerve dysfunction, or autonomic neuropathy (AN), is increasingly recognized in inflammatory bowel diseases.
- Previous studies suggest a higher prevalence of AN in Crohn's disease compared to ulcerative colitis.
- Understanding the specific patterns of autonomic dysfunction in different gastrointestinal disorders is crucial for patient management.
Purpose of the Study:
- To evaluate and compare autonomic nerve function in patients with ulcerative colitis (UC) and irritable bowel syndrome (IBS).
- To investigate the prevalence and characteristics of autonomic neuropathy (AN) in UC patients, considering disease activity and colectomy history.
- To compare autonomic function in UC and IBS patients with healthy controls and patients with Crohn's disease.
Main Methods:
- Utilized three non-invasive tests assessing heart rate variability: the E/I ratio (deep breathing) and acceleration/brake indices (tilt test).
- Evaluated 40 patients with total ulcerative colitis, 25 with irritable bowel syndrome, 56 healthy controls, and 33 patients with Crohn's disease.
- Excluded patients with diabetes; UC patients included those with inactive disease and prior colectomy.
Main Results:
- Patients with ulcerative colitis exhibited a significantly lower E/I ratio compared to controls, indicating vagal nerve dysfunction; 35% showed signs of AN.
- Irritable bowel syndrome patients demonstrated a 36% prevalence of AN, consistent with existing literature.
- Autonomic neuropathy in ulcerative colitis was predominantly vagal, contrasting with the sympathetic dysfunction observed in Crohn's disease.
Conclusions:
- Autonomic neuropathy is a common finding in ulcerative colitis, irrespective of disease activity or colectomy status.
- Vagal nerve dysfunction is the primary characteristic of AN in ulcerative colitis.
- The findings highlight distinct autonomic nervous system involvement patterns in inflammatory bowel diseases, with implications for diagnosis and treatment.