Altered esophageal pain threshold in irritable bowel syndrome
Abstract
Gut motility disorders and altered pain perception were reported in patients with irritable bowel syndrome (IBS). To verify foregut involvement in IBS, we studied 30 patients using esophageal manometry and 24-hr pH monitoring of the distal esophagus. Two subgroups of patients underwent esophageal provocative tests (bethanechol 50 micrograms/kg subcutaneously and esophageal balloon distension test). Twelve healthy volunteers formed a control group. A pain threshold on esophageal distension significantly lower than in healthy subjects (11.5 +/- 1 ml vs 22.2 +/- 1.7 ml, P < 0.01) was found in IBS patients. On the other hand, no differences between patients and controls were detected in lower esophageal sphincter pressure and length, esophageal body motility, or GER pattern; furthermore, bethanechol stimulation elicited similar esophageal body motility changes. Our study could confirm no detectable basal or bethanechol-induced esophageal motility disorders in IBS patients, nor enhanced GER. Esophageal involvement in IBS consists of a lower pain threshold on esophageal distension, possibly reflecting an altered visceral receptor sensitivity or modulation throughout the gut.
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Disturbances in the spinal modulation of nociception have been reported in patients with irritable bowel syndrome.
“In addition, disturbances in the spinal modulation of nociception have been reported in these patients [38,39].”
From Effectiveness of acceptance and commitment therapy in central pain sensitization syndromes: A systematic review (2021) · cites this paper as [39]
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- Authors
- Costantini, M., Sturniolo, G. C., Zaninotto, G., D'Inc�, R., Polo, R., Naccarato, R., & Ancona, E.
- Affiliations
- University of Padua (IT)
- Venue
- Digestive Diseases and Sciences
- Published
- 1993-02
- Volume
- 38
- Issue
- 2
- Pages
- 206-212
- ISSN
- 0163-2116 (ISSN-L)
- 1573-2568
- OpenAlex
- W2080716197
- Cited by
- 99
- References
- 50
- Citations by year
- 2023: 1 · 2022: 1 · 2021: 2 · 2020: 1 · 2018: 2 · 2016: 3 · 2015: 3 · 2014: 4 · 2013: 3 · 2012: 4
- FWCI
- 4.31
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Digestive Diseases and Sciences (publishedVersion)
- PubMed (publishedVersion)
- Padua Research Archive (University of Padova) (submittedVersion)
- Topics
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Health Sciences › Medicine › Gastroenterology › Gastroesophageal reflux and treatments
- Health Sciences › Health Professions › Pharmacy › Infant Health and Development
- Keywords
- irritable bowel syndrome, esophageal distension, esophageal motility, lower esophageal sphincter pressure, gastroesophageal reflux, bethanechol
- MeSH terms
- Adult, Aged, Analysis of Variance, Bethanechol Compounds, Colonic Diseases, Functional, Esophagus, Female, Gastroesophageal Reflux, Humans, Hydrogen-Ion Concentration, Male, Manometry, Middle Aged, Peristalsis, Pain Threshold, Bethanechol
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