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Intestinal membrane permeability and hypersensitivity in the irritable bowel syndrome
Open accessAbstract
Irritable bowel syndrome (IBS) is a common gastrointestinal disorder in which the underlying pathophysiology is poorly understood; however, increased intestinal permeability in diarrhea-predominant IBS patients has been reported. Here we demonstrate that diarrhea-predominant IBS (D-IBS) patients display increased intestinal permeability. We have also found that increased intestinal membrane permeability is associated with visceral and thermal hypersensitivity in this subset of D-IBS patients. We evaluated 54 D-IBS patients and 22 controls for intestinal membrane permeability using the lactulose/mannitol method. All subjects ingested 5g of lactulose and 2g of mannitol in 100ml of water after which their urine was collected. We also evaluated the mean mechanical visual analogue scale (M-VAS) pain rating to nociceptive thermal and visceral stimulation in all subjects. All study participants also completed the FBDSI scale. Approximately 39% of diarrhea-predominant IBS patients had increased intestinal membrane permeability as measured by the lactulose/mannitol ratio. These IBS patients also demonstrated higher M-VAS pain intensity reading scale. Interestingly, the IBS patients with hypersensitivity and increased intestinal permeability had a higher FBDSI score (100.8 + or - 5.4) than IBS patients with normal membrane permeability and sensitivity (51.6 + or - 12.7) and controls (6.1 + or - 5.6) (p<0.001). A subset of D-IBS patients had increased intestinal membrane permeability that was associated with an increased FBDSI score and increased hypersensitivity to visceral and thermal nociceptive pain stimuli. Thus, increased intestinal membrane permeability in D-IBS patients may lead to more severe IBS symptoms and hypersensitivity to somatic and visceral stimuli.
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Metadata
- Authors
- Zhou, Q., Zhang, B., & Verne, N. G.
- Affiliations
- The Ohio State University (US)
- Cincinnati VA Medical Center (US)
- Corresponding author
- Verne, Nicholas G.
- Venue
- Pain
- Published
- 2009-11
- Volume
- 146
- Issue
- 1
- Pages
- 41-46
- ISSN
- 0304-3959 (ISSN-L)
- PMC
- PMC2763174
- OpenAlex
- W1967139826
- Cited by
- 373
- References
- 48
- Citations by year
- 2026: 15 · 2025: 12 · 2024: 18 · 2023: 15 · 2022: 20 · 2021: 36 · 2020: 26 · 2019: 25 · 2018: 29 · 2017: 25 · 2016: 22 · 2015: 18 · 2014: 29 · 2013: 25 · 2012: 21
- FWCI
- 20.54
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Pain (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Neurological Disorders and Stroke (R01NS053090)
- National Center for Research Resources (M01RR000082)
- Topics
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
- Health Sciences › Medicine › Gastroenterology › Inflammatory Bowel Disease
- Keywords
- irritable bowel syndrome, diarrhea-predominant irritable bowel syndrome, intestinal permeability, visceral hypersensitivity, thermal hypersensitivity, lactulose/mannitol test, visceral pain, IBS symptom severity, gut-brain axis
- MeSH terms
- Adult, Catheterization, Cell Membrane Permeability, Diarrhea, Female, Hot Temperature, Humans, Hypersensitivity, Intestinal Mucosa, Male, Pain, Pain Measurement, Physical Stimulation, Severity of Illness Index, Irritable Bowel Syndrome
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