Effect of acute physical and psychological stress on gut autonomic innervation in irritable bowel syndrome
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Background & aims Stress is an important causative factor in irritable bowel syndrome (IBS). It remains unknown whether stress-related changes in gut function are mediated by altered autonomic efferent gut-specific innervation. We studied the effect of acute physical and psychological stress on autonomic innervation and visceral sensitivity in healthy volunteers and patients with IBS.Methods Twenty-four patients (20 women) with constipation-predominant IBS and 12 healthy volunteers (8 women) underwent either physical (cold water hand immersion) or psychological (dichotomous listening) stress on separate occasions. Assessments included stress perception (visual analogue scale), gut-specific autonomic innervation (rectal mucosal blood flow [RMBF] by laser Doppler flowmetry), and viscerosomatic sensitivity (anal and rectal electrosensitivity).Results Patients with IBS had a heightened baseline perception of stress (P < .01). RMBF decreased during physical stress (29.6% +/- 2.8% and 28.7% +/- 3.9%) and psychological stress (24.4% +/- 2.1% and 23.5% +/- 4.3%) in patients with IBS and controls, respectively (mean +/- SEM). During physical stress, rectal perception (23.2% +/- 6% vs .6% +/- 3% [IBS vs control group, P < .05]) and rectal pain thresholds (27.0% +/- 4% vs 1.3% +/- 5%, P < .001) decreased in patients with IBS only. Psychological stress reduced thresholds for rectal perception (19.4% +/- 6% vs 8% +/- 6%, P < .01) and rectal pain (28.4% +/- 4% vs 3.4% +/- 3.8%, P < .001) in patients with IBS only. Acute stress elevated anal perception thresholds in patients with IBS but not controls (physical stress: 14.7% +/- 14% vs -9.3% +/- 11%, P < .05; psychological stress: 24.7% +/- 9% vs 11% +/- 11%, P < .05).Conclusions Acute stress alters gut-specific efferent autonomic innervation in both controls and patients with IBS, although normalization is delayed in IBS. By contrast, only patients with IBS show heightened visceral sensation, suggesting involvement of a different regulatory mechanism, either central or peripheral.
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Physical and psychological stress, cognition, and early life experience can affect intestinal sensory perception.
“For example, it has been shown that physical and psychological stress (112), cognition (e.g., attention vs. distraction to aversive stimulus) (55), and early life experience (e.g., sexual and physical abuse) (39, 149) can affect intestinal sensory perception.”
From Intestinal microbiota and immune function in the pathogenesis of irritable bowel syndrome (2013) · cites this paper as [112]
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References 33 · Cited by 185
- Authors
- Murray, C. D. R., Flynn, J., Ratcliffe, L., Jacyna, M. R., Kamm, M. A., & Emmanuel, A. V.
- Affiliations
- St Mark's Hospital (GB)
- Imperial College London (GB)
- Northwick Park Hospital (GB)
- Corresponding author
- Emmanuel, Anton V.
- Venue
- Gastroenterology
- Publisher
- Elsevier BV
- Published
- 2004-12
- Volume
- 127
- Issue
- 6
- Pages
- 1695-1703
- ISSN
- 0016-5085 (ISSN-L)
- OpenAlex
- W1967976394
- Cited by
- 185
- References
- 33
- Citations by year
- 2026: 3 · 2025: 1 · 2024: 1 · 2023: 20 · 2022: 3 · 2021: 2 · 2020: 7 · 2019: 6 · 2018: 3 · 2017: 7 · 2016: 5 · 2015: 9 · 2014: 17 · 2013: 14 · 2012: 11
- FWCI
- 8.12
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Gastroenterology (publishedVersion)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Bristol Research (University of Bristol) (submittedVersion)
- Explore Bristol Research (submittedVersion)
- Topics
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Keywords
- irritable bowel syndrome, irritable bowel syndrome with constipation, acute stress, physical stress, psychological stress, visceral sensitivity, cold water immersion, perceived stress, gut-brain axis
- MeSH terms
- Adolescent, Adult, Aged, Autonomic Nervous System, Constipation, Female, Humans, Intestines, Male, Middle Aged, Perception, Rectum, Stress, Psychological, Pain Threshold, Irritable Bowel Syndrome
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