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Cited by 248Gastrointestinal motility and disordersPsychosomatic Disorders and Their TreatmentsInfant Health and Development

Altered Rectal Perception in Irritable Bowel Syndrome Is Associated With Symptom Severity

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Posserud, Iris, Syrous, Alma, Lindström, Lina, Tack, Jan, Abrahamsson, Hasse, Simrén, Magnus·2007·Gastroenterology
DOI 10.1053/j.gastro.2007.07.024
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Abstract

Background & aims Diverging results exist regarding the connection between altered visceral perception and gastrointestinal (GI) symptoms, as well as the effects of psychological status on visceral sensitivity. We sought to investigate different aspects of rectal perception in irritable bowel syndrome (IBS) and the association with GI and psychological symptoms. Methods We included 109 patients with IBS meeting Rome II criteria (77 women; age range, 20-71 years) and 29 healthy controls (21 women; age range, 20-68 years). They underwent rectal balloon distentions determining sensory thresholds for discomfort and pain, the perceived intensity of unpleasantness, and the viscerosomatic referral area. The fifth percentile (thresholds) and 95th percentile (unpleasantness and referral area) in controls were used to define altered perception. Questionnaires were used to assess severity of IBS-related GI symptoms and psychological symptoms. Results When combining the 3 aspects of perception, 67 patients (61%) had altered rectal perception. These patients, compared with normosensitive patients, more frequently reported moderate or severe pain (73% vs 44%; P < .01), bloating (73% vs 36%; P < .0001), diarrhea (47% vs 21%; P < .01), satiety (39% vs 13%; P < .01), and clinically significant anxiety (31% vs 12%; P < .05). In a multivariate analysis, only pain and bloating remained associated with altered rectal perception. Conclusions Altered rectal perception is common in IBS and seems to be one important pathophysiologic factor associated with GI symptom severity in general and pain and bloating in particular. It is not just a reflection of the psychological state of the patient.

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  • Accumulation of different mechanisms (psychological, sensory, and motor) increases both gastrointestinal and non-gastrointestinal symptom severity, as well as impairments in quality of life.

    “Accumulation of different mechanisms (psychological, sensory, and motor) increases both gastrointestinal and non-gastrointestinal symptom severity, as well as impairments in quality of life. 31,32”

    From Irritable bowel syndrome (2020) · cites this paper as [31]

    The multivariate analysis (page unavailable in our copy) finds that anxiety and measures of rectal perception are independently associated with overall gastrointestinal symptom severity. It does not establish that accumulating psychological, sensory, and motor mechanisms causes greater severity, nor does it assess non-gastrointestinal symptom severity or quality-of-life impairment. (LLM, conf=0.88)

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Cited by

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Authors
Posserud, I., Syrous, A., Lindström, L., Tack, J., Abrahamsson, H., & Simrén, M.
Affiliations
  • Sahlgrenska University Hospital (SE)
  • Universitair Ziekenhuis Leuven (BE)
Corresponding author
Simrén, Magnus
ORCID
Venue
Gastroenterology
Publisher
Elsevier BV
Published
2007-10
Volume
133
Issue
4
Pages
1113-1123
ISSN
0016-5085 (ISSN-L)
DOI
10.1053/j.gastro.2007.07.024
OpenAlex
W2116511946
Cited by
248
References
10
Citations by year
2026: 3 · 2025: 3 · 2024: 13 · 2023: 6 · 2022: 10 · 2021: 11 · 2020: 14 · 2019: 13 · 2018: 13 · 2017: 9 · 2016: 18 · 2015: 14 · 2014: 20 · 2013: 21 · 2012: 15
FWCI
14.15
Type
journal article
Language
en
Open access
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Gastroenterology (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • AstraZeneca
  • Medical Research Council
Topics
  • Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
  • Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
  • Health Sciences › Health Professions › Pharmacy › Infant Health and Development
Keywords
irritable bowel syndrome, visceral sensitivity, rectal balloon distension, sensory threshold, pain, bloating, symptom severity, anxiety, satiety, diarrhea
MeSH terms
Adult, Aged, Dilatation, Dilatation, Pathologic, Female, Humans, Hyperalgesia, Male, Middle Aged, Pain, Pain Measurement, Perception, Pressure, Surveys and Questionnaires, Rectum, Severity of Illness Index, Case-Control Studies, Pain Threshold, Irritable Bowel Syndrome

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