Sex specific alterations in autonomic function among patients with irritable bowel syndrome
Open accessAbstract
Background: Irritable bowel syndrome (IBS) is associated with increased psychological symptoms, early life stressors, and alterations in visceral perception and brain responses to noxious visceral stimuli. The autonomic nervous system (ANS) is a likely mediator for these brain-gut interactions. The few studies directly examining ANS measures have been suggestive of alterations in some IBS patients, but no studies to date have examined the potentially critical variables of sex differences or response to visceral stimulation. Aims: (1) To test differences in ANS function during rest and during a visceral stressor (rectosigmoid balloon distension) between IBS patients and healthy control subjects. (2) To examine the role of sex on the autonomic responses of IBS patients. Methods: Baseline autonomic measures were evaluated from 130 Rome I positive IBS patients and 55 healthy control subjects. Data were also collected from a subset of 46 IBS patients and 16 healthy control subjects during a sigmoid balloon distension study. Heart rate variability measures of peak power ratio (PPR) and peak power high frequency (PPHF) were analysed to assess sympathetic balance and parasympathetic response, respectively. Peripheral sympathetic response was measured by skin conductance. Results: IBS patients showed a greater skin conductance response to visceral distension than controls. IBS patients had higher PPR and lower PPHF across conditions. Male IBS patients had higher skin conductance and PPR than females and lower PPHF. Conclusions: IBS patients have altered autonomic responsiveness to a visceral stressor, with increased sympathetic and decreased parasympathetic activity. These differences are predominantly seen in males.
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Cites
The Hospital Anxiety and Depression Scale
Zigmond, A. S., & Snaith, R. P. (1983) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.1983.tb09716.x · Cited by 47,139 · see citing works
Depression and quality of life in older persons: A review
Sivertsen, H., Bjørkløf, G. H., Engedal, K., Selbæk, G., & Helvik, A.-S. (2015) · Dementia and Geriatric Cognitive Disorders · doi:10.1159/000437299 · Cited by 14,152 · see citing works
Akselrod, S., Gordon, D., Ubel, F. A., Shannon, D. C., Berger, A. C., & Cohen, R. J. (1981) · Science · doi:10.1126/science.6166045 · Cited by 5,079 · see citing works
Herrmann, C. (1997) · Journal of Psychosomatic Research · doi:10.1016/s0022-3999(96)00216-4 · Cited by 2,885 · see citing works
Elenkov, I. J., Wilder, R. L., Chrousos, G. P., & Vizi, E. S. (2000) · Pharmacological Reviews · doi:10.1016/s0031-6997(24)01470-4 · Cited by 2,252 · see citing works
AGA technical review on irritable bowel syndrome.
Drossman, D. A., Camilleri, M., Mayer, E. A., & Whitehead, W. E. (2002) · Gastroenterology · doi:10.1053/gast.2002.37095 · Cited by 1,384 · see citing works
Self-citationVasey, M. W., & Thayer, J. F. (1987) · Psychophysiology · doi:10.1111/j.1469-8986.1987.tb00324.x · Cited by 1,063 · see citing works
Review: Electrodermal Responses: What Happens in the Brain
Critchley, H. D. (2002) · The Neuroscientist · doi:10.1177/107385840200800209 · Cited by 997 · see citing works
Ratio scales of sensory and affective verbal pain descriptors
Gracely, R. H., McGrath, P., & Dubner, R. (1978) · Pain · doi:10.1016/0304-3959(78)90020-9 · Cited by 553 · see citing works
(2006) · Cited by 534 · see citing works
Circadian Profile of Cardiac Autonomic Nervous Modulation in Healthy Subjects:
Bonnemeier, H., WIEGAND, U. K. H., Brandes, A., Kluge, N., Katus, H. A., Richardt, G., & Potratz, J. (2003) · Journal of Cardiovascular Electrophysiology · doi:10.1046/j.1540-8167.2003.03078.x · Cited by 532 · see citing works
Heart rate variability in depressive and anxiety disorders
Gorman, J. M., & Sloan, R. P. (2000) · American Heart Journal · doi:10.1067/mhj.2000.109981 · Cited by 510 · see citing works
Drossman, D. A. (1994) · Medical Entomology and Zoology · Cited by 470 · see citing works
The functional gastrointestinal disorders
Olden, K. W. (1997) · General Hospital Psychiatry · doi:10.1016/s0163-8343(96)00109-0 · Cited by 439 · see citing works
Gender, sex hormones and autonomic nervous control of the cardiovascular system
Dart, A. M. (2002) · Cardiovascular Research · doi:10.1016/s0008-6363(01)00508-9 · Cited by 382 · see citing works
Repetitive sigmoid stimulation induces rectal hyperalgesia in patients with irritable bowel syndrome
Munakata, J., Naliboff, B. D., Harraf, F., Kodner, A., Lembo, T., Chang, L., Silverman, D. H. S., & Mayer, E. (1997) · Gastroenterology · doi:10.1016/s0016-5085(97)70219-1 · Cited by 380 · see citing works
Self-citationEvidence for two distinct perceptual alterations in irritable bowel syndrome
Naliboff, B. D., Munakata, J., Fullerton, S. C., Gracely, R. H., Kodner, A., Harraf, F., & Mayer, E. A. (1997) · Gut · doi:10.1136/gut.41.4.505 · Cited by 371 · see citing works
Self-citationGender differences in irritable bowel syndrome
Chang, L., & Heitkemper, M. M. (2002) · Gastroenterology · doi:10.1053/gast.2002.36603 · Cited by 351 · see citing works
Self-citationAKSELROD, S., Gordon, D., Ubel, F. A., Shannon, D. C., & Barger, A. C. (1981) · doi:10.21236/ada106978 · Cited by 334 · see citing works
Mixed-effects models in psychophysiology
Bagiella, E., Sloan, R. P., & Heitjan, D. F. (2000) · Psychophysiology · doi:10.1111/1469-8986.3710013 · Cited by 315 · see citing works
Aggarwal, A., Cutts, T. F., Abell, T. L., Cardoso, S., Familoni, B., Bremer, J., & Karas, J. (1994) · Gastroenterology · doi:10.1016/0016-5085(94)90753-6 · Cited by 297 · see citing works
Sex-related differences in IBS patients: central processing of visceral stimuli
Naliboff, B. D., Berman, S. M., Chang, L., Derbyshire, S. W. G., Suyenobu, B. Y., Vogt, B. A., Mandelkern, M. A., & Mayer, E. A. (2003) · Gastroenterology · doi:10.1016/s0016-5085(03)00400-1 · Cited by 291 · see citing works
Self-citationIrritable bowel syndrome patients show enhanced modulation of visceral perception by auditory stress
Dickhaus, B., Mayer, E. A., Firooz, N., Stains, J., Conde, F. A., Olivas, T. I., Fass, R., Chang, L., Mayer, M., & Naliboff, B. D. (2003) · The American Journal of Gastroenterology · doi:10.1111/j.1572-0241.2003.07156.x · Cited by 204 · see citing works
Self-citationA prospective assessment of bowel habit in irritable bowel syndrome in women: Defining an alternator
Drossman, D. A., Morris, C. B., Hu, Y., Toner, B. B., Diamant, N. E., Leserman, J., Shetzline, M. A., Dalton, C. B., & Bangdiwala, S. I. (2005) · Gastroenterology · doi:10.1053/j.gastro.2004.12.006 · Cited by 201 · see citing works
Central representation of the sympathetic nervous system in the cerebral cortex
Westerhaus, M. J., & Loewy, A. D. (2001) · Brain Research · doi:10.1016/s0006-8993(01)02453-2 · Cited by 184 · see citing works
The Enteric Nervous System I: Organisation and Classification
Hansen, M. B. (2003) · Pharmacology & Toxicology · doi:10.1034/j.1600-0773.2003.t01-1-920301.x · Cited by 182 · see citing works
Neurovisceral integration in cardiac and emotional regulation
Thayer, J. F., & Siegle, G. J. (2002) · IEEE Engineering in Medicine and Biology Magazine · doi:10.1109/memb.2002.1032635 · Cited by 152 · see citing works
Autonomic nervous system function in women with irritable bowel syndrome
Heitkemper, M., Jarrett, M., Cain, K. C., Burr, R., Levy, R. L., Feld, A., & Hertig, V. (2001) · Digestive Diseases and Sciences · doi:10.1023/a:1010671514618 · Cited by 145 · see citing works
Central autonomic network: functional organization and clinical correlations
Jellinger, K. A. (1998) · European Journal of Neurology · doi:10.1046/j.1468-1331.1998.520216.x · Cited by 145 · see citing works
Elsenbruch, S., & Orr, W. C. (2001) · American Journal of Gastroenterology · doi:10.1111/j.1572-0241.2001.03526.x · Cited by 140 · see citing works
Viramontes, B. E., Camilleri, M., McKinzie, S., Pardi, D. S., Burton, D. D., & Thomforde, G. M. (2001) · The American Journal of Gastroenterology · doi:10.1111/j.1572-0241.2001.04138.x · Cited by 119 · see citing works
Bockus, H. L., Bank, J., & Wilkinson, S. A. (1928) · The American Journal of the Medical Sciences · doi:10.1097/00000441-192812000-00006 · Cited by 109 · see citing works
Adeyemi, E., Desai, K., Towsey, M., & Ghista, D. N. (1999) · The American Journal of Gastroenterology · doi:10.1111/j.1572-0241.1999.00861.x · Cited by 100 · see citing works
Sex‐based differences in gastrointestinal pain
Mayer, E. A., Berman, S. M., Chang, L., & Naliboff, B. D. (2004) · European Journal of Pain · doi:10.1016/j.ejpain.2004.01.006 · Cited by 98 · see citing works
Self-citationJarrett, M. E., Burr, R. L., Cain, K. C., Hertig, V., Weisman, P., & Heitkemper, M. M. (2003) · Digestive Diseases and Sciences · doi:10.1023/a:1021904216312 · Cited by 94 · see citing works
Buysschaert, M., Donckier, J. E., Dive, A., Ketelslegers, J., & Lambert, A. E. (1985) · Diabetes · doi:10.2337/diab.34.11.1181 · Cited by 94 · see citing works
Autonomic cardiovascular responses are impaired in women with irritable bowel syndrome
Waring, W. S., Chui, M., Japp, A., Nicol, E. F., & Ford, M. J. (2004) · Journal of Clinical Gastroenterology · doi:10.1097/01.mcg.0000135362.35665.49 · Cited by 83 · see citing works
Autonomic regulation of cardiac function during sleep in patients with irritable bowel syndrome
Orr, W. C., Elsenbruch, S., & Harnish, M. J. (2000) · American Journal of Gastroenterology · doi:10.1111/j.1572-0241.2000.02318.x · Cited by 83 · see citing works
Autonomic functioning during REM sleep differentiates IBS symptom subgroups
Thompson, J. J., Elsenbruch, S., Harnish, M. J., & Orr, W. C. (2002) · American Journal of Gastroenterology · doi:10.1111/j.1572-0241.2002.07112.x · Cited by 78 · see citing works
Evidence for Autonomic Dysregulation in the Irritable Bowel Syndrome
Gupta, V. A., Sheffield, D., & Verne, G. N. (2002) · Digestive Diseases and Sciences · doi:10.1023/a:1016424007454 · Cited by 76 · see citing works
Laser Doppler flowmetry as a measure of extrinsic colonic innervation in functional bowel disease
Emmanuel, A. V., & Kamm, M. A. (2000) · Gut · doi:10.1136/gut.46.2.212 · Cited by 70 · see citing works
Elsenbruch, S., Lovallo, W. R., & Orr, W. C. (2001) · Psychosomatic Medicine · doi:10.1097/00006842-200109000-00014 · Cited by 64 · see citing works
Lee, C.-T., Chuang, T., Lu, C.-L., Chen, C., Chang, F.-Y., & Lee, S. (1998) · Digestive Diseases and Sciences · doi:10.1023/a:1018848122993 · Cited by 56 · see citing works
Burr, R. L., Heitkemper, M. M., Jarrett, M. E., & Cain, K. C. (2000) · Biological Research For Nursing · doi:10.1177/109980040000200203 · Cited by 54 · see citing works
Power spectrum of heart rate variability: a non-invasive test of integrated neurocardiac function.
Fallen, E. L., Kamath, M. V., & Ghista, D. N. (1988) · PubMed · Cited by 48 · see citing works
Current insights into the pathophysiology of irritable bowel syndrome
Schwetz, I., Bradesi, S., & Mayer, E. A. (2003) · Current Gastroenterology Reports · doi:10.1007/s11894-003-0071-1 · Cited by 40 · see citing works
Self-citationAbdominal Symptoms Are Not Related to Anorectal Function in the Irritable Bowel Syndrome
Ragnarsson, G. (1999) · Scandinavian Journal of Gastroenterology · doi:10.1080/00365529950173645 · Cited by 39 · see citing works
Buysschaert, M., Donckier, J., Dive, A., et al. (1985) · Diabetes · doi:10.2337/diabetes.34.11.1181 · Cited by 20 · see citing works
The role of gender and bowel habit predominance on visceral perception in IBS
CHANG, L., Naliboff, B. D., Schmulson, M. J., Lee, O. Y., Olivas, T. I., & Mayer, E. A. (2001) · Gastroenterology · doi:10.1016/s0016-5085(08)83761-4 · Cited by 9 · see citing works
Self-citationAutonomic functioning during REM sleep differentiates IBS symptom subgroups
Thompson, J., Elsenbruch, S., Harnish, M. J., & Orr, W. C. (2001) · Gastroenterology · doi:10.1016/s0016-5085(08)83177-0 · Cited by 6 · see citing works
Evidence for Autonomic dysregulation in irritable bowel syndrome
GUPTA, V., SHEFFIELD, D., & NICHOLASVERNE, G. (2001) · Gastroenterology · doi:10.1016/s0016-5085(01)83747-1 · Cited by 6 · see citing works
Autonomic functioning during REM sleep differentiates IBS symptom subgroups
THOMPSON, J., ELSENBRUCH, S., HARNISH, M., & ORR, W. (2001) · Gastroenterology · doi:10.1016/s0016-5085(01)83177-2 · Cited by 2 · see citing works
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Research works printed but not linked: 1
- [40]40. Littell RC, Pendergast J, Natarajan R. Modelling covariance structure in the analysis of repeated measures data. Stat Med 2000;19:1793-819.
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Central changes associated with chronic pelvic pain and endometriosis
Brawn, J., Morotti, M., Zondervan, K. T., Becker, C. M., & Vincent, K. (2014) · Human Reproduction Update · doi:10.1093/humupd/dmu025 · Cited by 274 · see citing works
“In response to painful distension of the sigmoid colon and rectum, individuals with IBS have demonstrated decreases in parasympathetic and increases in sympathetic nervous system activity when compared with healthy controls (although this finding was only significant in men with IBS) (Tillisch et al., 2005).”
New insights into the pathogenesis and pathophysiology of irritable bowel syndrome
Öhman, L., & Simrén, M. (2007) · Digestive and Liver Disease · doi:10.1016/j.dld.2006.10.014 · Cited by 155 · see citing works
Sex- and Gender-Related Differences in Common Functional Gastroenterologic Disorders
Narayanan, S. P., Anderson, B., & Bharucha, A. E. (2021) · Mayo Clinic Proceedings · doi:10.1016/j.mayocp.2020.10.004 · Cited by 131 · see citing works
Kennedy, P. J., Cryan, J. F., Quigley, E. M. M., Dinan, T. G., & Clarke, G. (2014) · Psychological Medicine · doi:10.1017/s003329171400052x · Cited by 120 · see citing works
Heart rate variability in the irritable bowel syndrome: A review of the literature
Mazurak, N., Seredyuk, N., Sauer, H., Teufel, M., & Enck, P. (2012) · Neurogastroenterology & Motility · doi:10.1111/j.1365-2982.2011.01866.x · Cited by 102 · see citing works
Autonomic nervous system dysregulation in irritable bowel syndrome
Salvioli, B., Pellegatta, G., Malacarne, M., Pace, F., Malesci, A., Pagani, M., & Lucini, D. (2015) · Neurogastroenterology & Motility · doi:10.1111/nmo.12512 · Cited by 88 · see citing works
Functional findings in irritable bowel syndrome
Posserud, I. (2006) · World Journal of Gastroenterology · doi:10.3748/wjg.v12.i18.2830 · Cited by 83 · see citing works
Cain, K. C., Jarrett, M. E., Burr, R. L., Hertig, V. L., & Heitkemper, M. M. (2007) · Neurogastroenterology & Motility · doi:10.1111/j.1365-2982.2006.00877.x · Cited by 67 · see citing works
Spiegel, B. M. R. (2011) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2011.02.030 · Cited by 67 · see citing works
Labus, J., Gupta, A., Gill, H. K., Posserud, I., Mayer, M., Raeen, H., Bolus, R., Simren, M., Naliboff, B. D., & Mayer, E. A. (2013) · Alimentary Pharmacology & Therapeutics · doi:10.1111/apt.12171 · Cited by 64 · see citing works
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Self-citationTak, L. M., Janssens, K. A. M., Dietrich, A., Slaets, J. P. J., & Rosmalen, J. G. M. (2010) · Psychotherapy and Psychosomatics · doi:10.1159/000296136 · Cited by 27 · see citing works
- Authors
- Tillisch, K., Mayer, E. A., Labus, J. S., Stains, J., Chang, L., & Naliboff, B. D.
- Affiliations
- University of California, Los Angeles (US)
- Corresponding author
- Tillisch, K
- Venue
- Gut
- Publisher
- BMJ
- Published
- 2005-05-28
- Volume
- 54
- Issue
- 10
- Pages
- 1396-1401
- ISSN
- 0017-5749 (ISSN-L)
- 1468-3288
- PMC
- PMC1774694
- OpenAlex
- W2153133372
- Semantic Scholar
- ec555808086ac72211678169db5b88bdec272668
- Cited by
- 156
- References
- 53
- Citations by year
- 2026: 8 · 2025: 4 · 2024: 2 · 2023: 6 · 2022: 4 · 2021: 4 · 2020: 3 · 2019: 2 · 2018: 3 · 2017: 6 · 2016: 5 · 2015: 12 · 2014: 12 · 2013: 8 · 2012: 11
- FWCI
- 9.74
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Gut (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (DK64539)
- National Institute of Nursing Research (R01NR007768, NR007768)
- National Institute of Diabetes and Digestive and Kidney Diseases (P50DK064539)
- 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, autonomic nervous system, sex differences, heart rate variability, skin conductance, sympathetic activity, parasympathetic activity, brain-gut interaction, visceral sensation
- MeSH terms
- Adult, Aged, Analysis of Variance, Autonomic Nervous System, Catheterization, Defecation, Female, Humans, Male, Middle Aged, Parasympathetic Nervous System, Rectum, Sex Factors, Stress, Psychological, Sympathetic Nervous System, Irritable Bowel Syndrome
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