Abstract：
BACKGROUND/AIMS:The pathways underlying rectal hypersensitivity to balloon distention in patients with irritable bowel syndrome (IBS) are not known. The aim of this study was to characterize the involvement of sacral and thoracolumbar afferents in the perception of rectal distention. METHODS:Rectal balloon distention was performed in 15 normal control subjects, 6 patients with spinal cord injury, and 50 patients with IBS using a slow-volume ramp (40 mL/min) or rapid phasic step distension. Additional studies were performed in the presence of 2% intrarectal lidocaine. RESULTS:Patients with spinal cord injury with lesions below T7 reported sensations only during phasic distention. Sixty percent of patients with IBS (n = 50) were hypersensitive for discomfort during phasic distention, whereas only 4% were hypersensitive during ramp distention. Less than 15% of patients were hypersensitive for the sensation of stool. In normal patients, lidocaine increased thresholds in response to slow ramp distention by 40%-70% but had no effect on perception in response to other types of distention. Lidocaine had no effect on (1) thresholds in response to either ramp or phasic distention in normosensitive or hypersensitive patients with IBS or (2) the rate of receptive relaxation or rectal compliance in any group. CONCLUSIONS:Rapid phasic distention preferentially stimulates splanchnic afferents. Hypersensitivity of these afferents in patients with IBS is unaffected by mucosally applied lidocaine.
journal_name
Gastroenterologyjournal_title
Gastroenterologyauthors
Lembo T,Munakata J,Mertz H,Niazi N,Kodner A,Nikas V,Mayer EAdoi
10.1016/0016-5085(94)90809-5subject
Has Abstractpub_date
1994-12-01 00:00:00pages
1686-96issue
6eissn
0016-5085issn
1528-0012pii
S0016508594003641journal_volume
107pub_type
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