Abstract：
Interaction between gut stimuli may induce symptom overlap in patients with functional gastrointestinal disorders. The aim is to determine the effect of increased volumes of colonic contents on gastric sensory/motor responses and satiety in patients with constipation-predominant irritable bowel syndrome (IBS-C) and overlapping dyspeptic symptoms, and a cohort of healthy subjects.
In 15 patients with IBS-C and 10 healthy subjects, the effect of real versus sham colonic filling with gas (1080 ml) on gastric sensitivity (measured by stepwise distensions of the stomach), gastric compliance, abdominal perception, and nutrient drink tolerance was studied on separate days.
In healthy subjects, colonic gas filling induced an increment in gastric sensitivity to distension (mean score 2.0 ± 0.2 before, and 3.0 ± 0.4 after; p = 0.038). In IBS, basal sensitivity was greater and remained unchanged after colonic gas filling (score 4.0 ± 0.1 and 3.8 ± 0.3, respectively; p < 0.001 vs. basal in health). Colonic gas infusion induced abdominal symptoms that were significantly greater in IBS-C (score 2.6 ± 0.1) than in health (score 1.7 ± 0.4; p = 0.027), with minor changes in gastric tone, and no changes in gastric compliance in both groups. Colonic filling produced a profound reduction in nutrient drink tolerance in IBS (791 ± 87 ml sham filling, 491 ± 58 ml gas filling; p < 0.001) but only a minor reduction in health (940 ± 70 ml sham filling, 860 ± 94 ml gas filling; p = 0.223).
The volume of the colonic contents modulates satiety in patients with IBS-C, due to a general visceral pan-hypersensitivity. These effects should be considered in the choice of treatment for constipation in these patients.
In 15 patients with IBS-C and 10 healthy subjects, the effect of real versus sham colonic filling with gas (1080 ml) on gastric sensitivity (measured by stepwise distensions of the stomach), gastric compliance, abdominal perception, and nutrient drink tolerance was studied on separate days.
In healthy subjects, colonic gas filling induced an increment in gastric sensitivity to distension (mean score 2.0 ± 0.2 before, and 3.0 ± 0.4 after; p = 0.038). In IBS, basal sensitivity was greater and remained unchanged after colonic gas filling (score 4.0 ± 0.1 and 3.8 ± 0.3, respectively; p < 0.001 vs. basal in health). Colonic gas infusion induced abdominal symptoms that were significantly greater in IBS-C (score 2.6 ± 0.1) than in health (score 1.7 ± 0.4; p = 0.027), with minor changes in gastric tone, and no changes in gastric compliance in both groups. Colonic filling produced a profound reduction in nutrient drink tolerance in IBS (791 ± 87 ml sham filling, 491 ± 58 ml gas filling; p < 0.001) but only a minor reduction in health (940 ± 70 ml sham filling, 860 ± 94 ml gas filling; p = 0.223).
The volume of the colonic contents modulates satiety in patients with IBS-C, due to a general visceral pan-hypersensitivity. These effects should be considered in the choice of treatment for constipation in these patients.
摘要：
肠道刺激之间的相互作用可能会导致功能性胃肠病患者的症状重叠。目的是确定结肠内容物增加对便秘型肠易激综合征（IBS-C）和消化不良症状重叠患者的胃感觉/运动反应和饱腹感的影响。和一群健康的受试者。
在15例IBS-C患者和10例健康受试者中，真实与假结肠充气（1080毫升）对胃敏感性的影响（通过胃的逐步扩张来测量），胃顺应性,腹部感知，并在不同的日子研究了营养饮料的耐受性。
在健康的受试者中，结肠充气引起胃对扩张的敏感性增加(前平均评分2.0±0.2，和后3.0±0.4；p=0.038)。在IBS中,结肠充气后的基础敏感性更高，并且保持不变（评分分别为4.0±0.1和3.8±0.3；p<0.001vs.健康基础)。IBS-C（评分2.6±0.1）的结肠气体输注引起的腹部症状明显高于健康（评分1.7±0.4；p=0.027），随着胃张力的微小变化，两组的胃顺应性均无变化。结肠填充导致IBS的营养饮料耐受性大大降低（791±87ml假填充，491±58毫升气体填充；p<0.001），但健康状况仅略有下降（940±70毫升假填充，860±94毫升气体填充；p=0.223）。
结肠内容物的体积调节IBS-C患者的饱腹感，由于一般的内脏泛过敏。在选择这些患者的便秘治疗方法时应考虑这些影响。
在15例IBS-C患者和10例健康受试者中，真实与假结肠充气（1080毫升）对胃敏感性的影响（通过胃的逐步扩张来测量），胃顺应性,腹部感知，并在不同的日子研究了营养饮料的耐受性。
在健康的受试者中，结肠充气引起胃对扩张的敏感性增加(前平均评分2.0±0.2，和后3.0±0.4；p=0.038)。在IBS中,结肠充气后的基础敏感性更高，并且保持不变（评分分别为4.0±0.1和3.8±0.3；p<0.001vs.健康基础)。IBS-C（评分2.6±0.1）的结肠气体输注引起的腹部症状明显高于健康（评分1.7±0.4；p=0.027），随着胃张力的微小变化，两组的胃顺应性均无变化。结肠填充导致IBS的营养饮料耐受性大大降低（791±87ml假填充，491±58毫升气体填充；p<0.001），但健康状况仅略有下降（940±70毫升假填充，860±94毫升气体填充；p=0.223）。
结肠内容物的体积调节IBS-C患者的饱腹感，由于一般的内脏泛过敏。在选择这些患者的便秘治疗方法时应考虑这些影响。
