Increased visceral sensitivity in Giardia-induced postinfectious irritable bowel syndrome and functional dyspepsia.: Effect of the 5HT3-antagonist ondansetron
Increased visceral sensitivity in Giardia-induced postinfectious irritable bowel syndrome and functional dyspepsia.: Effect of the 5HT3-antagonist ondansetron
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DOI：
10.1111/j.1365-2982.2007.00988.x
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发表时间：
2007-12-01
影响因子：
3.5
通讯作者：
Hausken, T.
中科院分区：
文献类型：
--
作者：
Dizdar, V.;Gilja, O. H.;Hausken, T.
在一次水传播贾第虫病爆发中，1300名受试者被诊断为贾第虫，其中139人继续有腹部症状，其中三分之二的人粪便培养和显微镜检查呈阴性。认为这些患者患有感染后功能性胃肠道疾病。我们研究了贾第虫感染后持续腹部症状患者的内脏高敏感性，并评估了5-HT（3）-拮抗剂昂丹司琼的作用。包括22例贾第虫阴性粪便患者和19例对照。一组患者（n = 15）同时患有肠易激综合征（IBS）和功能性消化不良（FD）。所有受试者都接受了与三维超声相结合的汤的饱腹感测试。22例患者中有15例接受了口服5-HT 3拮抗剂昂丹司琼的双盲、随机、安慰剂对照研究。与对照组比较，患者饮水量明显降低（P < 0.01），胃排空明显减少（P < 0.05）。与对照组相比，患者在空腹和餐后均出现更多症状（P < 0.001）。恩丹西酮对上述指标无明显影响，但餐后恶心反应明显减轻（P < 0.05）。总之，贾第虫引起的胃肠道症状的患者同时发生IBS和FD。他们表现出胃敏感性，饮水量降低和胃排空延迟。5-HT 3拮抗剂昂丹司琼没有改善饮水量，胃排空或症状，但恶心。
In an outbreak of waterborne giardiasis where 1300 subjects were diagnosed, with Giardia lamblia, 139 continued to have abdominal symptoms of whom two of three had negative stool culture and microscopy. These were considered to have a postinfectious functional gastrointestinal disorder. We investigated visceral hypersensitivity in patients with persisting abdominal symptoms after Giardia infection and assessed the effect of 5HT(3)-antagonist ondansetron. Twenty-two patients with Giardia negative stools and 19 controls were included. A subset of patients (n = 15) had both irritable bowel syndrome (IBS) and functional dyspepsia (FD). All subjects underwent a satiety test with a soup combined with three-dimensional ultrasound. Fifteen of 22 patients underwent double-blind, randomized, placebo-controlled study with the 5-HT3 antagonist ondansetron given orally. Drinking capacity was lower in patients than in controls (P < 0.01) and gastric emptying was reduced (P < 0.05). Patients had more symptoms both fasting and postprandially (P < 0.001) compared to controls. Ondansetron had no effect on these parameters except from less nausea postprandially (P < 0.05). In conclusion, patients with Giardia-induced gastrointestinal symptoms developed both IBS and FD. They exhibited gastric hypersensitivity with lower drinking capacity and delayed gastric emptying. The 5-HT3 antagonist ondansetron did not improve drinking capacity, gastric emptying or symptoms except nausea.