TOLERANCE FOR RECTOSIGMOID DISTENSION IN IRRITABLE BOWEL SYNDROME
TOLERANCE FOR RECTOSIGMOID DISTENSION IN IRRITABLE BOWEL SYNDROME
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DOI：
10.1016/0016-5085(90)90332-u
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发表时间：
1990-05-01
期刊：
影响因子：
29.4
通讯作者：
SCHUSTER, MM
中科院分区：
文献类型：
--
作者：
WHITEHEAD, WE;HOLTKOTTER, B;SCHUSTER, MM
测试了两个假设：(a) 肠易激综合征患者对直肠乙状结肠球囊扩张的耐受性降低是由夸大任何厌恶刺激的疼痛的心理倾向引起的，(b) 球囊扩张引起的收缩是疼痛报告的原因。比较了 16 名肠易激患者、10 名不满足肠易激限制性标准的功能性肠病患者、25 名乳糖吸收不良者和 18 名无症状对照者对直肠乙状结肠中气球逐步扩张的耐受性与将一只手放在冰水中的耐受性。在膨胀球囊上方 5 厘米和下方 5 厘米处测量收缩活动。使用心理测试来评估神经质、焦虑和抑郁，并进行标准化的精神病学访谈。肠易激综合征患者对气球扩张的耐受性显着较低，但对冰水的耐受性则不然，并且气球耐受性与神经质或其他测量的心理特征不相关。直肠乙状结肠和直肠蠕动也与球囊扩张的耐受性无关。两种假设均被拒绝。外周机制（例如受体敏感性改变）可能是肠易激综合征中腹胀痛的原因。
Two hypotheses were tested: (a) lowered tolerance for balloon distention of the rectosigmoid in patients with irritable bowel syndrome is caused by a psychological tendency to exaggerate the painfulness of any aversive stimulus, and (b) contractions elicited by balloon distention are responsible for pain reports. Tolerance for stepwise distention of a balloon in the rectosigmoid was compared with tolerance for holding one hand in ice water in 16 irritable bowel patients, 10 patients with functional bowel disorder who did not satisfy restrictive criteria for irritable bowel, 25 lactose malabsorbers, and 18 asymptomatic controls. Contractile activity was measured 5 cm above and 5 cm below the distending balloon. Psychometric tests were used to assess neuroticism, anxiety, and depression, and a standardized psychiatric interview was administered. Patients with irritable bowel syndrome had significantly lower tolerance for balloon distention but not ice water, and balloon tolerance was not correlated with neuroticism or other psychological traits measured. Rectosigmoid and rectal motility were also not related to tolerance for balloon distention. Both hypotheses were rejected. A peripheral mechanism such as altered receptor sensitivity may be the cause of distention pain in irritable bowel syndrome.