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KMID : 0812020050110010058
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Korean Journal of Neurogastroenterology and Motility
2005 Volume.11 No. 1 p.58 ~ p.65
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The Rectal Perception in Patients with Constipation-predominant Irritable Bowel Syndrome and Functional Constipation
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Yang Jae-Hoon
Lee Joon-Seong
Hong Su-Jin
Im Hee-Hyuk
Hwang Kyung-Ran
Kim Hyun-Jung
Lee Sang-Ho
Ko Bong-Min
Jung In-Seop
Ryu Chang-Beom
Kim Jin-Oh
Cho Joo-Young
Lee Moon Sung
Shim Chan-Sup
Kim Boo-Sung
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Abstract
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Background/Aims: The differential diagnosis of constipation-predominant irritable bowel syndrome (IBS-C) and functional constipation (FC) is difficult in many cases, even though the suggested pathophysiologies are quite different. The presence of visceral hypersensitivity, which is frequent in diarrhea-predominant irritable bowel syndrome, is still controversial in IBS-C. The aim of this study was to evaluate the differences in rectal visceral sensitivity to rectal distension in patients with IBS-C and FC.
Methods: In thirty eight patients with FC and 31 patients with IBS-C, as accessed by the Rome II criteria, rectal visceral sensitivity and compliance were measured by a barostat examination. Pressure thresholds of the first sense, urgency, maximum tolerable volume and the sensitivity index percentage were compared in both group according to the gender.
Results: for the female patients, the sensitivity index percentage of the IBS-C was significantly lower than that of FC (p<0.05). for the male patients, the first sense threshold pressure was significantly lower in the IBS-C patients than in the FC patients, (p<0.05).
Conclusions: The patients with IBS-C showed more rectal visceral hypersensitivity compared with the FC patients irrespective of the gender. Male patients with IBS-C showed visceral hypersensitivity to low-grade stimuli; in contrast, the female patients with IBS-C showed hypersensitivity to high-grade stimuli, suggesting a differential pathophysiologic mechanism of visceral hypersensitivity in the different gender patients with IBS-C. (Kor J Neurogastroenterol Motil 2005;11:58-65)
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KEYWORD
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Constipation-predominant irritable bowel syndrome, Functional constipation, Barostat, Gender, Visceral hypersensitivity,
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