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首页> 外文期刊>BioPsychoSocial Medicine >Altered rectal sensory response induced by balloon distention in patients with functional abdominal pain syndrome
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Altered rectal sensory response induced by balloon distention in patients with functional abdominal pain syndrome

机译：功能性腹痛综合征患者因球囊扩张引起的直肠感觉反应改变

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Background Functional abdominal pain syndrome (FAPS) has chronic unexplained abdominal pain and is similar to the psychiatric diagnosis of somatoform pain disorder. A patient with irritable bowel syndrome (IBS) also has chronic unexplained abdominal pain, and rectal hypersensitivity is observed in a majority of the patients. However, no reports have evaluated the visceral sensory function of FAPS precisely. We aimed to test the hypothesis that FAPS would show altered visceral sensation compared to healthy controls or IBS. The present study determined the rectal perceptual threshold, intensity of sensation using visual analogue scale (VAS), and rectal compliance in response to rectal balloon distention by a barostat in FAPS, IBS, and healthy controls. Methods First, the ramp distention of 40 ml/min was induced and the thresholds of discomfort, pain, and maximum tolerance (mmHg) were measured. Next, three phasic distentions (60-sec duration separated by 30-sec intervals) of 10, 15 and 20 mmHg were randomly loaded. The subjects were asked to mark the VAS in reference to subjective intensity of sensation immediately after each distention. A pressure-volume relationship was determined by plotting corresponding pressures and volumes during ramp distention, and the compliance was calculated over the linear part of the curve by calculating from the slope of the curve using simple regression. Results Rectal thresholds were significantly reduced in IBS but not in FAPS. The VAS ratings of intensity induced by phasic distention (around the discomfort threshold of the controls) were increased in IBS but significantly decreased in FAPS. Rectal compliance was reduced in IBS but not in FAPS. Conclusion An inconsistency of visceral sensitivity between lower and higher pressure distention might be a key feature for understanding the pathogenesis of FAPS.
机译：背景功能性腹痛综合征（FAPS）具有无法解释的慢性腹痛，类似于躯体形式疼痛症的精神病学诊断。肠易激综合症（IBS）的患者也患有慢性无法解释的腹痛，并且在大多数患者中观察到直肠过敏。但是，尚无报道准确评估FAPS的内脏感觉功能。我们旨在检验以下假说：与健康对照组或IBS相比，FAPS会显示出内脏感觉改变。本研究确定了FAPS，IBS和健康对照中使用恒压仪对直肠球囊扩张做出反应时的直肠知觉阈值，使用视觉模拟量表（VAS）的感觉强度以及直肠顺应性。方法首先，诱发40 ml / min的斜度膨胀，并测量不适，疼痛和最大耐受性（mmHg）的阈值。接下来，随机加载10、15和20 mmHg的三个阶段性扩张（持续时间为60秒，间隔30秒）。要求受试者在每次扩张后立即参照主观感觉强度标记VAS。通过绘制斜面膨胀期间的相应压力和体积来确定压力-体积关系，并通过使用简单回归从曲线的斜率计算出曲线的线性部分，从而计算顺应性。结果IBS患者的直肠阈值显着降低，而FAPS患者则没有。在IBS中，由阶段性扩张引起的强度的VAS评分（在对照组的不适阈值附近）升高，而FAPS则显着降低。 IBS降低了直肠顺应性，而FAPS降低了直肠顺应性。结论低压和高压膨胀之间内脏敏感性的不一致可能是了解FAPS发病机制的关键特征。

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