title: Jejunal sensorimotor dysfunction in irritable bowel syndrome: clinical and psychosocial features.
abstract: OBJECTIVE
  The interrelationships between enteric hypersensitivity, dysmotility, and psychosocial factors in the pathogenesis of irritable bowel syndrome (IBS) are poorly understood. The aims of this study were to (1) compare the clinical, jejunal motor, and psychological features in patients with IBS who have heightened sensitivity and those who have normal sensitivity to jejunal balloon distention and (2) examine psychosocial correlates of sensory and/or motor dysfunction.
  
  
  METHODS
  Female patients with IBS (n = 24) and healthy controls (n = 9) underwent 24-hour ambulant duodenojejunal manometry, assessment of jejunal sensitivity by balloon distention, and comprehensive psychosocial assessment.
  
  
  RESULTS
  In 6 (25%) and 10 (42%) patients, hypersensitivity was present at the threshold for initial perception and at the threshold for pain, respectively. After ingestion of a high-energy standard meal, all patients with heightened sensitivity for perception had abnormalities in the postprandial motor pattern compared with one third of patients with normal sensitivity. In this subgroup with hypersensitivity and postprandial dysmotility, clinical features were not discriminative but an inherently ineffectual coping style featuring both anger hyperreactivity and defensive control of anger was highly characteristic.
  
  
  CONCLUSIONS
  In IBS, abnormal postprandial jejunal motor activity is related to jejunal mechanoreceptor-related hypersensitivity, and such sensorimotor dysfunction has a specific psychological profile.
authors.affiliation: Department of Gastroenterology, Royal North Shore Hospital, Sydney, New South Wales, Australia.
authors.forename: P R
authors.initials: PR
authors.lastname: Evans
authors.forename: E J
authors.initials: EJ
authors.lastname: Bennett
authors.forename: Y T
authors.initials: YT
authors.lastname: Bak
authors.forename: C C
authors.initials: CC
authors.lastname: Tennant
authors.forename: J E
authors.initials: JE
authors.lastname: Kellow
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000786:Anger; D002404:Catheterization; D003109:Colonic Diseases, Functional / Q000503:physiopathology / Q000523:psychology*; D004435:Eating; D005215:Fasting; D005260:Female; D005769:Gastrointestinal Motility; D006801:Humans; D007583:Jejunum / Q000503:physiopathology*; D016015:Logistic Models; D008365:Manometry; D008875:Middle Aged; D017288:Pain Threshold; D010465:Perception; D011581:Psychological Tests; D012677:Sensation