Impact of corticotropin-releasing hormone on gastrointestinal motility and adrenocorticotropic hormone in normal controls and patients with irritable bowel syndrome.
BACKGROUND
Corticotropin-releasing hormone (CRH) plays a key role in modulating intestinal motility in stressed animals.


OBJECTIVE
To evaluate the effect of CRH on intestinal motility in humans and to determine whether patients with irritable bowel syndrome (IBS) have an exaggerated response to CRH.


METHODS
Ten IBS patients diagnosed by Rome criteria and 10 healthy controls.


METHODS
CRH (2 micrograms/kg) was intravenously administered during duodenal and colonic manometry and plasma adrenocorticotropic hormone (ACTH) was measured by radioimmunoassay.


RESULTS
CRH induced motility of the descending colon in both groups (p < 0.001) and induced greater motility indexes in IBS patients than in controls (p < 0.05). CRH produced duodenal phase III motor activity in 80% of the subjects and duodenal dysmotility in 40% of IBS patients. Abdominal symptoms evoked by CRH in IBS patients lasted significantly longer than those in controls (p < 0.05). CRH induced significant increases in plasma ACTH levels in both groups (p < 0.001) and produced significantly higher plasma ACTH levels in IBS patients than in controls (p < 0.001).


CONCLUSIONS
Human intestinal motility is probably modulated by exogenous CRH. The brain-gut in IBS patients may have an exaggerated response to CRH.
Fukudo
S
S
Department of Psychosomatic Medicine, Tohoku University School of Medicine, Sendai, Japan.
Nomura
T
T
Hongo
M
M
D000324:Adrenocorticotropic Hormone / Q000097:blood*; D000328:Adult; D016022:Case-Control Studies; D003106:Colon / Q000503:physiopathology; D003109:Colonic Diseases, Functional / Q000097:blood / Q000503:physiopathology*; D003346:Corticotropin-Releasing Hormone / Q000494:pharmacology*; D004386:Duodenum / Q000503:physiopathology; D005260:Female; D005769:Gastrointestinal Motility / Q000187:drug effects*; D006801:Humans; D008297:Male; D008365:Manometry
D000324:Adrenocorticotropic Hormone; D003346:Corticotropin-Releasing Hormone