A pilot study on chemospecific duodenal visceral sensitivity in inflammatory bowel disease in remission.
BACKGROUND
Patients with inflammatory bowel disease (IBD) in remission frequently experience symptoms resembling irritable bowel syndrome (IBS). In IBS altered motility and visceral sensitivity are found throughout the whole gastrointestinal tract. We aimed to study chemospecific antroduodenal sensitivity in IBD patients.


METHODS
Antroduodenal manometry was performed in 10 IBD patients in remission and 13 controls. Small volumes of nutrients and acid were administered intraduodenally. Motility variables and sensation scores were compared before and after each infusion.


RESULTS
Acid and lipid infusion decreased the number of antral pressure waves in both groups (p < 0.05). After acid infusion the number of duodenal pressure waves in the sideholes just distal to the infusion port increased in IBD patients compared to the controls (p < 0.05). Lipid infusion increased the number of duodenal propagated pressure waves in both groups, but in controls they were also increased over longer distances (p < 0.005). None of the infusions significantly affected the sensation scores.


CONCLUSIONS
Subtle alterations in chemospecific responses to lipids and acid in IBD patients in remission were observed, affecting duodenal motor activity but not duodenal perception. These changes are indicative of changes at the chemoreceptor level in the duodenal wall in this patient group.
Minderhoud
Itta M
IM
Department of Gastroenterology, University Medical Centre Utrecht, The Netherlands.
Smout
André J
AJ
Oldenburg
Bas
B
Samsom
Melvin
M
D000704:Analysis of Variance; D016022:Case-Control Studies; D002628:Chemoreceptor Cells / Q000187:drug effects / Q000502:physiology*; D004386:Duodenum / Q000187:drug effects / Q000503:physiopathology*; D005260:Female; D005769:Gastrointestinal Motility; D006801:Humans; D006851:Hydrochloric Acid / Q000494:pharmacology; D015212:Inflammatory Bowel Diseases / Q000503:physiopathology*; D043183:Irritable Bowel Syndrome / Q000503:physiopathology; D008055:Lipids / Q000494:pharmacology; D008297:Male; D008365:Manometry; D008875:Middle Aged; D010865:Pilot Projects
D008055:Lipids; D006851:Hydrochloric Acid