title: Feeding and colonic distension provoke altered autonomic responses in irritable bowel syndrome.
abstract: OBJECTIVE
  Alterations in autonomic balance, detectable by heart rate variability (HRV) analysis, have been shown to occur after a meal in patients with irritable bowel syndrome (IBS). There are few data on changes in sympathovagal responses in IBS to other forms of enteric stimulation such as colonic distension. The aim of this study was to determine the effects of colonic balloon distension on HRV in the fasting and the postprandial state in healthy subjects and in IBS patients.
  
  
  METHODS
  Eight IBS patients and 8 age- and gender-matched healthy subjects underwent unsedated descending colonic distension before and after a 1000 kcal liquid meal. Low- (LF) and high-frequency (HF) HRV band values obtained from 2-min ECG segments recorded before and during distension were compared between groups, and between fasting and postprandial states. A visual analogue scale was used to determine sensation during colonic distension.
  
  
  RESULTS
  HF values decreased significantly with feeding in IBS patients (p=0.01), but not in healthy subjects. The low-to-high frequency (LF/HF) ratio was significantly higher postprandially in IBS patients (p=0.02) and, additionally, was decreased (p<0.01) with colonic distension in the fed state, independently of colonic sensitivity or distending volume. Moreover, changes in the LF/HF ratio with distension in the fed versus the fasting state were negatively correlated in IBS patients but positively correlated in healthy subjects (both p<0.05).
  
  
  CONCLUSIONS
  IBS patients demonstrated altered autonomic responses to feeding and colonic distension. Further studies should determine whether these alterations could explain the postprandial exacerbation of symptoms in IBS.
authors: Gastrointestinal Investigation Unit, Department of Gastroenterology, Royal North Shore Hospital & University of Sydney, St Leonards, NSW 2065, Australia.
authors: Clinton
authors: C
authors: Ng
authors: Allison
authors: A
authors: Malcolm
authors: Ross
authors: R
authors: Hansen
authors: John
authors: J
authors: Kellow
mesh_terms: D000328:Adult; D001341:Autonomic Nervous System / Q000503:physiopathology*; D002404:Catheterization; D003106:Colon / Q000503:physiopathology*; D004562:Electrocardiography; D005260:Female; D006339:Heart Rate; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000503:physiopathology*; D008297:Male; D010147:Pain Measurement; D019518:Postprandial Period; D012677:Sensation