Review article: gastrointestinal sensory and motor disturbances in inflammatory bowel disease - clinical relevance and pathophysiological mechanisms.
BACKGROUND
It is well known that inflammation has a profound impact on the neuromuscular apparatus of the gastrointestinal tract during the inflammatory insult and in periods of remission, at the site of inflammation and at distance from this site. The importance of this interaction is illustrated by the higher prevalence of functional gut disorders in patients with inflammatory bowel disease.


OBJECTIVE
To document the epidemiological and clinical significance of functional alterations of gut motility and sensitivity in patients with inflammatory bowel disease and to formulate potential pathophysiological mechanisms.


CONCLUSIONS
Functional gut disorders occur frequently in patients with inflammatory bowel disease, both during inflammatory episodes and in periods of remission, and have a major impact on their quality of life. The clinical manifestations of these motility and sensitivity disorders vary and are often difficult to treat, mainly because therapeutic guidelines and specific diagnostic tests to distinguish inflammatory bowel disease from functional gut disorders are lacking. Chronic bowel inflammation results in a complicated interaction between neuroendocrine serotonin-predominant cells of the mucosa, inflammatory cells (particularly mast cells) in the submucosa, the intrinsic and extrinsic innervation and the muscular apparatus including the interstitial cells of Cajal. The outcome of this interaction is a perturbation of gastrointestinal motor function, both locally and at distance from the site of inflammation and during both acute inflammation and remission.
De Schepper
H U
HU
Laboratory of Experimental Medicine and Pediatrics, Division of Gastroenterology, University of Antwerp, Antwerp, Belgium.
De Man
J G
JG
Moreels
T G
TG
Pelckmans
P A
PA
De Winter
B Y
BY
D005769:Gastrointestinal Motility; D006801:Humans; D007154:Immune System Diseases / Q000150:complications; D015212:Inflammatory Bowel Diseases / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D007422:Intestines / Q000294:innervation; D008407:Mast Cells / Q000502:physiology; D009422:Nervous System Diseases / Q000150:complications; D012701:Serotonin / Q000502:physiology
D012701:Serotonin