[Contribution of the patent foramen ovale to the etiopathogeny of the irritable bowel syndrome].
A higher prevalence of cardiac right-to-left shunt through a patent foramen ovale (PFO) has been recently reported in the irritable bowel syndrome (IBS). At the same time, signs of ischemia in medullary cerebral microcirculation and the presence of excess sympathetic activity in peripheral circulation have been identified, both related with change in pain perception and autonomic dysfunction characteristic of IBS. Considering these findings together, the possible etiopathogenic role of PFO in the development of IBS can be proposed, because the paradoxical embolism characteristic of PFO could damage the cerebral and intestinal microcirculation, and that injury would be also amplified by the percentage of venous blood that shunts the pulmonary filter, producing an alteration in the metabolism of serotonin, pro-inflammatory bradykinins or neurotensin, substances with a proven etiopathogenic relationship with IBS.
Alvarez-Fernández
J A
JA
Unidad de Neurosonología y Hemodinámica Cerebral. Hospital Hospiten-Rambla. Santa Cruz de Tenerife. Islas Canarias. España. jalvarez@hospiten.es
Alarcón-Fernández
O
O
Pérez-Quintero
R
R
D054092:Foramen Ovale, Patent / Q000150:complications*; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000209:etiology*