title: Irritable pouch syndrome is characterized by visceral hypersensitivity.
abstract: BACKGROUND
  Irritable pouch syndrome (IPS) is a functional disorder in patients with ileal pouch-anal anastomosis (IPAA), which presents with symptoms in the absence of structural abnormalities of the pouch. Thus, it resembles other functional disorders, such as irritable bowel syndrome characterized by visceral hypersensitivity in the presence of normal rectal biomechanics. The aim was to assess pouch biomechanics and perception of balloon distension in different groups of subjects with IPAA and to correlate the findings with clinical features.
  
  
  METHODS
  Pouch tone, compliance, and sensation to balloon distension were measured in 18 patients with IPS, 11 patients with active pouch inflammation (pouchitis or Crohn's disease of the pouch), and 12 asymptomatic subjects with normal pouches. All patients were recruited from a subspecialty Pouchitis Clinic.
  
  
  RESULTS
  Scores of sensation of gas, urge to defecate, and pain measured by visual analog scales at various distension pressures were significantly higher in IPS than pouchitis and normal pouch patients. Pouch tone was comparable among the groups and compliance was reduced in the pouchitis group. The visual analog scale showed a trend of correlation with the Pouchitis Disease Activity Index symptom scores in IPS.
  
  
  CONCLUSIONS
  IPS, like other gut functional disorders, is characterized by visceral hypersensitivity, with normal pouch biomechanics.
authors.affiliation: Department of Gastroenterology, Digestive Disease Institute, the Cleveland Clinic Foundation, Cleveland, Ohio, USA.
authors.forename: Bo
authors.initials: B
authors.lastname: Shen
authors.forename: Claudia
authors.initials: C
authors.lastname: Sanmiguel
authors.forename: Ana E
authors.initials: AE
authors.lastname: Bennett
authors.forename: Lei
authors.initials: L
authors.lastname: Lian
authors.forename: Brett
authors.initials: B
authors.lastname: Larive
authors.forename: Feza H
authors.initials: FH
authors.lastname: Remzi
authors.forename: Victor W
authors.initials: VW
authors.lastname: Fazio
authors.forename: Edy E
authors.initials: EE
authors.lastname: Soffer
mesh_terms: D016022:Case-Control Studies; D005260:Female; D006801:Humans; D006967:Hypersensitivity; D043183:Irritable Bowel Syndrome / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D019449:Pouchitis / Q000473:pathology*; D016737:Proctocolectomy, Restorative; D011379:Prognosis; D011788:Quality of Life