title: Autonomic nervous system activity in constipation-predominant irritable bowel syndrome patients.
abstract: BACKGROUND
  The main mechanism underlying irritable bowel syndrome is currently believed to be a dysfunction of the brain-gut axis. Autonomic nervous system dysfunction can contribute to development of irritable bowel syndrome symptoms by disturbing visceral sensations.
  
  
  METHODS
  Thirty patients with a diagnosis of constipation-predominant irritable bowel syndrome and 30 healthy volunteers were included in the study. Resting and functional autonomic nervous system tests and percutaneous electrogastrography were performed. Plasma adrenalin, noradrenalin, insulin, ghrelin and cholecystokinin activity was analyzed.
  
  
  RESULTS
  Increased sympathetic activation with disturbed parasympathetic function was demonstrated. Patients had substantially higher plasma catecholamine concentration, which confirms sympathetic overbalance. Hyperinsulinemia may explain sympathetic predominance followed by gastric and intestinal motility deceleration. Abnormal, reduced ghrelin and cholecystokinin titre may disturb brain-gut axis functioning and may be responsible for gastric motility deceleration. In electrogastrography, distinctly lower values of fasting normogastria percentage and dominant power were observed. Patients had substantially lower slow wave coupling percentage both in fasting and postprandial periods, which negatively correlated with plasma catecholamines level. Gastric myoelectrical activity disturbances may result from lack of sympatho-parasympathetic equilibrium.
  
  
  CONCLUSIONS
  Central sympathetic influence within the brain-gut axis is most probably responsible for myoelectrical activity disturbances in irritable bowel syndrome patients.
authors: Department of Pathophysiology, Jagiellonian University, Medical College, Cracow, Poland.
authors: Marcel
authors: M
authors: Mazur
authors: Agata
authors: A
authors: Furgała
authors: Konrad
authors: K
authors: Jabłoński
authors: Tomasz
authors: T
authors: Mach
authors: Piotr
authors: P
authors: Thor
mesh_terms: D000328:Adult; D001341:Autonomic Nervous System / Q000503:physiopathology*; D016022:Case-Control Studies; D002395:Catecholamines / Q000097:blood; D003248:Constipation / Q000097:blood / Q000150:complications* / Q000503:physiopathology*; D004576:Electromyography; D005215:Fasting / Q000097:blood; D005247:Feeding Behavior; D005260:Female; D005768:Gastrointestinal Hormones / Q000097:blood; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000097:blood / Q000150:complications* / Q000503:physiopathology*; D008297:Male; D012119:Respiration
chemical_list: D002395:Catecholamines; D005768:Gastrointestinal Hormones