title: Interaction between preprandial and postprandial rectal sensory and motor abnormalities in IBS.
abstract: OBJECTIVE
  Rectal sensory and motor interactions in patients with IBS have not been studied in detail. The aim of this study was to evaluate fasting and postprandial rectal sensorimotor characteristics and their interactions in IBS compared with healthy controls.
  
  
  METHODS
  We included 274 patients with IBS and 34 controls. All subjects underwent a rectal barostat study before and 60 min after a standardised liquid meal (800 kcal; 60% fat). Sensory thresholds, intensity of sensations, viscerosomatic referral and compliance were measured. During 15 min before the first distension sequence and until 50 min after meal intake, rectal balloon volumes were registered in 5 min intervals at operating pressure to quantify rectal tone. Mixed models were used to analyse the rectal tone response over time.
  
  
  RESULTS
  Rectal sensory thresholds and compliance were decreased and viscerosomatic referral areas increased in patients with IBS compared with controls. Meal intake increased rectal sensitivity, compliance and referral areas in patients and controls and the same proportions of patients were hypersensitive to distension before and after meal intake. There was a higher basal rectal tone in IBS and a significantly different rectal tone response after meal intake in patients with IBS compared with controls and, interestingly, also in IBS with rectal hypersensitivity (defined in the preprandial state), compared with normosensitive patients.
  
  
  CONCLUSIONS
  Meal intake affects rectal sensorimotor function in IBS and health. Importantly, the rectal tone responses to a high-caloric meal are different between patients with IBS and controls, as well as between hypersensitive and normosensitive patients with IBS.
authors.affiliation: Department of Internal Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden University of Gothenburg Centre for Person-Centered Care (GPCC), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Hans
authors.initials: H
authors.lastname: Törnblom
authors.affiliation: Translational Research Center for Gastrointestinal Disorders (TARGID), University of Leuven, Leuven, Belgium.
authors.forename: Lukas
authors.initials: L
authors.lastname: Van Oudenhove
authors.affiliation: Translational Research Center for Gastrointestinal Disorders (TARGID), University of Leuven, Leuven, Belgium.
authors.forename: Jan
authors.initials: J
authors.lastname: Tack
authors.affiliation: Department of Internal Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden University of Gothenburg Centre for Person-Centered Care (GPCC), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Magnus
authors.initials: M
authors.lastname: Simrén
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D005215:Fasting; D005260:Female; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D058748:Pain Perception / Q000502:physiology*; D019518:Postprandial Period / Q000502:physiology*; D011312:Pressure; D011446:Prospective Studies; D012007:Rectum / Q000503:physiopathology*; D012684:Sensory Thresholds; D055698:Touch Perception / Q000502:physiology*; D064232:Visual Analog Scale
keywords: COLORECTAL PHYSIOLOGY; INTESTINAL MOTILITY; IRRITABLE BOWEL SYNDROME; VISCERAL SENSITIVITY