Fats and visceral sensitivity In IBS patients - HelpForIBS.com Message Boards

The American Journal of Gastroenterology
Volume 100 Issue 2 Page 383 - February 2005
doi:10.1111/j.1572-0241.2005.40100.x

Visceral Sensitivity and Symptoms in Patients with Constipation- or Diarrhea-predominant Irritable Bowel Syndrome (IBS): Effect of a Low-Fat Intraduodenal Infusion

Maria Pia Caldarella, M.D.1, Angelo Milano, M.D.1, Francesco Laterza, M.D.1, Flora Sacco, M.D.1, Crysanthi Balatsinou, M.D.1, Domenico Lapenna, M.D.1, Sante Donato Pierdomenico, M.D.1, Franco Cuccurullo, M.D.1, and Matteo Neri, M.D.1

BACKGROUND: Visceral hypersensitivity is common in Irritable Bowel Syndrome (IBS) patients, and symptoms exacerbate postprandially (after eating). Yet the effects of nutrients on visceral sensitivity and symptoms in these patients have not been fully explored.

AIMS: To evaluate the differences of visceral sensitivity and symptoms in healthy subjects and IBS patients during fasting and intraduodenal lipids (fats) infusion.

METHODS: Graded rectal distensions at fixed tension levels were performed in 16 IBS patients (8 IBS-C and 8 IBS-D) and 6 healthy subjects before and during intraduodenal lipids infusion at 0.5 kcal/min. Tension levels were increased in 4 gr increments up to 64 gr or discomfort during both conditions. At each step, perception and symptoms were measured by means of a validated questionnaire.

RESULTS: In basal conditions, perception thresholds in IBS patients and health were, respectively, 8 ± 2 gr versus 32 ± 9 gr (p< 0.001) with no changes during lipids. Intraduodenal lipids infusion significantly lowered threshold of discomfort in IBS patients in comparison to fasting (24 ± 6 gr vs 34 ± 4 gr; p< 0.05), while health tolerated all distension without discomfort. No differences of compliance, perception, or discomfort were observed between the two subgroups of patients at each tension step. The predominant symptom elicited in patients with IBS-C was abdominal pain (54%), while patients with IBS-D exhibited urgency (63%, p< 0.005); this pattern was maintained during lipids.

CONCLUSIONS: Intraduodenal lipids increase visceral sensitivity in both IBS-C and IBS-D; symptoms specificity in response to rectal distension is maintained in the postprandial period. Lipids may be responsible for the postprandial symptoms exacerbation in IBS.

http://www.blackwell-synergy.com/links/doi/10.1111/j.1572-0241.2005.40100.x/abs/

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