Meal induced rectosigmoid tone modification: a low caloric meal accurately separates functional and organic gastrointestinal disease patients

di Stefano, M.; Miceli, E.; Missanelli, A.; Mazzocchi, S.; Corazza, G. R.
October 2006
Gut;Oct2006, Vol. 55 Issue 10, p1409
Academic Journal
Background and aims: Diagnosis of irritable bowel syndrome (IBS) is based on arbitrary criteria due to the lack of an accurate diagnostic test. The aim of this study was to evaluate whether rectosigmoid tone modification after a meal represents an accurate diagnostic approach. Methods: In a secondary care setting, 32 constipation predominant and 24 diarrhoea predominant IBS patients, 10 functional diarrhoea and 10 functional constipation patients, 29 organic gastrointestinal disease patients, and 10 healthy volunteers underwent a rectal barostat test to measure fasting and postprandial rectosigmoid tone. Rectosigmoid response was assessed following three meals containing different amounts of calories: 200 kcal, 400 kcal and 1000 kcal. Results: After 200 kcal, healthy volunteers and patients with organic diseases showed a reduction in rectosigmoid volume of at least 28% of fasting volume, indicating a meal induced increase in muscle tone. In contrast, patients with diarrhoea predominant IBS showed dilation of the rectosigmoid colon, indicative of reduced tone, and patients with constipation predominant IBS showed a mild volume reduction or no modification. Functional diarrhoea and constipation patients showed rectosigmoid tone modification resembling that of the corresponding IBS subtype. A 400 kcal meal normalised rectosigmoid tone in more than half of the constipation predominant IBS patients but none of the diarrhoea predominant IBS patients. In contrast, a 1000 kcal meal normalised tone response in all IBS patients. Sensitivity of the test was 100%, specificity 93%, positive predictive value 96%, and negative predictive value 100%. Conclusion: A postprandial reduction in rectosigmoid tone of at least 28% of fasting value after a low caloric meal accurately separates organic and functional gastrointestinal disease patients. This parameter may therefore be used in the positive diagnosis of IBS.


Related Articles

  • Functional Bowel Disorders in Iranian Population using Rome III Criteria. Sorouri, Majid; Pourhoseingholi, Mohammad A.; Vahedi, Mohsen; Safaee, Azadeh; Moghimi-Dehkordi, Bijan; Pourhoseingholi, Asma; Habibi, Manijeh; Zali, Mohammad R. // Saudi Journal of Gastroenterology;Jul2010, Vol. 16 Issue 3, p154 

    Background/Aim: To study the prevalence and risk factors of functional bowel disorders (FBD) in Iranian community using Rome III criteria. Materials and Methods: This study was a cross-sectional household survey conducted from May 2006 to December 2007 in Tehran province, Iran, including 18,180...

  • Safer alternatives to Zelnorm.  // Consumer Reports;Sep2004, Vol. 69 Issue 9, p47 

    Reports on alternatives to taking tegaserod maleate (Zelnorm), a drug approved for short-term relief of irritable bowel syndrome (IBS) with constipation. Details of safety concerns surrounding the drug for some users; Questions of the drug's effectiveness; Significance of dietary changes to...

  • Symptom Differences in Moderate to Severe IBS Patients Based on Predominant Bowel Habit. Schmulson, Max; Oh-Young Lee; Lin Chang; Naliboff, Bruce; Mayer, Emeran A. // American Journal of Gastroenterology;Oct1999, Vol. 94 Issue 10, p2929 

    OBJECTIVE: We sought to determine if irritable bowel syndrome (IBS) patients with different bowel habit predominance differ in self-reported viscerosensory symptoms related to the upper and lower gastrointestinal (GI) tract, somatosensory symptoms, and constitutional functions. METHODS: Six...

  • Irritable Bowel Syndrome – A Review Article. Lescheid, David W. // Indian Journal of Dental Sciences;Jun2015, Vol. 7 Issue 2, Special section p4 

    The article focuses on irritable bowel syndrome (IBS) which is among functional bowel disorders including functional abdominal bloating, constipation, and diarrhea. Topics discussed the symptoms, characteristics and diagnosis of IBS, the coexistence of IBS with other functional gastrointestinal...

  • The Irritable Bowel Syndrome. Zammit, Edward // Malta Medical Journal;Jun2009, Vol. 21 Issue 2, p34 

    The article offers information on the diagnosis of irritable bowel syndrome (IBS), a gastrointestinal disorder associated with abdominal pain, diarrhea, and altered bowel movements. Although IBS poses a negative impact in the quality of life and social functioning of patients, it is inferred...

  • A Dose-Ranging, Phase II Study of the Efficacy and Safety of Alosetron in Men with Diarrhea-Predominant IBS. Chang, Lin; Ameen, Vanessa Z.; Dukes, George E.; McSorley, David J.; Carter, Eric G.; Mayer, Emeran A. // American Journal of Gastroenterology;Jan2005, Vol. 100 Issue 1, p115 

    BACKGROUND: A randomized, double blind, placebo-controlled dose-ranging study was conducted to assess the efficacy of alosetron in men with diarrhea-predominant irritable bowel syndrome (IBS).METHODS: Six hundred and sixty-two men were randomized to treatment with alosetron 0.5, 1.0, 2.0, 4.0...

  • Irritable bowel syndrome support. Watson, Brenda // Alive: Canada's Natural Health & Wellness Magazine;Dec2005, Issue 278, p44 

    The article presents remedial measures for Irritable bowel syndrome(IBS). It informs that the IBS sufferers faces abdominal pain and altered bowel function such as constipation and diarrhea. In worse cases some people suffer from bouts of constipation and diarrhea. It mentions that a causative...

  • Abdominal pain and functional gastrointestinal disorders. Guthrie, Elspeth; Thompson, David // BMJ: British Medical Journal (International Edition);9/28/2002, Vol. 325 Issue 7366, p701 

    Discusses the overlap of functional disorders that deal with gastrointestinal pain syndromes. Controversy about the classification system for functional gastrointestinal disorders (FGID); Prevalence of irritable bowel syndrome; Involvement of psychological and physiological factors; Aim of drug...

  • Prevalence of Gastrointestinal Symptoms in a Multiracial Asian Population, With Particular Reference to Reflux-Type Symptoms. Khek Yu Ho; Jin Yong Kang; Adeline Seow // American Journal of Gastroenterology;Oct1998, Vol. 93 Issue 10, p1816 

    Objective: Data on the epidemiology of chronic gastrointestinal symptoms in the East are limited. The aims of this study were to estimate the prevalence of chronic gastrointestinal symptoms in Singapore and to determine whether ethnic differences in the prevalence of these symptoms exist....


Read the Article


Sign out of this library

Other Topics