JEJUNAL SENSORIMOTOR DYSFUNCTION IN IRRITABLE-BOWEL-SYNDROME - CLINICAL AND PSYCHOSOCIAL FEATURES

Background & Aims: The interrelationships between enteric hypersensiti vity, dysmotility, and psychosocial factors in the pathogenesis of irr itable bowel syndrome (IBS) are poorly understood, The aims of this st udy were to (1) compare the clinical, jejunal motor, and psychological features in patients with IBS who have heightened sensitivity and tho se who have normal sensitivity to jejunal balloon distention and (2) e xamine psychosocial correlates of sensory and/or motor dysfunction, Me thods: Female patients with IBS (n = 24) and healthy controls (n = 9) underwent 24-hour ambulant duodenojejunal manometry, assessment of jej unal sensitivity by balloon distention, and comprehensive psychosocial assessment. Results: In 6 (25%) and 10 (42%) patients, hypersensitivi ty was present at the threshold for initial perception and at the thre shold for pain, respectively, After ingestion of a high-energy standar d meal, all patients with heightened sensitivity for perception had ab normalities in the postprandial motor pattern compared with one third of patients with normal sensitivity, In this subgroup with hypersensit ivity and postprandial dysmotility, clinical features were not discrim inative but an inherently ineffectual coping style featuring both ange l hyperreactivity and defensive control of anger was highly characteri stic, Conclusions: in IBS, abnormal postprandial jejunal motor activit y is related to jejunal mechanoreceptor-related hypersensitivity, and such sensorimotor dysfunction has a specific psychological profile.