Irritable pouch syndrome is characterized by visceral hypersensitivity
Bo Shen MD
Departments of Gastroenterology and Colorectal Surgery, Digestive Disease Institute, the Cleveland Clinic Foundation, Cleveland, Ohio
Search for more papers by this authorClaudia Sanmiguel MD
Department of Gastroenterology, Cedars Sinai Medical Center, Los Angeles, California
Search for more papers by this authorAna E. Bennett MD
Departments of Gastroenterology and Colorectal Surgery, Digestive Disease Institute, the Cleveland Clinic Foundation, Cleveland, Ohio
Search for more papers by this authorLei Lian MD, PhD
Departments of Gastroenterology and Colorectal Surgery, Digestive Disease Institute, the Cleveland Clinic Foundation, Cleveland, Ohio
Search for more papers by this authorBrett Larive MS
Department of Quantitative Sciences, the Cleveland Clinic Foundation, Cleveland, Ohio
Search for more papers by this authorFeza H. Remzi MD
Department of Quantitative Sciences, the Cleveland Clinic Foundation, Cleveland, Ohio
Search for more papers by this authorVictor W. Fazio MB, MS
Department of Quantitative Sciences, the Cleveland Clinic Foundation, Cleveland, Ohio
Search for more papers by this authorCorresponding Author
Edy E. Soffer MD
Department of Gastroenterology, Cedars Sinai Medical Center, Los Angeles, California
Department of Gastroenterology, Cedars Sinai Medical Center, Los Angeles, CASearch for more papers by this authorBo Shen MD
Departments of Gastroenterology and Colorectal Surgery, Digestive Disease Institute, the Cleveland Clinic Foundation, Cleveland, Ohio
Search for more papers by this authorClaudia Sanmiguel MD
Department of Gastroenterology, Cedars Sinai Medical Center, Los Angeles, California
Search for more papers by this authorAna E. Bennett MD
Departments of Gastroenterology and Colorectal Surgery, Digestive Disease Institute, the Cleveland Clinic Foundation, Cleveland, Ohio
Search for more papers by this authorLei Lian MD, PhD
Departments of Gastroenterology and Colorectal Surgery, Digestive Disease Institute, the Cleveland Clinic Foundation, Cleveland, Ohio
Search for more papers by this authorBrett Larive MS
Department of Quantitative Sciences, the Cleveland Clinic Foundation, Cleveland, Ohio
Search for more papers by this authorFeza H. Remzi MD
Department of Quantitative Sciences, the Cleveland Clinic Foundation, Cleveland, Ohio
Search for more papers by this authorVictor W. Fazio MB, MS
Department of Quantitative Sciences, the Cleveland Clinic Foundation, Cleveland, Ohio
Search for more papers by this authorCorresponding Author
Edy E. Soffer MD
Department of Gastroenterology, Cedars Sinai Medical Center, Los Angeles, California
Department of Gastroenterology, Cedars Sinai Medical Center, Los Angeles, CASearch for more papers by this authorAbstract
Background:
Irritable pouch syndrome (IPS) is a functional disorder in patients with ileal pouch–anal anastomosis (IPAA), which presents with symptoms in the absence of structural abnormalities of the pouch. Thus, it resembles other functional disorders, such as irritable bowel syndrome characterized by visceral hypersensitivity in the presence of normal rectal biomechanics. The aim was to assess pouch biomechanics and perception of balloon distension in different groups of subjects with IPAA and to correlate the findings with clinical features.
Methods:
Pouch tone, compliance, and sensation to balloon distension were measured in 18 patients with IPS, 11 patients with active pouch inflammation (pouchitis or Crohn's disease of the pouch), and 12 asymptomatic subjects with normal pouches. All patients were recruited from a subspecialty Pouchitis Clinic.
Results:
Scores of sensation of gas, urge to defecate, and pain measured by visual analog scales at various distension pressures were significantly higher in IPS than pouchitis and normal pouch patients. Pouch tone was comparable among the groups and compliance was reduced in the pouchitis group. The visual analog scale showed a trend of correlation with the Pouchitis Disease Activity Index symptom scores in IPS.
Conclusions:
IPS, like other gut functional disorders, is characterized by visceral hypersensitivity, with normal pouch biomechanics. (Inflamm Bowel Dis 2011)
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