A research of migrating motor complex in patients with irritable bowel syndrome / 中华内科杂志

ABSTRACT

Objectives To compare the migrating motor complex (MMC) in irritable bowel syndrome (IBS) patients with that in healthy controls. To explore whether discrete clustered contractions (DCC) are connected with abdominal pain in IBS patients. To improve the method of measuring gastroenteric motility (esp. jejunum). Methods By using 16-channel water-perfused catheter and manometry instruments, MMC in 16 cases of IBS with constipation (IBS-C), 18 cases of IBS with diarrhea (IBS-D) and 18 cases of healthy controls were monitored. Results The MMC durations of IBS-C and IBS-D patients were (127.5±25.5) min and (74.5±18.7) min, respectively. Comparision with those in the control group [(87.5±24.2) min]showed significant differences (P<0. 001). The contraction amplitudes of stage Ⅲ in different sites of IBS-C patients decreased significantly as compared with those in the controls [jejunum, (39.8±11.7) mm Hg vs. (61.1±14.1) mm Hg,P<0.001,1 mm Hg=0.133 kPa]. The propagation velocities of stage Ⅲ in different sites of IBS-C patients also decreased significantly as compared with those in the controls [jejunum, (1.8±0.9) cm/min vs. (2.6±0.8) cm/min,P<0.01].The contraction amplitudes of stage Ⅲ in different sites of IBS-D patients increased significantly as compared with those in the controls [jejunum, (69.7±20.5) mm Hg vs. (61.1±14.1) mm Hg, P<0.01]. The propagation velocities of stage Ⅲ in different sites of IBS-D patients also increased significantly as compared with those in the controls [jejunum, (4.1±2.5) cm/min vs. (2.6±0.8) cm/min, P < 0. 01]. DCC incidences of IBS-C and IBS-D were 87.5% and 88. 8%, respectively. Comperision with those in the normal group (83.3%) did not show significant difference (P>0.05). The prevalences of abnormal stage Ⅲ contractions (include disturbances and interferences of stage Ⅲ contractions) in IBS-C and IBS-D patients were 68.8% and 66. 7%, respectively; there were no significant differences between the two groups (P > 0. 05). However abnormal stage Ⅲ contractions did not exist in healthy controls. Conclusions (1) The MMC of IBS-C and IBS-D patients are changed, as compared with that in healthy people; this implies that small intestinal motility dysfunction is one of the pathogenetic factors of IBS. The abnormal stage Ⅲ contractions in jejunum may be a predominant change in IBS gastroenteric motility. (2) No apparent connection is found between DCC and pain in IBS. (3) By using 16-channel water-perfused catheter, we first carried out the method of monitoring jejunum contractions in China. Parameters of MMC in Chinese healthy people were investigated, esp. those of jejunum.