Peripheral Mechanisms of Symptom Generation in Irritable Bowel Syndrome

There is considerable interest in the mechanisms that underlie symptom generation in irritable bowel syndrome (IBS) and particularly those mechanisms peripheral to higher centres in the nervous system. While the central nervous system is important in IBS, it is restricted largely to the role of beha...

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Main Author: Stephen M Collins
Format: Article
Language:English
Published: Wiley 2001-01-01
Series:Canadian Journal of Gastroenterology
Online Access:http://dx.doi.org/10.1155/2001/690794
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author Stephen M Collins
author_facet Stephen M Collins
author_sort Stephen M Collins
collection DOAJ
description There is considerable interest in the mechanisms that underlie symptom generation in irritable bowel syndrome (IBS) and particularly those mechanisms peripheral to higher centres in the nervous system. While the central nervous system is important in IBS, it is restricted largely to the role of behaviour in stress perception and symptom reporting. The gut and the autonomic nervous system are principal areas of research in identifying mechanisms underlying symptom generation and in the identification of new targets for drug development. While motility changes occur in IBS, they are neither specific nor predictable, and this is one reason why drugs aimed at influencing motility patterns have enjoyed limited success to date. This success has prompted interest in sensory physiology to explain pain and other discomforts expressed by patients with IBS. Patients with IBS exhibit intolerance to rectal distension and other manoeuvres of the gut, while exhibiting normal or raised thresholds for somatic pain. The mechanisms underlying the development of hyperalgesia or allodynia in the gut remain to be determined. In other systems and experimental models, low grade inflammation is a predicable inducer of these states, and recent evidence suggests that a subpopulation of patients with IBS develop chronic symptoms after acute gastroenteritis. This and other inflammatory stimuli may induce a hyperalgesic state and alter motor function in patients with IBS. Substances that mediate these changes are not fully understood, but there is growing recognition of the role of serotonin as a sensitizing agent.
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spelling doaj-art-7f35b56730ed442386f089e3181c5f6a2025-02-03T01:29:17ZengWileyCanadian Journal of Gastroenterology0835-79002001-01-0115Suppl B14B16B10.1155/2001/690794Peripheral Mechanisms of Symptom Generation in Irritable Bowel SyndromeStephen M Collins0Division of Gastroenterology, McMaster University, Hamilton, Ontario, CanadaThere is considerable interest in the mechanisms that underlie symptom generation in irritable bowel syndrome (IBS) and particularly those mechanisms peripheral to higher centres in the nervous system. While the central nervous system is important in IBS, it is restricted largely to the role of behaviour in stress perception and symptom reporting. The gut and the autonomic nervous system are principal areas of research in identifying mechanisms underlying symptom generation and in the identification of new targets for drug development. While motility changes occur in IBS, they are neither specific nor predictable, and this is one reason why drugs aimed at influencing motility patterns have enjoyed limited success to date. This success has prompted interest in sensory physiology to explain pain and other discomforts expressed by patients with IBS. Patients with IBS exhibit intolerance to rectal distension and other manoeuvres of the gut, while exhibiting normal or raised thresholds for somatic pain. The mechanisms underlying the development of hyperalgesia or allodynia in the gut remain to be determined. In other systems and experimental models, low grade inflammation is a predicable inducer of these states, and recent evidence suggests that a subpopulation of patients with IBS develop chronic symptoms after acute gastroenteritis. This and other inflammatory stimuli may induce a hyperalgesic state and alter motor function in patients with IBS. Substances that mediate these changes are not fully understood, but there is growing recognition of the role of serotonin as a sensitizing agent.http://dx.doi.org/10.1155/2001/690794
spellingShingle Stephen M Collins
Peripheral Mechanisms of Symptom Generation in Irritable Bowel Syndrome
Canadian Journal of Gastroenterology
title Peripheral Mechanisms of Symptom Generation in Irritable Bowel Syndrome
title_full Peripheral Mechanisms of Symptom Generation in Irritable Bowel Syndrome
title_fullStr Peripheral Mechanisms of Symptom Generation in Irritable Bowel Syndrome
title_full_unstemmed Peripheral Mechanisms of Symptom Generation in Irritable Bowel Syndrome
title_short Peripheral Mechanisms of Symptom Generation in Irritable Bowel Syndrome
title_sort peripheral mechanisms of symptom generation in irritable bowel syndrome
url http://dx.doi.org/10.1155/2001/690794
work_keys_str_mv AT stephenmcollins peripheralmechanismsofsymptomgenerationinirritablebowelsyndrome