Kosin Med J.  2013 Jun;28(1):49-54. 10.7180/kmj.2013.28.1.49.

Two Cases of Increased Parasympathetic Nerve System in Irritable Bowel Syndrome with Diarrhea as a Predominant Symptom

• Kang EK
• Choi JS

• KMID: 2308511
• DOI: http://doi.org/10.7180/kmj.2013.28.1.49

Abstract

The irritable bowel syndrome(IBS) is a chronic functional gastrointestinal disorder, characterized by abdominal pain, bloating and bowel disturbance. The pathophysiology of IBS is very complicated. Recent studies indicate that the most important mechanisms include visceral hypersensitivity, abnormal gut motility, autonomic nervous system(ANS) dysfunction and disorder of regulation of the brain-gut axis. Patients with IBS frequently present impaired autonomic regulation. Heart rate variability(HRV) is an acknowledged tool for estimating autonomic function. We experienced two cases of increased parasympathetic nervous system by HRV in irritable bowel syndrome with diarrhea as a predominant symptom.

Keyword

Autonomic nervous system; Heart rate variability; Irritable bowel syndrome

MeSH Terms

Abdominal Pain
Autonomic Nervous System
Axis, Cervical Vertebra
Diarrhea
Gastrointestinal Diseases
Heart Rate
Humans
Hypersensitivity
Irritable Bowel Syndrome
Parasympathetic Nervous System

Figure

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  Fig. 1. Five-minute time & frequency domain indices of heart rate variability (case 1)

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  Fig. 2. Five-minute time & frequency domain indices of heart rate variability (case 2)

Reference

1.Aggarwal A., Cutts TF., Abell TL., Cardoso S., Familoni B., Bremer J, et al. Predominant symptoms in irritable bowel syndrome correlate with specific autonomic nervous system abnormalities. Gastroenterology. 1994. 106:945–50.

2.Luczak H., Laurig W. An analysis of heart rate variability. Ergonomics. 1973. 16:85–97.

3.Liu J., Hou X. A review of the irritable bowel syndrome investigation on epidemiology, pathogenesis and pathophysiology in China. J Gastroenterol Hepatol. 2011. 26:88l–93.

4.Barclay GR., Turnberg LA. Effect of psychological stress on salt and water transport in the human jejunum. Gastroenterology. 1987. 93:91–7.

5.Taylor CT., Keely SJ. The autonomic nervous system and inflammatory bowel disease. Auton Neurosci. 2007. 133:104–14.

6.Evans PR., Bak YT., Shuter B., Hoschl R., Kellow JE. Gastroparesis and small bowel dysmotility in irritable bowel syndrome. Dig Dis Sci. 1997. 42:2087–93.

7.Arad M., Abboud S., Radai MM., Adunsky A. Heart rate variability parameters correlate with functional independence measures in ischemic stroke patients. J Electrocardiol. 2002. 35:243–6.

8.Hon EH LS. Electronic evaluations of the fetal heart rate patterns preceding fetal death, further observations. Am J Obstet Gynecol. 1963. 87:814–26.

9.Aronson D., Mittleman MA., Burger AJ. Measures of heart period variability as predictors of mortality in hospitalized patients with decompensated congestive heart failure. Am J Cardiol. 2004. 93:59–63.

10.Vinik AI., Maser RE., Mitchell BD., Freeman R. Diabetic autonomic neuropathy. Diabetes Care. 2003. 26:1553–79.

11.Jeong KS. The outline of HRV. J Korean Acad Fam Med. 2004. 25:S528–32.

12.Heart rate variability: standards of measurement, physiological interpretation and clinical use. Task Force of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. Circulation. 1996. 93:1043–65.