Z Gastroenterol 2004; 42 - 19
DOI: 10.1055/s-2004-827123

Visceral hypesthesia in patients with Crohn's disease

C Csizmadia 1, A Illés 1, S Undi 1, L Nagy 1, Á Király 1
  • 13rd Dept. of Medicine, University of Pécs, Medical Centre, Pécs

Visceral hyperesthesia was found to play etiologic role in the development of symptoms of irritable bowel syndrome (IBS). Crohn's disease (CD) was shown to produce chronic abdominal pain.

The aim of our study was to test the perceptual thresholds to rectosigmoideal balloon distension in patients with CD. Rectosigmoideal balloon distension was carried out with semirandom ascending phasic (870ml/min) distension with SVS-barostat in 5 CD (without any inflammatory manifestations in the rectosigmoideal region), in 5 Rome II positive alternating IBS patients and in 5 healthy volunteers.

Results: Pressures of urge were 20±3mmHg *, 26±2mmHg, 28±2mmHg in CD, IBS and healthy patients. Pain thresolds were 56±3mmHg*, 33±2mmHg *, 43±4mmHg respectively. Rectal compliance was: 3.1±0.1ml/mmHg *, 5,6±0,04ml/mmHg*, 6±0,3ml/mmHg respectively. (*: P≤0.01 ANOVA, analysis of variance, Duncan's contrast)

Conclusion: Chronic abdominal pain induced by ileal manifestation of CD produces tolerance to visceral pain most likely through the activation of descending inhibitory pathways of pain. CD patients have decreased rectal compliance that can be related to an inflammatory process.