Clinical Research
Copyright ©The Author(s) 2003. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Oct 15, 2003; 9(10): 2293-2299
Published online Oct 15, 2003. doi: 10.3748/wjg.v9.i10.2293
Pan-enteric dysmotility, impaired quality of life and alexithymia in a large group of patients meeting ROME II criteria for irritable bowel syndrome
Piero Portincasa, Antonio Moschetta, Giuseppe Baldassarre, Donato F. Altomare, Giuseppe Palasciano
Piero Portincasa, Antonio Moschetta, Giuseppe Palasciano, Section of Internal Medicine, Department of Internal Medicine and Public Medicine (DIMIMP), University Medical School, Bari
Giuseppe Baldassarre, Division of Geriatrics, Hospital “Miulli”, Acquaviva delle Fonti, Bari, Italy
Donato F. Altomare, Section of Surgery, Department of Emergency and Organ Transplant (DETO), University Medical School, Bari, Italy
Author contributions: All authors contributed equally to the work.
Correspondence to: Piero Portincasa, MD, PhD, Chair Person of Semeiotica Medica-Section of Internal Medicine, Department of Internal and Public Medicine (DIMIMP), University of Bari Medical School-Policlinico-70124 Bari-Italy. p.portincasa@semeiotica.uniba.it
Telephone: +39-80-5478-227 Fax: +39-80-5478-232
Received: May 10, 2003
Revised: July 25, 2003
Accepted: August 2, 2003
Published online: October 15, 2003
Abstract

AIM: Psychological factors, altered motility and sensation disorders of the intestine can be variably associated with irritable bowel syndrome (IBS). Such aspects have not been investigated simultaneously. The aim of this paper was to evaluate gastrointestinal motility and symptoms, psychological spectrum and quality of life in a large group of IBS patients in southern Italy.

METHODS: One hundred IBS patients (F:M = 73:27, age 48 ± 2 years, mean ± SE) fulfilling ROME II criteria matched with 100 healthy subjects (F:M = 70:30, 45 ± 2 years). Dyspepsia, bowel habit, alexithymia, psycho-affective profile and quality of life were assessed using specific questionnaires. Basally and postprandially, changes in gallbladder volumes and antral areas after liquid meal and orocaecal transit time (OCTT) were measured respectively by ultrasonography and H2-breath test. Appetite, satiety, fullness, nausea, and epigastric pain/discomfort were monitored using visual-analogue scales.

RESULTS: Compared with controls, IBS patients had increased dyspepsia (score 12.6 ± 0.7 vs 5.1 ± 0.2, P < 0.0001), weekly bowel movements (12.3 ± 0.4 vs 5.5 ± 0.2, P < 0.00001, comparable stool shape), alexithymia (score 59.1 ± 1.1 vs 40.5 ± 1.0, P = 0.001), poor quality of life and psycho-affective profile. IBS patients had normal gallbladder emptying, but delayed gastric emptying (T50: 35.5 ± 1.0 vs 26.1 ± 0.6 min, P = 0.00001) and OCTT (163.0 ± 5.4 vs 96.6 ± 1.8 min, P = 0.00001). Fullness, nausea, and epigastric pain/discomfort were greater in IBS than in controls.

CONCLUSION: ROME II IBS patients have a pan-enteric dysmotility with frequent dyspepsia, associated with psychological morbidity and greatly impaired quality of life. The presence of alexithymia, a stable trait, is a novel finding of potential interest to detect subgroups of IBS patients with different patterns recoveed after therapy.

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