Effect of Physical Exercise on Autonomic Nerve Function in Irritable Bowel Syndrome (original) (raw)
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Effect of Moderate Physical Exercise on Autonomic Balance in Irritable Bowel Syndrome
Journal of Bangladesh Society of Physiologist, 2015
Background: Altered autonomic balance has been noted in Irritable bowel syndrome Regular physical exercise may cause restoration of autonomic balance in health and disease. Objective: To assess the effect of brisk walking on the autonomic balance by analysis of heart rate variability in patients with Irritable bowel syndrome (IBS). Methods: This prospective study was conducted in the Department of Physiology, Bangabandhu Sheikh Mujib Medical University (BSMMU) in 2013.Seventy seven male IBS patients aged 20-50 years, were enrolled from Gastroenterology OPD, BSMMU, Dhaka. Twenty eight healthy sedentary male with similar age were control. HRV measures were recorded once prior to exercise and then after 3 months of brisk walking. For assessing autonomic balance, LF/HF ratio and Max/Min RR was evaluated by Polyrite D machine and software. ANOVA, Independent sample t-test and paired t-test were used for statistical analysis. Results: The pre-exercise mean values of LF/HF ratio were significantly higher (p<0.001) in all IBS patients compared to those of control. The post exercise LF/HF ratio were significantly lower (p<0.05) in all IBS patients compared to their pre-exercise values. Conclusion: This study concluded that the sympathovagal balance was towards sympathetic predominance in IBS and regular moderate physical exercise may shift the balance towards parasympathetic predominance in them.
Assessment of Autonomic Nerve Function In Patients With Irritable Bowel Syndrome
Journal of Bangladesh Society of Physiologist, 2012
Background: Autonomic nerve function impairment is related to development of Irritable Bowel Syndrome (IBS). Heart rate variability (HRV) is a useful tool to measure autonomic nerve function activity and also sympatho-vagal balance.Objective: To assess autonomic nerve function activity by heart rate variability analysis in patients with Irritable Bowel Syndrome.Methods: This cross sectional study was conducted in the Department of Physiology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka from 1st July 2010 to 30th June 2011. Ninety patients aged 20-50 years of both sexes with Irritable bowel syndrome were included in the study group. They were enrolled from the OPD of Gastroenterology in BSMMU. For comparison age and sex matched 30 apparently healthy subjects were also studied as control. The power spectral HRV parameters were recorded by a digital Polyrite. For statistical analysis ANOVA, independent sample t-test were performed.Results: Mean resting pulse rate, mean H...
Autonomic Nervous System Function In Women With Irritable Bowel Syndrome
Digestive diseases and …, 2001
Autonomic nervous system (ANS) balance was assessed in women with and without irritable bowel syndrome (IBS) using laboratory tests of function (ie, expiratory/inspiratory ratio, Valsalva, posture changes, and cold pressor) and spectral and nonspectral measures of heart rate variability (HRV). Women with (N ϭ 103) and without IBS (N ϭ 49) were recruited, interviewed, then completed a laboratory assessment and wore a 24-hr Holter monitor Analysis using the entire sample showed little difference between IBS and control women and between subgroups with IBS on either laboratory measures or 24-hr HRV measures. However, analysis restricted to those women with severe IBS symptoms showed quite pronounced differences between two IBS subgroups on 24-hr HRV measures. Parasympathetic tone was significantly lower and ANS balance was significantly higher in the constipation-predominant compared to the diarrhea-predominant group. Subgroups of women with IBS do differ in ANS function as measured by 24-hr HRV; however, these differences are only apparent among women with severe symptoms. These findings point out the importance of considering symptom severity when interpreting studies of IBS.
Journal of Neurogastroenterology and Motility, 2018
Background/Aims The prevalence and severity of irritable bowel syndrome (IBS) declines with age, but the cause of this is unknown. This study tested 2 hypotheses: (1) autonomic nervous system responses to eating and bowel distention, measured by heart rate variability (HRV), differs by age in IBS patients and (2) HRV is correlated with colonic motility and IBS symptoms. Methods One hundred and fifty-six Rome III positive IBS patients and 31 healthy controls underwent colonic manometry with bag distention in the descending colon, followed by ingestion of an 810-kcal meal. HRV, evaluated by low frequency (%LF; 0.04-0.15 Hz) component, high frequency (%HF; 0.15-0.40 Hz) component, and the LF/HF ratio, was measured during colonic distention and after the meal. Motility index and subjective symptom scores were simultaneously quantified. Results Both colonic distention and eating decreased %HF and increased the LF/HF ratio, and both indices of autonomic nervous system correlated with age. In IBS patients, %HF negatively correlated with the postprandial motility index after adjusting for age. The %HF and LF/HF ratios also correlated with psychological symptoms but not bowel symptoms in IBS patients. Conclusion Decreased vagal activity is associated with increase in age and greater postprandial colonic motility in patients with IBS, which may contribute to postprandial symptoms.
Journal of neurogastroenterology and motility, 2015
To determine if potential biomarkers can be used to identify subgroups of people with irritable bowel syndrome (IBS) who will benefit the most or the least from a comprehensive self-management (CSM) intervention. In a two-armed randomized controlled trial a CSM (n = 46) was compared to a usual care (n = 46) group with follow-up at 3 and 6 months post randomization. Biomarkers obtained at baseline included heart rate variability, salivary cortisol, serum interleukin-10, and lactulose/mannitol ratio. Linear mixed models were used to test whether these biomarkers predicted improvements in the primary outcomes including daily abdominal pain, Gastrointestinal Symptom Score and IBS-specific quality of life (QOL). The nurse-delivered 8-session CSM intervention is more effective than usal care in reducing abdominal pain, reducing Gastrointestinal Symptom Score, and enhancing QOL. Participants with lower nighttime high frequency heart rate variability (vagal modulation) and increased low fre...
Digestive Diseases and Sciences, 2008
Our aim was to study autonomic function in patients with Irritable bowel syndrome (IBS) without constipation and psychiatric comorbidity. Respiratory sinus arrhythmia (RSA) (representing cardiac vagal activity), skin conductance (representing sympathetic activity) and heart rate were measured at baseline and as a response to emotional stress and rectal discomfort in 33 women with IBS and 21 healthy women. Baseline heart rate was higher in the patients than in the healthy volunteers. Both groups had decreased RSA and increased heart rate and skin conductance level when exposed to emotional stress, but the autonomic responses did not differ significantly between the groups. At discomfort threshold the patients had increased heart rate response and skin conductance amplitude when compared to the healthy volunteers. Correlations between autonomic responses and the depression subscale of the Hospital Anxiety and Depression (HAD) score differed markedly between the diarrhea-predominant IBS patients and the IBS patients with alternating stool habits.
Journal of Science and Medicine in Sport, 2010
Introduction ! Estimates suggest that irritable bowel syndrome (IBS) affects between 10 -30 % of the population . IBS is likely to cause a significant reduction in quality of life (QoL) . In recent years there has been increased interest in evaluating QoL interventions and reports suggest the majority of IBS patients use some form of self-treatment . Studies involving healthy adults have indicated that exercise can improve feelings and symptoms of fatigue, bloating and constipation. Thus, it seems intuitively appealing to promote participation in regular exercise in the management of IBS. Whilst IBS management programmes often suggest that exercise might be a worthwhile health promoting activity, we found no randomised controlled trials (RCT) that have evaluated the effects of an exercise intervention in patients experiencing IBS. Moreover, observational and non-randomised studies predominantly involving healthy participants have provided contradictory evidence of an association between IBS-related symptoms and exercise participation . While the underlying mechanisms for the potential benefits of exercise on IBS symptoms are not fully understood, it has been suggested that decreased gastrointestinal blood flow, neuroimmuno-endocrine alternations, increased gastrointestinal motility and mechanical bouncing during exercise may be responsible . The stress reducing effect of exercise has also been offered as a possible explanation and studies have reported reductions in feelings of stress and well-being after exercise in both healthy adults and clinical populations. Given the nature of IBS and associated symptoms, achieving participation in regular exercise may be difficult for IBS patients. Therefore, we examined the feasibility of a brief exercise intervention that was intentionally pragmatic using a RCT methodology. This study also aimed to evaluate the effects of exercise on IBS-specific QoL, symptoms associated with IBS and participation in exercise, in previously sedentary IBS patients. Abstract ! While it seems intuitively appealing to promote participation in regular exercise in the management of irritable bowel syndrome, limited randomised controlled trial evidence exists to support this recommendation. We examined the feasibility and effects of an exercise intervention upon quality of life and irritable bowel symptoms using a randomised controlled trial methodology. Patients with a clinically confirmed diagnosis of irritable bowel syndrome according to Rome II criteria were randomised to either an exercise consultation intervention or usual care for 12 weeks. Outcomes included irritable bowel specific quality of life, symptoms (total symptoms, constipation, diarrhoea and pain) and exercise par-ticipation. The recruitment rate of eligible patients identified from hospital records was 18.3% (56/305). Analyses revealed no differences in quality life scores between groups at 12-week follow-up. The exercise group reported significantly improved symptoms of constipation (mean difference = 10.9, 95% CI = -20.1, -1.6) compared to usual care at follow-up. The intervention group participated in significantly more exercise than usual care at follow-up (mean difference = 21.6, 95 % CI = 9.4, 33.8). Recruitment of eligible patients into this study was possible but rates were low. Findings highlight the possibility that exercise may be an effective intervention for symptom management in patients with irritable bowel syndrome; this may be particularly the case for constipation predominant patients.