Pathophysiological mechanisms Altered gut reactivity(motility, secretion) in response to luminal (e.g, meals, gut distention, inflammation, bacterial factors) provocative environmental stimuli (e. g, psychosocial stress) resulting in symptoms of diarrhea andor constipation
16 Pathophysiological mechanisms 1. Altered gut reactivity (motility, secretion) in response to luminal (e.g., meals, gut distention, inflammation, bacterial factors) provocative environmental stimuli, (e.g., psychosocial stress) resulting in symptoms of diarrhea and/or constipation
IBS- Abnormal motility 2000 Meal Sigmoid 1500 Motility Index 1000 IBS 500 Normal 0 50 100 130 Minutes
Minutes Sigmoid Motility Index IBS - Abnormal motility
1BS- Abnormal motility Normal Migrating Motor Complex(MMC) Phase I Quiescence 15-30 minutes J Phase‖l D Irregular 60 minutes contractions PhaseⅢ D Propagated 4-7 minutes contractions Interdigestive 90 minute cycle
IBS - Abnormal motility Normal Migrating Motor Complex (MMC) Phase I 15-30 minutes Phase II 60 minutes Phase III 4-7 minutes Interdigestive 90 minute cycle Quiescence Irregular contractions Propagated contractions
IBS- Abnormal motility Prolonged Propagated Contractions(PPCs) Abdominal cramps More common in Bs Occur in ileum Peristaltic 44c Correlate strongly with pain(BS patients) I= ileum, C= colon
IBS - Abnormal motility Prolonged Propagated Contractions (PPCs) • More common in IBS • Occur in ileum • Peristaltic • Correlate strongly with pain (IBS patients)