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Sympathetic Nerve Dysfunction is Common in Patients With Chronic Intestinal Pseudo-obstruction.

Mattsson, Tomas; Roos, Robert; Sundkvist, Göran LU ; Valind, Sven LU and Ohlsson, Bodil LU (2008) In Journal of Clinical Gastroenterology 42(2). p.174-177
Abstract
GOAL: To clarify whether disturbances in the autonomic nervous system, reflected in abnormal cardiovascular reflexes, could explain symptoms of impaired heat regulation in patients with intestinal pseudo-obstruction. BACKGROUND: Chronic intestinal pseudo-obstruction is a clinical syndrome characterized by diffuse, unspecific gastrointestinal symptoms due to damage to the enteric nervous system or the smooth muscle cells. These patients often complain of excessive sweating or feeling cold, suggesting disturbances in the autonomic nervous system. Earlier studies have pointed to a coexistence of autonomic disturbances in the enteric and cardiovascular nervous system. STUDY: Thirteen consecutive patients (age range 23 to 79, mean 44 y)... (More)
GOAL: To clarify whether disturbances in the autonomic nervous system, reflected in abnormal cardiovascular reflexes, could explain symptoms of impaired heat regulation in patients with intestinal pseudo-obstruction. BACKGROUND: Chronic intestinal pseudo-obstruction is a clinical syndrome characterized by diffuse, unspecific gastrointestinal symptoms due to damage to the enteric nervous system or the smooth muscle cells. These patients often complain of excessive sweating or feeling cold, suggesting disturbances in the autonomic nervous system. Earlier studies have pointed to a coexistence of autonomic disturbances in the enteric and cardiovascular nervous system. STUDY: Thirteen consecutive patients (age range 23 to 79, mean 44 y) fulfilling the criteria for chronic intestinal pseudo-obstruction were investigated. Six of them complained of sweating or a feeling of cold. Examination of autonomic reflexes included heart rate variation to deep-breathing (expiration/inspiration index), heart rate reaction to tilt (acceleration index, brake index), and vasoconstriction (VAC) due to indirect cooling by laser doppler (VAC-index; high index indicates impaired VAC). Test results in patients were compared with healthy individuals. RESULTS: Patients had significantly higher (more abnormal) median VAC-index compared with healthy controls [1.79 (interquartile ranges 1.89) vs. 0.08 (interquartile ranges 1.29); P=0.0007]. However, symptoms of impaired heat regulation were not related to the VAC-index. There were no differences in expiration/inspiration, acceleration index, or brake index between patients and controls. CONCLUSIONS: The patients with severe gastrointestinal dysmotility showed impaired sympathetic nerve function which, however, did not seem to be associated with symptoms of impaired heat regulation. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Journal of Clinical Gastroenterology
volume
42
issue
2
pages
174 - 177
publisher
Lippincott Williams & Wilkins
external identifiers
  • pmid:18209588
  • wos:000252862400012
  • scopus:38349092314
ISSN
1539-2031
DOI
10.1097/01.mcg.0000225649.54566.02
language
English
LU publication?
yes
id
e9b03b9a-d98c-4b9c-ba00-f12e40631306 (old id 1021224)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/18209588?dopt=Abstract
date added to LUP
2008-02-13 14:21:24
date last changed
2017-07-02 04:34:49
@article{e9b03b9a-d98c-4b9c-ba00-f12e40631306,
  abstract     = {GOAL: To clarify whether disturbances in the autonomic nervous system, reflected in abnormal cardiovascular reflexes, could explain symptoms of impaired heat regulation in patients with intestinal pseudo-obstruction. BACKGROUND: Chronic intestinal pseudo-obstruction is a clinical syndrome characterized by diffuse, unspecific gastrointestinal symptoms due to damage to the enteric nervous system or the smooth muscle cells. These patients often complain of excessive sweating or feeling cold, suggesting disturbances in the autonomic nervous system. Earlier studies have pointed to a coexistence of autonomic disturbances in the enteric and cardiovascular nervous system. STUDY: Thirteen consecutive patients (age range 23 to 79, mean 44 y) fulfilling the criteria for chronic intestinal pseudo-obstruction were investigated. Six of them complained of sweating or a feeling of cold. Examination of autonomic reflexes included heart rate variation to deep-breathing (expiration/inspiration index), heart rate reaction to tilt (acceleration index, brake index), and vasoconstriction (VAC) due to indirect cooling by laser doppler (VAC-index; high index indicates impaired VAC). Test results in patients were compared with healthy individuals. RESULTS: Patients had significantly higher (more abnormal) median VAC-index compared with healthy controls [1.79 (interquartile ranges 1.89) vs. 0.08 (interquartile ranges 1.29); P=0.0007]. However, symptoms of impaired heat regulation were not related to the VAC-index. There were no differences in expiration/inspiration, acceleration index, or brake index between patients and controls. CONCLUSIONS: The patients with severe gastrointestinal dysmotility showed impaired sympathetic nerve function which, however, did not seem to be associated with symptoms of impaired heat regulation.},
  author       = {Mattsson, Tomas and Roos, Robert and Sundkvist, Göran and Valind, Sven and Ohlsson, Bodil},
  issn         = {1539-2031},
  language     = {eng},
  number       = {2},
  pages        = {174--177},
  publisher    = {Lippincott Williams & Wilkins},
  series       = {Journal of Clinical Gastroenterology},
  title        = {Sympathetic Nerve Dysfunction is Common in Patients With Chronic Intestinal Pseudo-obstruction.},
  url          = {http://dx.doi.org/10.1097/01.mcg.0000225649.54566.02},
  volume       = {42},
  year         = {2008},
}