[en] OBJECTIVE: Visceral hypersensitivity is considered a key symptom in inflammatory bowel
disease (IBD) and irritable bowel syndrome (IBS), both of which seriously affect health-related
quality of life (HrQoL). Previous findings are mostly based on invasive procedures that may
interfere with the assessment of visceral perception. The current study, therefore, investigates
whether IBD and IBS are characterized by altered perception of “natural” gastric distensions
(“interoception”). METHODS: Twenty IBD patients in remission (13 Crohn‟s disease, 7 ulcerative colitis), 12
IBS patients, and 20/12 matched healthy control (HC) individuals, respectively, underwent the
water load test, in which they could drink ad libitum until the subjective thresholds of satiation
(stage 1) and fullness (stage 2) were reached. Gastric motility was assessed using
electrogastrography. RESULTS: IBD patients drank significantly more water until satiation than IBS patients,
whereas no differences between patients and HC groups were observed. Electrogastrographic
patterns were comparable between groups, suggesting no pathologies in gastric motility in IBD
or IBS. The amount of water consumed until satiation negatively correlated with HrQoL related
Gastric interoception in IBD and IBS to bowel symptoms in IBD patients, but was positively associated with emotional well-being in IBS patients. CONCLUSION: Our findings implicate relative gastric hypersensitivity in IBS, and relative hyposensitivity in IBD patients, which are both related to specific HrQoL aspects.
Disciplines :
Neurosciences & comportement
Auteur, co-auteur :
SCHULZ, André ; University of Luxembourg > Faculty of Humanities, Education and Social Sciences (FHSE) > Department of Behavioural and Cognitive Sciences (DBCS)
Welsch, Sina-Katharina
Etringer, Sarah
HANSEN, Greta ; University of Luxembourg > Faculty of Humanities, Education and Social Sciences (FHSE) > Department of Behavioural and Cognitive Sciences (DBCS)
Milbert, Léa
SCHNEIDER, Jochen ; University of Luxembourg > Luxembourg Centre for Systems Biomedicine (LCSB) > Medical Translational Research
LUTZ, Annika ; University of Luxembourg > Faculty of Humanities, Education and Social Sciences (FHSE) > Department of Behavioural and Cognitive Sciences (DBCS)
WILMES, Paul ; University of Luxembourg > Luxembourg Centre for Systems Biomedicine (LCSB) > Systems Ecology
Vögele, Claus ; University of Luxembourg > Faculty of Humanities, Education and Social Sciences (FHSE) > Department of Behavioural and Cognitive Sciences (DBCS)
Baumgart, D.C., Carding, S.R., Inflammatory bowel disease: cause and immunobiology. Lancet 369 (2007), 1627–1640, 10.1016/S0140-6736(07)60750-8.
Molodecky, N.A., Soon, I.S., Rabi, D.M., Ghali, W.A., Ferris, M., Chernoff, G., et al. Increasing incidence and prevalence of the inflammatory bowel diseases with time, based on systematic review. Gastroenterology 142 (2012), 46–54, 10.1053/j.gastro.2011.10.001 e42quiz e30.
Bao, C.H., Liu, P., Liu, H.R., Wu, L.Y., Shi, Y., Chen, W.F., et al. Alterations in brain grey matter structures in patients with crohn's disease and their correlation with psychological distress. J. Crohns Colitis 9 (2015), 532–540, 10.1093/ecco-jcc/jjv057.
Khalsa, S.S., Adolphs, R., Cameron, O.G., Critchley, H.D., Davenport, P.W., Feinstein, J.S., et al. Interoception and mental health: a roadmap. Biol. Psychiatry Cogn. Neurosci. Neuroimag. 3 (2018), 501–513, 10.1016/j.bpsc.2017.12.004.
Schulz, A., Schultchen, D., Vögele, C., Interoception, stress, and physical symptoms in stress-associated diseases. Eur. J. Health Psychol. 27 (2020), 132–153.
Schulz, A., Vögele, C., Interoception and stress. Front. Psychol., 6, 2015, 993, 10.3389/fpsyg.2015.00993.
Bernstein, C.N., Niazi, N., Robert, M., Mertz, H., Kodner, A., Munakata, J., et al. Rectal afferent function in patients with inflammatory and functional intestinal disorders. Pain 66 (1996), 151–161.
Bernstein, C.N., Frankenstein, U.N., Rawsthorne, P., Pitz, M., Summers, R., McIntyre, M.C., Cortical mapping of visceral pain in patients with GI disorders using functional magnetic resonance imaging. Am. J. Gastroenterol. 97 (2002), 319–327, 10.1111/j.1572-0241.2002.05464.x.
Mayer, E.A., Berman, S., Suyenobu, B., Labus, J., Mandelkern, M.A., Naliboff, B.D., et al. Differences in brain responses to visceral pain between patients with irritable bowel syndrome and ulcerative colitis. Pain 115 (2005), 398–409, 10.1016/j.pain.2005.03.023.
Atanasova, K., Lotter, T., Reindl, W., Lis, S., Multidimensional assessment of interoceptive abilities, emotion processing and the role of early life stress in inflammatory bowel diseases. Front. Psychiatry, 12, 2021, 680878, 10.3389/fpsyt.2021.680878.
Mikocka-Walus, A.A., Turnbull, D.A., Andrews, J.M., Moulding, N.T., Holtmann, G.J., The effect of functional gastrointestinal disorders on psychological comorbidity and quality of life in patients with inflammatory bowel disease. Aliment. Pharmacol. Ther. 28 (2008), 475–483, 10.1111/j.1365-2036.2008.03754.x.
Coen, S.J., Yaguez, L., Aziz, Q., Mitterschiffthaler, M.T., Brammer, M., Williams, S.C., et al. Negative mood affects brain processing of visceral sensation. Gastroenterology 137 (2009), 253–261 61 e1-2.
Schulz, A., Lass-Hennemann, J., Sütterlin, S., Schächinger, H., Vögele, C., Cold pressor stress induces opposite effects on cardioceptive accuracy dependent on assessment paradigm. Biol. Psychol. 93 (2013), 167–174, 10.1016/j.biopsycho.2013.01.007.
van Dyck, Z., Schulz, A., Blechert, J., Herbert, B.M., Lutz, A.P.C., Vogele, C., Gastric interoception and gastric myoelectrical activity in bulimia nervosa and binge-eating disorder. Int. J. Eat. Disord. 54 (2021), 1106–1115, 10.1002/eat.23291.
van Dyck, Z., Vögele, C., Blechert, J., Lutz, A.P., Schulz, A., Herbert, B.M., The water load test as a measure of gastric interoception: development of a two-stage protocol and application to a healthy female population. PLoS ONE, 11, 2016, e0163574, 10.1371/journal.pone.0163574.
Herbert, B.M., Muth, E.R., Pollatos, O., Herbert, C., Interoception across modalities: on the relationship between cardiac awareness and the sensitivity for gastric functions. PLoS ONE, 7, 2012, e36646, 10.1371/journal.pone.0036646.
Kim, E.S., Cho, K.B., Park, K.S., Jang, B.I., Kim, K.O., Jeon, S.W., et al. Predictive factors of impaired quality of life in Korean patients with inactive inflammatory bowel disease: association with functional gastrointestinal disorders and mood disorders. J. Clin. Gastroenterol. 47 (2013), e38–e44, 10.1097/MCG.0b013e318266fff5.
Simren, M., Axelsson, J., Gillberg, R., Abrahamsson, H., Svedlund, J., Bjornsson, E.S., Quality of life in inflammatory bowel disease in remission: the impact of IBS-like symptoms and associated psychological factors. Am. J. Gastroenterol. 97 (2002), 389–396, 10.1111/j.1572-0241.2002.05475.x.
Camilleri, M., Di Lorenzo, C., Brain-gut axis: from basic understanding to treatment of IBS and related disorders. J. Pediatr. Gastroenterol. Nutr. 54 (2012), 446–453, 10.1097/MPG.0b013e31823d34c3.
Drossman, D.A., Functional gastrointestinal disorders: history, pathophysiology, clinical features and Rome IV. Gastroenterology 150 (2016), 1262–1279, 10.1053/j.gastro.2016.02.032 .e2.
Ohman, L., Simren, M., Pathogenesis of IBS: role of inflammation, immunity and neuroimmune interactions. Nature reviews. Gastroenterol. Hepatol. 7 (2010), 163–173, 10.1038/nrgastro.2010.4.
Sharma, P., Makharia, G., Yadav, R., Dwivedi, S.N., Deepak, K.K., Gastric myoelectrical activity in patients with inflammatory bowel disease. J. Smooth Muscle. Res. 51 (2015), 50–57, 10.1540/jsmr.51.50.
Kohno, N., Nomura, M., Okamoto, H., Kaji, M., Ito, S., The use of electrogastrography and external ultrasonography to evaluate gastric motility in Crohn's disease. J. Med. Invest. 53 (2006), 277–284, 10.2152/jmi.53.277.
Bracci, F., Iacobelli, B.D., Papadatou, B., Ferretti, F., Lucchetti, M.C., Cianchi, D., et al. Role of electrogastrography in detecting motility disorders in children affected by chronic intestinal pseudo-obstruction and Crohn's disease. Eur. J. Pediatr. Surg. 13 (2003), 31–34, 10.1055/s-2003-38290.
Levy, J., Riley, B., Lazar, J., Davidovics, Z., Chen, J., Electrogastrographic (EGG) patterns are within normal limits in patients with inflammatory bowel disease and early satiety. J. Pediatr. Gastroenterol. Nutr., 29, 1999, 491.
Wittchen, H.U., Zaudig, M., Fydrich, T.SKID, Strukturiertes Klinisches Interview Für DSM-IV; Achse I und II. Achse II : Persönlichkeitsstörungen. SKID-II. 1997, Hogrefe, Göttingen.
Beck, A., Steer, R., Brown, G., Beck Depression Inventory-II. 1996 San Antonio.
Spielberger, C.D., Gorsuch, R.L., Lushene, R.E., Manual for the State-Trait Anxiety Inventory. 1970, Consulting Psychologists Press, Palo Alto (CA).
Hauser, W., Dietz, N., Grandt, D., Steder-Neukamm, U., Janke, K.H., Stein, U., et al. Validation of the inflammatory bowel disease questionnaire IBDQ-D, German version, for patients with ileal pouch anal anastomosis for ulcerative colitis. Z Gastroenterol 42 (2004), 131–139, 10.1055/s-2004-812835.
Janke, K.H., Bauer, M., Raible, A., Gregor, M., Steder-Neukamm, U., Klump, B., et al. Lebensqualität bei chronisch entzündlichen Darmerkrankungen – die Deutsche Version des Inflammatory Bowel Disease Questionnaire zur krankheitsspezifischen Lebensqualitätsmessung. Gesundheitswesen 67 (2005), 656–664.
Janke, K.H., Klump, B., Steder-Neukamm, U., Hoffmann, J., Hauser, W., [Validation of the German version of the inflammatory bowel disease questionnaire (Competence Network IBD, IBDQ-D)]. Psychother. Psychosom. Med. Psychol. 56 (2006), 291–298, 10.1055/s-2006-932661.
Rose, M., Fliege, H., Hildebrandt, M., Korber, J., Arck, P., Dignass, A., et al. [Validation of the new German translation version of the "Short Inflammatory Bowel Disease Questionnaire" (SIBDQ)]. Z Gastroenterol 38 (2000), 277–286, 10.1055/s-2000-14868.
Svedlund, J., Sjodin, I., Dotevall, G., GSRS–a clinical rating scale for gastrointestinal symptoms in patients with irritable bowel syndrome and peptic ulcer disease. Dig. Dis. Sci. 33 (1988), 129–134, 10.1007/BF01535722.
Koch, K.L., Stern, R.M., Handbook of Electrogastrography. 2004, University Press, Oxford.
Huang, J.S., Terrones, L., Simmons, A.N., Kaye, W., Strigo, I., Pilot study of functional magnetic resonance imaging responses to somatic pain stimuli in youth with functional and inflammatory gastrointestinal disease. J. Pediatr. Gastroenterol. Nutr. 63 (2016), 500–507, 10.1097/MPG.0000000000001390.
Naliboff, B.D., Derbyshire, S.W., Munakata, J., Berman, S., Mandelkern, M., Chang, L., et al. Cerebral activation in patients with irritable bowel syndrome and control subjects during rectosigmoid stimulation. Psychosom. Med. 63 (2001), 365–375, 10.1097/00006842-200105000-00006.
Naliboff, B.D., Munakata, J., Fullerton, S., Gracely, R.H., Kodner, A., Harraf, F., et al. Evidence for two distinct perceptual alterations in irritable bowel syndrome. Gut 41 (1997), 505–512, 10.1136/gut.41.4.505.
Verne, N.G., Robinson, M.E., Price, D.D., Hypersensitivity to visceral and cutaneous pain in the irritable bowel syndrome. Pain 93 (2001), 7–14, 10.1016/S0304-3959(01)00285-8.
Roberts, C., Albusoda, A., Farmer, A.D., Aziz, Q., Rectal hypersensitivity in inflammatory bowel disease: a systematic review and Meta-analysis. Crohn's Colitis, 360(3), 2021, 10.1093/crocol/otab041 otab041.
Principi, M., Losurdo, G., Iannone, A., Contaldo, A., Deflorio, V., Ranaldo, N., et al. Differences in dietary habits between patients with inflammatory bowel disease in clinical remission and a healthy population. Ann. Gastroenterol. 31 (2018), 469–473, 10.20524/aog.2018.0273.
Limdi, J.K., Aggarwal, D., McLaughlin, J.T., Dietary practices and beliefs in patients with inflammatory bowel disease. Inflamm. Bowel Dis. 22 (2016), 164–170, 10.1097/MIB.0000000000000585.
Cameron, O.G., Interoception: the inside story–a model for psychosomatic processes. Psychosom. Med 63 (2001), 697–710, 10.1097/00006842-200109000-00001.
Craig, A.D., How do you feel? Interoception: the sense of the physiological condition of the body. Nature Rev. 3 (2002), 655–666, 10.1038/nrn894.
Mertz, H., Morgan, V., Tanner, G., Pickens, D., Price, R., Shyr, Y., et al. Regional cerebral activation in irritable bowel syndrome and control subjects with painful and nonpainful rectal distention. Gastroenterology 118 (2000), 842–848.
Zhang, S., Chen, F., Wu, J., Liu, C., Yang, G., Piao, R., et al. Altered structural covariance and functional connectivity of the insula in patients with Crohn's disease. Quant. Imag. Med. Surg. 12 (2022), 1020–1036, 10.21037/qims-21-509.
Kong, N., Gao, C., Xu, M., Gao, X., Changes in the anterior cingulate cortex in Crohn's disease: a neuroimaging perspective. Brain Behav., 11, 2021, e02003, 10.1002/brb3.2003.
Porcelli, P., Leoci, C., Guerra, V., Taylor, G.J., Bagby, R.M., A longitudinal study of alexithymia and psychological distress in inflammatory bowel disease. J. Psychosom. Res. 41 (1996), 569–573, 10.1016/s0022-3999(96)00221-8.
Rief, W., Broadbent, E., Explaining medically unexplained symptoms-models and mechanisms. Clin. Psychol. Rev. 27 (2007), 821–841, 10.1016/j.cpr.2007.07.005.
Schaefer, M., Egloff, B., Gerlach, A.L., Witthoft, M., Improving heartbeat perception in patients with medically unexplained symptoms reduces symptom distress. Biol. Psychol. 101 (2014), 69–76, 10.1016/j.biopsycho.2014.05.012.
Van den Bergh, O., Witthoft, M., Petersen, S., Brown, R.J., Symptoms and the body: taking the inferential leap. Neurosci. Biobehav. Rev. 74 (2017), 185–203, 10.1016/j.neubiorev.2017.01.015.
Garfinkel, S.N., Seth, A.K., Barrett, A.B., Suzuki, K., Critchley, H.D., Knowing your own heart: distinguishing interoceptive accuracy from interoceptive awareness. Biol. Psychol. 104 (2015), 65–74, 10.1016/j.biopsycho.2014.11.004.
Garfinkel, S.N., Manassei, M.F., Hamilton-Fletcher, G., In den Bosch, Y., Critchley, H.D., Engels, M, Interoceptive dimensions across cardiac and respiratory axes. Philos. Trans. R. Soc. Lond. B Biol. Sci., 371, 2016, 20160014, 10.1098/rstb.2016.0014.
Herbert, B.M., Pollatos, O., The relevance of interoception for eating behavior and eating disorders. Tsakiris, M, De Preester, H, (eds.) The Interoceptive Mind. From Homeostasis to Awareness, 2019, University Press, Oxford, 165–186.
Pollatos, O., Herbert, B.M., Interoception: definitions, dimension, neural substrate. Hauke, G, Kritikos, A, (eds.) Embodiment in Psychotherapy. A Practitioner's Guide, 2018, Springer Nature, Cham, 15–28.
Pollatos, O., Herbert, B.M., Mai, S., Kammer, T., Changes in interoceptive processes following brain stimulation. Philos. Trans. R. Soc. Lond. B Biol. Sci., 371, 2016, 20160016, 10.1098/rstb.2016.0016.
Simons, M., Taft, T.H., Doerfler, B., Ruddy, J.S., Bollipo, S., Nightingale, S., et al. Narrative review: risk of eating disorders and nutritional deficiencies with dietary therapies for irritable bowel syndrome. Neurogastroenterol. Motil., 2021, e14188, 10.1111/nmo.14188.
McGowan, A., Harer, K.N., Irritable bowel syndrome and eating disorders: a burgeoning concern in gastrointestinal clinics. Gastroenterol. Clin. North Am. 50 (2021), 595–610, 10.1016/j.gtc.2021.03.007.
Ilzarbe, L., Fabrega, M., Quintero, R., Bastidas, A., Pintor, L., Garcia-Campayo, J., et al. Inflammatory bowel disease and eating disorders: a systematized review of comorbidity. J. Psychosom. Res. 102 (2017), 47–53, 10.1016/j.jpsychores.2017.09.006.
Schulz, A., Ferreira de Sá, D.S., Dierolf, A.M., Lutz, A., van Dyck, Z., Vögele, C., et al. Short-term food deprivation increases amplitudes of heartbeat-evoked potentials. Psychophysiology 52 (2015), 695–703, 10.1111/psyp.12388.
