Review article: gastrointestinal sensory and motor disturbances in inflammatory bowel disease – clinical relevance and pathophysiological mechanisms

Summary Background  It is well known that inflammation has a profound impact on the neuromuscular apparatus of the gastrointestinal tract during the inflammatory insult and in periods of remission, at the site of inflammation and at distance from this site. The importance of this interaction is illu...

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Published in:Alimentary pharmacology & therapeutics 2008-04, Vol.27 (8), p.621-637
Main Authors: DE SCHEPPER, H. U., DE MAN, J. G., MOREELS, T. G., PELCKMANS, P. A., DE WINTER, B. Y.
Format: Article
Language:English
Subjects:
Biological and medical sciences
Digestive system
Gastroenterology. Liver. Pancreas. Abdomen
Gastrointestinal Motility
Humans
Immune System Diseases - complications
Inflammatory Bowel Diseases - diagnosis
Inflammatory Bowel Diseases - etiology
Inflammatory Bowel Diseases - physiopathology
Intestines - innervation
Mast Cells - physiology
Medical sciences
Nervous System Diseases - complications
Other diseases. Semiology
Pharmacology. Drug treatments
Serotonin - physiology
Stomach. Duodenum. Small intestine. Colon. Rectum. Anus
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Summary:Summary Background  It is well known that inflammation has a profound impact on the neuromuscular apparatus of the gastrointestinal tract during the inflammatory insult and in periods of remission, at the site of inflammation and at distance from this site. The importance of this interaction is illustrated by the higher prevalence of functional gut disorders in patients with inflammatory bowel disease. Aims  To document the epidemiological and clinical significance of functional alterations of gut motility and sensitivity in patients with inflammatory bowel disease and to formulate potential pathophysiological mechanisms. Results and conclusions  Functional gut disorders occur frequently in patients with inflammatory bowel disease, both during inflammatory episodes and in periods of remission, and have a major impact on their quality of life. The clinical manifestations of these motility and sensitivity disorders vary and are often difficult to treat, mainly because therapeutic guidelines and specific diagnostic tests to distinguish inflammatory bowel disease from functional gut disorders are lacking. Chronic bowel inflammation results in a complicated interaction between neuroendocrine serotonin‐predominant cells of the mucosa, inflammatory cells (particularly mast cells) in the submucosa, the intrinsic and extrinsic innervation and the muscular apparatus including the interstitial cells of Cajal. The outcome of this interaction is a perturbation of gastrointestinal motor function, both locally and at distance from the site of inflammation and during both acute inflammation and remission.
ISSN:0269-2813
1365-2036
DOI:10.1111/j.1365-2036.2008.03624.x