SNFGE SNFGE
 
Thématique :
- Colo-proctologie
Originalité :
Réexamen
Solidité :
Très solide
Doit faire évoluer notre pratique :
Dans certains cas
 
 
Nom du veilleur :
Professeur Frank ZERBIB
Coup de coeur :
 
 
Gut
  2018/02  
 
  2018 Feb;67(2):255-262.  
  doi: 10.1136/gutjnl-2016-312361.  
 
  Visceral hypersensitivity is associated with GI symptom severity in functional GI disorders: consistent findings from five different patient cohorts.  
 
  Simrén M, Törnblom H, Palsson OS, van Tilburg MAL, Van Oudenhove L, Tack J, Whitehead WE  
  https://www.ncbi.nlm.nih.gov/pubmed/28104632  
 
 

Abstract

OBJECTIVE:

Our aim was to evaluate the association between visceral hypersensitivity and GI symptom severity in large cohorts of patients with functional GI disorder (FGID) and to adjust for psychological factors and general tendency to report symptoms.

DESIGN:

We included five cohorts of patients with FGIDs (IBS or functional dyspepsia; n=1144), who had undergone visceral sensitivity testing using balloon distensions (gastric fundus, descending colon or rectum) and completed questionnaires to assess GI symptom severity, non-GI somatic symptoms, anxiety and depression. Subjects were divided into sensitivity tertiles based on pain/discomfort thresholds. GI symptom severity was compared between sensitivity tertiles in each cohort and corrected for somatisation, and anxiety and depression.

RESULTS:

In all five cohorts, GI symptom severity increased gradually with increasing visceral sensitivity, with significant differences in GI symptom severity between the sensitivity tertiles (p<0.0001), with small to medium effect sizes (partial η2: 0.047-0.11). The differences between sensitivity tertiles remained significant in all cohorts after correction for anxiety and depression, and also after correction for non-GI somatic symptom reporting in all of the cohorts (p<0.05).

CONCLUSIONS:

A gradual increase in GI symptom severity with increasing GI sensitivity was demonstrated in IBS and functional dyspepsia, which was consistent across several large patient groups from different countries, different methods to assess sensitivity and assessments in different parts of the GI tract. This association was independent of tendency to report symptoms or anxiety/depression comorbidity. These findings confirm that visceral hypersensitivity is a contributor to GI symptom generation in FGIDs.

 

 
Question posée
 
Quel est le rôle de l’hypersensibilité viscérale dans les troubles fonctionnels digestifs ?
 
Question posée
 
Cette étude confirme des études précédentes qui montrent que l’hypersensibilité viscérale est un facteur indépendant de sévérité des troubles fonctionnels digestifs, en particulier vis-à-vis des degrés d’anxiété et de dépression.
 
Commentaires

Etude de confirmation sur des cohortes différentes de patients, donc les résultats sont solides. L’impact thérapeutique devrait être majeur mais nous manquons de traitements ciblant spécifiquement et très efficacement la sensibilité viscérale (anti-dépresseurs, hypnose ?).

 
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