Correlation of visceral sensitivity and rectum mucosal enterochromaffin cells in patients with diarrhea irritable bowel syndrome
Objective To investigate the characteristic changes of anorectal motility and visceral sensitivity in patients with diarrhea irritable bowel syndrome(IBS-D),whether these changes are related to rectum mucosal enterochromaffin cells.Method Forty-nine patients with IBS-D admitted to Beijing Chao-Yang Hospital from November 2021 to January 2023 were assigned to the IBS-D group,and twenty-one healthy individuals were assigned to control group.The irritable bowel syndrome severity scoring system(IBS-SSS),anorectal motility,including anal resting pressure,maximum anal sphincter systolic pressure,anal sphincter length and relaxation rate were tested.In addition,initial sensory threshold,defecation threshold,and maximum tolerance value were assessed of the two groups.The biopsy samples were obtained during colonoscopy examination from rectum for detection of enterochromaffin cells by immunohistochemistry stainings with 5-HT.Partial correlation analysis was used to analyze the correlation between the number of enterochromaffin cells in rectal mucosa and visceral sensitivity.Result There was no significant difference in sex constituent ratio between the two groups(P＞0.05).There were significant difference in age and BMI between the two groups(P＜0.05).The scores of IBS-SSS in IBS-D group were significantly higher than those in healthy control group(P＜0.05).The initial sensory threshold,defecation threshold and maximum tolerance value are lower than those in the control group(P＜0.05).There were no significant differences in anorectal pressure measurement indexes such as maximum systolic pressure,duration of contraction and anal sphincter length between the two groups(P＞0.05),while the resting pressure was lower than the control group and the anal canal relaxation rate in IBS-D group was higher than that in control group(P＜0.05).The number of EC cells with 5-HT positive staining in IBS-D group was significantly higher than the control group[7.0(5.5,8.0)/HP vs 1.0(1.0,1.5)/HP,P＜0.05].The number of EC was negatively correlated with the initial sensory threshold,defecation threshold and maximum tolerance value(P＜0.05).There was no significant correlation with IBS-SSS score(P＞0.05).Conclusion IBS-D patients had increased number of rectum mucosal enterochromaffin cells,which related with visceral hypersensitivity.The results from this study could be helpful for physician to improve the health cares for IBS-D patients.
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