Sacral Nerve Modulation Has No Effect on the Postprandial Response in Irritable Bowel Syndrome
Received 8 January 2020
Accepted for publication 22 May 2020
Published 30 June 2020 Volume 2020:13 Pages 235—244
Checked for plagiarism Yes
Review by Single-blind
Peer reviewer comments 3
Editor who approved publication: Professor Andreas M. Kaiser
Janne Fassov,1 Donghua Liao,2 Christina Brock,3 Lilli Lundby,4 Søren Laurberg,4 Klaus Krogh1
1Department Of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark; 2GIOME Academia, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark; 3Mech-Sense, Department of Gastroenterology and Hepatology, Aalborg University Hospital and Clinical Institute, Faculty of Health Sciences Aalborg University, Aalborg, Denmark; 4Department of Surgery, Aarhus University Hospital, Aarhus, Denmark
Correspondence: Janne Fassov
Department of Hepatology and Gastroenterology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, Aarhus N 8200, Denmark
Tel +45 26756602
Purpose: Irritable bowel syndrome is a common gastrointestinal disorder with a global prevalence of approximately 11%. Onset or worsening of symptoms following digestion is one of the characteristics of the condition. The present study aimed at evaluating the postprandial sensory and motor response before and after treatment with sacral nerve modulation.
Patients and Methods: Twenty-one irritable bowel syndrome patients, 12 diarrhea-predominant and 9 mixed, were eligible for a 6-week sacral nerve modulation test period. Patients were investigated with multimodal impedance planimetry including a standardized meal at baseline and at the end of 2 weeks of suprasensory stimulation embedded in the 6-week sacral nerve modulation period.
Results: There was no statistical significant difference in the sensory response to heat or cold before and after sacral nerve modulation, p> 0.05. At baseline, wall tension increased after the meal (mean 124.79 [range 82.5 to 237.3] mmHg.mm before the meal, mean 207.76 [range, 143.5 to 429] mmHg.mm after the meal), p=0.048 indicating a postprandial response. During sacral nerve modulation, the postprandial increase in wall tension did not reach statistical significance (mean 86.79 [range 28.8 to 204.5] mmHg.mm before the meal, mean 159.71 [range 71.3 to 270.8] mmHg.mm after the meal), p=0.277. However, there was no statistically significant difference between the postprandial wall tension at baseline and during sacral nerve modulation, p=0.489. Likewise, we found no difference between pressure or stretch ratio at baseline and during sacral nerve modulation, p> 0.05.
Conclusion: Sacral nerve modulation does not exert its positive treatments effects in diarrhea-predominant and mixed irritable bowel syndrome through a modulation of the postprandial response.
Keywords: sacral nerve stimulation, sacral nerve modulation, postprandial response, gastrocolic response, irritable bowel syndrome
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