| Objective: To explore the characteristics of rectal perception and its correlation with vitamin D content and autonomic nervous function in diarrhea-predominant irritable bowel syndrome(IBS-D).Methods: Using the Rome IV diagnostic criteria,42 of the 200 inpatients admitted to the Department of Gastroenterology of Dalian Central Hospital from January 2022 to December 2022 were selected as the IBS-D case group.In addition,36 healthy people who were examined at the health examination center of the hospital during the same period were selected as the health control group.The questionnaire method was used to investigate the general situation(including age,gender,education level,health status,disease status of first-degree relatives,etc.),lifestyle habits(including smoking,drinking,drinking strong tea,whether to eat breakfast,eating speed,exercise habits,etc.),and eating habits(including whether there is a spicy diet,cold food,fried diet,seafood diet,high FODMAP eating habits,etc.)of the two groups of study subjects.After the survey,the two sets of data were compared,the differences were analyzed,and the data obtained were statistically processed by SPSS26.0 statistical application software to explore the risk factors that may lead to the incidence of IBS-D.The20-channel high-resolution anorectal manometry(HRAM)system was used to detect rectal sensory function in two groups of study subjects and analyze the characteristics of rectal sensory function in IBS-D patients.Serum 25-(OH)D concentrations in the two groups were recorded,the differences between the two groups were compared,and the correlation between rectal sensory function and vitamin D in IBS-D patients was explored.The 24-hour heart rate variability(HRV)examination was used to evaluate the autonomic function characteristics of IBS-D patients,and to explore the correlation between rectal sensory function and autonomic function in IBS-D patients.The SPSS26.0 statistical application software was used to perform statistical analysis on the obtained data.If P<0.05,the difference was statistically significant.The subjects of this topic have signed an informed consent form,the project leader abides by scientific ethics and integrity,abides by national laws and regulations,and this topic meets ethical requirements and has passed the ethical review.Results: 1.General condition survey analysis: Compared with the healthy control group,the population of IBS-D case group was predominantly male,and there was a significant difference in the ratio of men and women(P <0.05);the proportion of patients with alcohol consumption in the IBS-D case group was significantly higher than that in the healthy control group(P<0.05),the incidence of chronic diseases in the IBS-D case group was significantly higher than that in the healthy control group(P<0.05),and the proportion of first-degree relatives in the IBS-D case group with similar gastrointestinal symptoms was significantly higher than that in the healthy control group(P<0.05).There was no significant difference in labor type,education level,and smoking between the two groups(P>0.05).2.Comparison of living habits and general eating habits: there were statistically significant differences between the IBS-D case group and the healthy control group in the following six factors: whether to eat breakfast,weekly frequency of spicy food intake,weekly frequency of raw and cold food intake,weekly frequency of seafood intake,weekly frequency of exercise and weekly frequency of insomnia.(P<0.05).There were no significant differences between the two groups in eating speed,drinking strong tea and weekly frying diet frequency(P > 0.05).3.Comparison of dietary habits with high FODMAP: Compared with healthy control group,the proportion of people in IBS-D group who liked eating fruits,vegetables and dairy products rich in FODMAP was significantly higher than that in healthy control group,with statistical significance(P<0.05);There was no significant difference between the two groups in the proportion of people who preferred to eat Fo Dmap-rich grains(P > 0.05).4.Comparison of rectal sensory function: The patients in IBS-D case group had more sensitive rectal sensory function than the healthy control group,and the initial rectal sensory threshold,initial defecation threshold and maximum rectal tolerance threshold were all lower than those in the healthy control group,with statistical significance(P<0.05).5.Comparison of serum 25-(OH)D content: Compared with healthy control group,the serum 25-(OH)D content in IBS-D case group was significantly lower than that in healthy control group(P < 0.05).6.Correlation between rectal sensory function and serum 25-(OH)D content: There was a positive correlation between serum 25-(OH)D content and rectal sensory threshold in IBS-D case group(r > 0,P < 0.05).The lower the serum 25-(OH)D content,the lower the threshold and the higher the rectal sensitivity.7.Comparison of autonomic nervous system function: The levels of r MSSD,PNN50 and HF in IBS-D case group were significantly higher than those in healthy control group(P<0.05).The levels of SDNN,LF/HF and LF in IBS-D case group were significantly lower than those in healthy control group,but there was no significant difference in SDANN between the two groups(p>0.05).8.Correlation between rectal sensory function and autonomic nervous function: r MSSD,PNN50 and HF levels were negatively correlated with initial rectal sensory threshold,initial defecation threshold and maximum rectal tolerance threshold in IBS-D case group(r<0,P<0.05).There was a positive correlation between LF level and initial rectal sensory threshold,initial defecation threshold and maximum rectal tolerance threshold in IBS-D case group(r>0,P<0.05).There was no significant correlation between SDNN and LF/HF levels and initial rectal sensory threshold,initial defecation threshold and maximum rectal tolerance threshold in IBS-D case group(P > 0.05).Conclusions: 1.There were differences in the gender of the IBS-D group in this round of study,and the proportion of males was significantly higher than that of females.Alcohol consumption,chronic illness,and family inheritance may also increase the risk of IBS-D.2.Cravings for spicy,raw cold,seafood and lack of adequate sleep may be important risk factors for the onset of IBS-D;Regular eating breakfast and exercise may be an effective preventive measure for IBS-D.3.High FODMAP diet may be an important risk factor for the onset of IBS-D.4.The subjects in the IBS-D group in this round of study have increased rectal sensitivity,decreased serum 25-(OH)D content,and autonomic imbalance,mainly elevated parasympathetic tension.5.The lower the serum 25-(OH)D content of the IBS-D group in this round of study,the higher the rectal sensitivity;The higher the parasympathetic tone,the higher the rectal sensitivity. |
