Sensory adaptation training improves persistent symptoms in IBS-C
Compared with escitalopram, sensory adaptation training significantly improved hypersensitivity and bowel symptoms in irritable bowel syndrome with constipation, according to a study published in Clinical and Translational Gastroenterology.
“The barostat [G&J Electronics] is not widely used clinically, similar to other motility tools, but is commercially available, has been used in innumerable studies, and with some training can be adapted for sensori-behavioral therapy,” Satish S.C. Rao, MD, PhD, FRCP, from the division of neurogastroenterology/motility at Augusta University, and colleagues wrote. “Hence, [sensory adaptation training (SAT)] could be a viable treatment option for selected patients with refractory IBS symptoms, but further validation is needed including comparison with sham therapy, and newer visceral analgesics, and assessment of durability of response.”
Rao and colleagues identified 49 patients with IBS-C and randomly assigned 26 to sensory adaptation training and 23 to escitalopram 10 mg daily for 3 months.
“SAT was performed by repetitive gradual distension of 10-cm long highly compliant rectal balloon above tolerability thresholds using barostat,” the researchers wrote.
Investigators compared the impact of treatment on sensory thresholds and symptoms. Other outcome measures included patients achieving improvements in rectal hypersensitivity (20% or more increase in 2/3 or more sensory thresholds) and pain (30% or more decrease).
Results showed that compared with escitalopram, SAT improved the want to defecate (change: 13.5 vs. 2.2 mm Hg; P = .0006). In addition, SAT improved maximum tolerability (change: 14.8 vs. 1.6 mm Hg; P < .0001). Compared with escitalopram, there was a greater percentage of hypersensitivity responders observed with SAT (69% vs. 17%; P < .001); however, not pain responders (58% vs. 44%).
“Daily pain scores did not differ between groups or escitalopram (P = .06) but decreased with SAT (P = .0046) compared with baseline,” Rao and colleagues wrote.
According to researchers, SAT vs. escitalopram increased rectal compliance (P < .019) and spontaneous bowel movements per week (P = .04). Five patients assigned to escitalopram withdrew due to adverse events.