What is visceral hypersensitivity
This post is for general information purposes only, is not meant to diagnose or treat, and is in no way a replacement for consulting a medical professional.
When it comes to irritable bowel syndrome (IBS), there can be a lot of long, confusing terms thrown around. It can be difficult to figure out what specifically applies to you since symptoms are incredibly unique and different person-to-person.
Visceral hypersensitivity definitely falls into this category. It’s a reason why, for many people with IBS, you might experience gut symptoms or pain where a person without IBS may not.
It’s estimated that roughly two-thirds of people with IBS experience visceral hypersensitivity, (although surveys have come back with a wide4 range from 33-90% of patients). It also tends to be more common in people with the IBS-D subtype (diarrhea predominant IBS).
Studies have also seen that the reported severity of IBS symptoms in people with visceral hypersensitivity is much higher than for those who don’t experience it.
Visceral refers to the internal organs of the body, so actually visceral hypersensitivity as a term on its own is quite vague. When we think of it in relation to IBS, we’re often referring to it in the large intestine (colon).
This would mean that for people with hypersensitivity, stimulation in the gut can trigger the nerves to send messages to the brain indicating pressure is being experienced. Our brain then reacts and tells us that we are experiencing gut pain or symptoms.
The gut is home to a huge amount of nerve endings – the enteric nervous system. And when the communication between the gut and the brain via this system is functioning normally, slight changes in volume in the gut don’t create pain reactions. There are two components that are a part of visceral hypersensitivity. One is an increased pain response to stimuli which would normally trigger pain, and the second is a pain response to normal stimuli that normally wouldn’t trigger pain.
Thus, changes in the volume in the large intestine, or perhaps also the muscle contractions that occur to propel our food along the gut for digestion, can kick off this cascade much sooner than it would for people without gut hypersensitivity.
In fact, many people with IBS don’t necessarily create more gas in the large intestine compared to those without IBS – their body is just reacting to the change in pressure at a much lower level than the average person.
Foods that tend to draw water into the gut, and/or are highly fermentable by the gut bacteria in the colon, are therefore common culprits for IBS symptoms when it comes to visceral hypersensitivity (for example, FODMAPs). The gastrocolic reflex can also play a role in triggering symptoms related to visceral hypersensitivity.
The development of visceral hypersensitivity, like IBS, is unknown. Since the two seem to be quite closely linked, many of the possible factors are the same, like GI infections, gut bacteria imbalances, inflammation, stress and other psychological factors, diet, and genes.
While there is a wide range of pharmaceuticals and natural remedies meant to help with visceral hypersensitivity in IBS, there is still a lack in clinical evidence confirming the efficacy of these methods.
Figuring out what your specific triggers are – whether that’s stress, exercise, diet etc. is going to offer the most benefits when it comes to managing your IBS and reducing the frequency and intensity that any symptoms occur.
Farzaei, M. H., Bahramsoltani, R., Abdollahi, M., & Rahimi, R. (2016). The Role of Visceral Hypersensitivity in Irritable Bowel Syndrome: Pharmacological Targets and Novel Treatments. Journal of neurogastroenterology and motility, 22(4), 558–574. https://doi.org/10.5056/jnm16001
Lenhart, A., & Chey, W. D. (2017). A Systematic Review of the Effects of Polyols on Gastrointestinal Health and Irritable Bowel Syndrome. Advances in Nutrition(8), 587-596.
Mansueto, P., Seidita, A., D’Alcamo, A., & Carroccio, A. (2016). From Food Map to FODMAP in Irritable Bowel Syndrome. In E. Grossi, & F. Pace, Human Nutrition from the Gastroenterologist’s Perspective. Switzerland: Springer International Publishing.
Nybacka, S.; Störsrud, S.; Lindqvist, H.M.; Törnblom, H.; Simrén, M.; Winkvist, A. Habitual FODMAP Intake in Relation to Symptom Severity and Pattern in Patients with Irritable Bowel Syndrome. Nutrients 2021, 13, 27. https://doi.org/10.3390/nu13010027
Varju ́ P, Farkas N, Hegyi P, Garami A, Szabo ́ I, Ille ́s A, et al. (2017) Low fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAP) diet improves symptoms in adults suffering from irritable bowel syndrome (IBS) compared to standard IBS diet: A meta- analysis of clinical studies. PLoS ONE 12(8): e0182942. https://doi.org/10.1371/journal. pone.0182942
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