AUTHOR=Liu Jie , Lv Chaolan , Wang Wei , Huang Yizhou , Wang Bo , Tian Jiashuang , Sun Chenyu , Yu Yue 

TITLE=Slow, deep breathing intervention improved symptoms and altered rectal sensitivity in patients with constipation-predominant irritable bowel syndrome

JOURNAL=Frontiers in Neuroscience

VOLUME=16

YEAR=2022

URL=https://www.frontiersin.org/journals/neuroscience/articles/10.3389/fnins.2022.1034547

DOI=10.3389/fnins.2022.1034547

ISSN=1662-453X

ABSTRACT=<sec><title>Background and aim</title><p>Limited treatment options have been shown to alter the natural course of irritable bowel syndrome (IBS). Slow, deep breathing (SDB) is a common pain self-management intervention. This pilot study aimed to explore the impact of SDB on measures of autonomic and anorectal functions as well as patient-reported symptoms in constipation-predominant IBS (IBS-C).</p></sec><sec><title>Methods</title><p>Eighty-five IBS-C patients were enrolled in this study and randomly assigned to the experimental group (Group A, <italic>n</italic> = 42) and the control group (Group B, <italic>n</italic> = 43). SDB was conducted at six breathing cycles per minute with an inhalation for 4 s and exhalation for 6 s at a ratio of 2:3 and repeated for 30 min during the intervention. All subjects underwent high-resolution anorectal manometry (HRAM) and completed the standardized IBS symptom severity system (IBS-SSS) questionnaire. Meanwhile, changes in stool consistency, weekly frequency of complete spontaneous bowel movements (CSBMs), and weekly frequency of spontaneous bowel movements (SBMs) were recorded. All IBS-C patients received electrocardiogram (ECG) recordings for heart rate variability (HRV) analysis at baseline, weeks 3, 6.</p></sec><sec><title>Results</title><p>At baseline, no differences were found between Groups A and B. The IBS-SSS score and its five sub-scores of Group B patients were significantly higher at week 6 than those of Group A patients (all <italic>p</italic> &lt; 0.001). Furthermore, compared with Group B patients, Group A patients had a significantly higher threshold volume for the first sensation (<italic>p</italic> &lt; 0.001), desire to defecate (<italic>p</italic> = 0.017), and maximum tolerable volume (<italic>p</italic> = 0.018) at week 6 of the SDB treatment. We also noted significant improvements in stool consistency (<italic>p</italic> = 0.002), weekly SBM frequencies (<italic>p</italic> &lt; 0.001), and weekly CSBM frequencies (<italic>p</italic> = 0.018) of Group A patients at week 6 when compared with Group B patients. Finally, the corrected high frequency (HF) of Group A patients was significantly higher than the HF of Group B patients at week 3 (<italic>p</italic> &lt; 0.001) and at week 6 (<italic>p</italic> &lt; 0.001). Likewise, patients in Group A had a significantly higher root mean square of the successive differences (RMSSD) than that of patients in Group B at week 3 (<italic>p</italic> &lt; 0.001) and at week 6 (<italic>p</italic> &lt; 0.001).</p></sec><sec><title>Conclusion</title><p>We found that a 6-week SDB intervention improved symptoms and altered rectal sensation in IBS-C patients. Moreover, SDB enhanced vagal activity. These findings suggest that the effect of SDB on IBS-C may be due to mechanisms involving autonomic responses.</p></sec>