Effect of stress on oesophageal motor function in normal subjects and in patients with the irritable bowel syndrome

Stress can modulate the motor function of the stomach, small bowel, and colon in healthy subjects, and of the small bowel and colon in patients with the irritable bowel syndrome (IBS). The effect of stress on oesophageal motility in eight healthy subjects and in eight IBS patients was studied, using two pressure transducers positioned just above the lower oesophageal sphincter and 5 cm proximally. Stressors were: a video arcade game, delayed audio feedback, and hand immersion in cold water. Each stress period was followed by five swallows of water. Frequency and amplitude of oesophageal contractions and the number of simultaneous and multipeaked contractions were manually counted for each stress period and compared to the preceding rest period. Frequency of contractions (per minute) tended to decrease during stress periods, but achieved significance only with the video arcade game in the control group (2.0 (0.6) v 1.2 (0.4); p less than 0.01). No other trend was evident in either control or IBS patients. No abnormalities of oesophageal body function were recorded in IBS patients either in basal conditions, or under stress. Unlike the more complex motor programmes elsewhere in the gut, the preprogrammed nature of oesophageal peristalsis is not modulated by stress.