Anesthesiology & Pain Medicine >> Research >> Focus Areas >> Outcomes >> A Nursing Study of Gut Function in Menstruating Women
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Research Focus Areas:

A Nursing Study of Gut Function in Menstruating Women

Principal Investigators

M. M. Heitkemper, Ph.D., M. E. Jarrett, Ph.D., P. G. Richebé, M.D., Ph.D.


Irritable Bowel Syndrome (IBS) is a common functional gastrointestinal (GI) disorder characterized by abdominal pain and alterations in bowel pattern. IBS disproportionately affects women; 10-15% of women are affected. IBS is challenging to patients and health care providers in that the mechanism(s) accounting for symptoms are not well understood and treatment options are not consistently effective. The disorder is associated with variable levels of distress ranging from episodic mild to severe and at times disruptive to work and school. In terms of annual health care dollars, IBS is ranked second behind GERD. The focus of our work to date has been to understand those biobehavioral, gender, and psychological distress factors linked to symptom type and severity. Intriguing results support the hypothesis that psycho-logical, physiological and target gene polymorphisms differences exist in IBS subgroups. Psychological distress, the autonomic nervous system and serotonin transporter protein polymorphisms may serve as biomarkers of symptom type and severity in women with IBS. Validation of these biomarkers in patients with IBS could lead to development of targeted, novel therapies for subgroups with IBS. In this competitive renewal (R01NR 0194) application we propose to test the primary hypothesis that the divergence in vagal tone is associated with visceral sensitivity. We will also assess the physiologic links between vagal tone and other indicators of central mechanisms (arousal [startle reflex], and descending noxious inhibitory control). Results will allow us to examine biomarkers within a common heterogeneous condition. Specific aims: 1) Test the relationship between vagal tone and central arousal (startle reflex and diffuse noxious inhibitory control [DNIC]) in women with moderate to severe IBS; 2) compare indicators of central arousal mechanisms (startle reflex, DNIC) and upper GI visceral hypersensitivity (water loading), in three groups: moderate to severe diarrhea-predominant IBS versus women with moderate to severe constipation-predominant IBS versus control women; 3) test the relationship between vagal tone and rectal hypersensitivity in a subset of the women; 4) explore the relationships of startle reactivity, DNIC , and upper GI visceral hypersensitivity with genotype (SERT, a2-ADR, COMT, BNDF), abdominal pain reports, childhood abuse history, health related quality of life, current stress, and current and history of psychological distress. Results will increase our understanding of the underlying mechanisms accounting for chronic symptom reports as well as to examine biomarkers within a common heterogeneous condition, IBS.

Research Projects

A Nursing Study of Gut Function in Menstruating Women
M. M. Heitkemper, Ph.D., M. E. Jarrett, Ph.D., P. G. Richebé, M.D., Ph.D.
Abdominal Symptom Phenotypes: Pathways to New Biomarkers
M. M. Heitkemper, Ph.D., R. Shulman, M.D., P. G. Richebé, M.D, Ph.D., et al.
Closed Claims Project
K. Domino, M.D., MPH, K. Posner, Ph.D., F.W. Cheney, M.D., L. Lee, M.D.
Computerized Glucose Control in Critically Ill Patients
M. Horibe, M.D., J.D. Lang, M.D., B. G. Nair, Ph.D.
Determination of Risk Factors for Ischemic Optic Neuropathy After Spine Surgery
Lorri A. Lee, M.D.K., Domino, MD,MPH, K. Posner, PhD, et al.
Extubation Failure in Patients with Difficult Airways Study
M. M. Treggiari, M.D., Ph.D., M.P.H.
lst Tier Drugs + Theophylline In Pediatric Severe Asthma
J. Zimmerman, M.D., D. Jardine, M.D.
Pharmacokinetics of Intrathecal Drug Infusions
C.M. Bernards, MD, S. Flack, MBChB
Real-Time Electronic Alerts to Improve Antibiotic and Temperature Management in Surgical Patients
B. G. Nair, Ph.D., H. A. Schwid, M.D.
Resource Over Utilization due to Serious Alcohol Related Injuries (CR)
J. Jarvik, M.D., M.P.H., B.S. Roudsari, Ph.D., M.S. Vavilala, M.D., B. Bresnahan, Ph.D
SIDS and the Inner Ear: A Follow up study of Hearing, Vestibular Function and Respiratory Control
D. Rubens, M.D.
The Association Between Innate Immunity Genes and Outcome Following Sepsis in Children
J. H. Kim, M.D., G. P. Jarvik, M.D., D. Jardine, M.D.
The Gas Study: Comparing Neurodevelopment Outcome and Apnea in Infants
M.E, McCann, M.D., A. Lynn, M.D.
The Influence of Inhaled Nitric Oxide on Attenuating Hepatic Sinusoidal Leukocyte-Endothelial Interactions in Patients Undergoing Orthopic Liver Transplantation
J.D. Lang, Jr, M.D.
Use of Transthoracic Ultrasound to Triage Patients in Preanesthesia Clinic
E. Wako, M.D., G. Van Norman, M.D., G.A. Rooke, MD., Ph.D.