Location: Produce Safety and Microbiology ResearchTitle: Alterations in heart rate variability associated with IBS or IBD: a systematic review and meta-analysis
|SADOWSKI, ADAM - National College Of Natural Medicine|
|DUNLAP, CORINA - National College Of Natural Medicine|
|HANES, DOUGLAS - National College Of Natural Medicine|
Submitted to: Clinical and Translational Gastroenterology
Publication Type: Review Article
Publication Acceptance Date: 10/2/2020
Publication Date: 12/18/2020
Citation: Sadowski, A., Dunlap, C., Lacombe, A.C., Hanes, D. 2020. Alterations in heart rate variability associated with IBS or IBD: a systematic review and meta-analysis. Clinical and Translational Gastroenterology. 12:e00275. https://doi.org/10.14309/ctg.0000000000000275.
Interpretive Summary: Irritable Bowel Syndrome (IBS) and stress are highly related. Heart rate variability (HRV), the time difference between successive heart beats, is highly correlated to stress. In this meta-analysis we probe the literature in order to better understand the correlation between HRV and IBS symptoms. Our systematic review revealed that higher HRV does demonstrate moderate impact on IBS symptoms.
Technical Abstract: Objectives: Irritable Bowel Syndrome (IBS) and Inflammatory Bowel Disease (IBD) are gastrointestinal pathologies affecting large numbers of the global population and incurring significant healthcare costs. Disruptions in the gut-brain axis occurring in these conditions can lead to increased inflammation, affecting gastrointestinal and autonomic nervous system (ANS) function. Heart Rate Variability (HRV) is commonly used to assess the state of the sympathetic and parasympathetic function of the ANS, but it remains unclear how HRV measures are associated with gastrointestinal pathologies. Here we conduct a systematic review of the literature comparing HRV of subjects diagnosed with IBS or IBD to HRV in healthy controls. Methods: We searched PubMed, Cochrane Library, and CINAHL (EBSCO) for eligible studies up to 2018. We included any study comparing a recognized measure of HRV between a group of patients with either IBS or IBD to a group of matched HC, prior to any intervention. Studies were screened and data extracted from included articles using predefined criteria. Random effects meta-analysis was performed for each outcome, with effect size reported as standardized mean difference. Results: There were significant differences between IBD and healthy controls in time domain HRV as well as significant decreases in high-frequency (HF) power measures, in both IBS and IBD compared to HC. Conclusions: Parasympathetic nervous system activity, represented through HF power, appears to be lower in people with IBS and IBD, but conclusions are limited by the small number of studies that provide usable data, methodological heterogeneity, and high risks of bias in primary study methods and measures.