Open Access Open Badges Research

Changes in salivary physiological stress markers induced by muscle stretching in patients with irritable bowel syndrome

Toyohiro Hamaguchi12*, Shin Fukudo2, Motoyori Kanazawa2, Tadaaki Tomiie2, Kunihiko Shimizu3, Mineo Oyama3 and Kohji Sakurai3

Author Affiliations

1 Department of Occupational Therapy, School of Health and Social Services, Saitama Prefectural University, Saitama, Japan

2 Department of Behavioral Medicine, Tohoku University, Graduate School of Medicine, Sendai, Japan

3 Department of Occupational Therapy, Niigata University of Health and Welfare, Graduate School of Health Science, Niigata, Japan

For all author emails, please log on.

BioPsychoSocial Medicine 2008, 2:20  doi:10.1186/1751-0759-2-20

Published: 4 November 2008



Psychophysiological processing has been reported to play a crucial role in irritable bowel syndrome (IBS) but there has been no report on modulation of the stress marker chromogranin A (CgA) resulting from muscle stretching. We hypothesized that abdominal muscle stretching as a passive operation would have a beneficial effect on a biochemical index of the activity of the sympathetic/adrenomedullary system (salivary CgA) and anxiety.


Fifteen control and eighteen untreated IBS subjects underwent experimental abdominal muscle stretching for 4 min. Subjects relaxed in a supine position with their knees fully flexed while their pelvic and trunk rotation was passively and slowly moved from 0 degrees of abdominal rotation to about 90 degrees or the point where the subject reported feeling discomfort.

Changes in the Gastrointestinal Symptoms Rating Scale (GSRS), State Trait Anxiety Inventory (STAI), Self-rating Depression Scale (SDS), ordinate scale and salivary CgA levels were compared between controls and IBS subjects before and after stretching. A three-factor analysis of variance (ANOVA) with period (before vs. after) as the within-subject factor and group (IBS vs. Control), and sex (men vs. female) as the between-subject factors was carried out on salivary CgA.


CgA showed significant interactions between period and groups (F[1, 31] = 4.89, p = 0.03), and between groups and sex (F[1, 31] = 4.73, p = 0.03). Interactions between period and sex of CgA secretion were not shown (F[1, 3] = 2.60, p = 0.12). At the baseline, salivary CgA in IBS subjects (36.7 ± 5.9 pmol/mg) was significantly higher than in controls (19.9 ± 5.5 pmol/mg, p < 0.05). After the stretching, salivary CgA significantly decreased in the IBS group (25.5 ± 4.5 pmol/mg), and this value did not differ from that in controls (18.6 ± 3.9 pmol/mg).


Our results suggest the possibility of improving IBS pathophysiology by passive abdominal muscle stretching as indicated by CgA, a biochemical index of the activity of the sympathetic/adrenomedullary system.