As per the outcomes of a randomised clinical trial published in Clinical and Translational Gastroenterology, sensory adaptation training (SAT) improved bowel and rectal hypersensitivity commonly observed in patients with irritable bowel syndrome with constipation (IBS-C). Investigators undertook this study to compare the safety and efficacy of SAT with escitalopram.

A total of 49 patients received six biweekly sessions of SAT (26 patients) or escitalopram 10 mg every day (23 patients) for three months. Thereafter, the sensory thresholds and symptoms were noted and compared. The improvements in rectal hypersensitivity were considered as ≥a 20% increase in ≥ 2/3 sensory thresholds, and pain relief was determined as ≥ a 30% decline. The desire to defecate and maximum tolerability thresholds considerably improved in patients in SAT group than escitalopram group, as shown in Table 1:

There was a considerably higher proportion of hypersensitivity responders with SAT compared with escitalopram (69% versus 17%), but not pain responders (58% versus 44%). The pain scores decreased with the use of SAT compared to as it was at the baseline. Compared to escitalopram, SAT considerably improved the rectal compliance and overall spontaneous bowel movements per week. No patient withdrew from the study in SAT group; five patients withdrew from the escitalopram group due to adverse events.

Thus, compared to escitalopram, SAT has superior efficacy in improving bowel symptoms and hypersensitivity.