title: Direct clinical evidence for spinal hyperalgesia in a patient with irritable bowel syndrome.
abstract: OBJECTIVE
  Our objective was to evaluate GI motor and sensory function and spinal cord testing in a patient with severe irritable bowel syndrome.
  
  
  METHODS
  A patient is described who underwent an extensive assessment of GI motor and sensory function including transit studies, colonic and rectal barostat studies, sensory and manometric studies of the small bowel, and colon and anorectal physiology testing. The patient also underwent testing with spinal cord stimulation and spinal drug delivery as part of a pain management assessment.
  
  
  RESULTS
  The viscerosomatic referral pain pattern resulting from rectal distention was consistent with spinal hyperalgesia. The patient underwent testing for spinal cord stimulation and spinal drug delivery.
  
  
  CONCLUSIONS
  This novel finding provides direct clinical evidence for the presence of spinal hyperalgesia in a patient with irritable bowel syndrome, consistent with the existing indirect clinical evidence and animal data.
authors.affiliation: Department of Gastroenterology, Royal North Shore Hospital and University of Sydney, Australia.
authors.forename: A
authors.initials: A
authors.lastname: Malcolm
authors.forename: S F
authors.initials: SF
authors.lastname: Phillips
authors.forename: J E
authors.initials: JE
authors.lastname: Kellow
authors.forename: M J
authors.initials: MJ
authors.lastname: Cousins
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000328:Adult; D003109:Colonic Diseases, Functional / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D006930:Hyperalgesia / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology*; D008365:Manometry; D013116:Spinal Cord / Q000503:physiopathology*