Visceral hyperalgesia in children with functional abdominal pain.
OBJECTIVE
Our purpose was to evaluate visceral sensitivity and psychologic profiles in children with functional gastrointestinal disorders.


METHODS
We measured visceral perception in the stomach and in the rectum by using an electronic barostat. Psychologic questionnaires were completed. Ten children with recurrent abdominal pain (RAP)(8 female, mean age 11.3 +/- 0.8 years), 10 children with irritable bowel syndrome (IBS) (8 female, mean age 13.0 +/- 0.9 years), and 15 control children (8 female, mean age 12.7 +/- 1.2 years) completed the study.


RESULTS
Thresholds for visceral perception in the rectum were decreased in patients with IBS (P <.001 vs control patients) and in patients with RAP (P <.05 vs control patients). Children with IBS had lower thresholds than children with RAP (P <.01). In contrast, thresholds for perception were decreased in the stomach of children with RAP (P <.005 vs control patients) but not in children with IBS. There were elevated anxiety scores in 45% of patients. Duration of symptoms was associated with higher scores of anxiety (P <.001) and depression (P <.02).


CONCLUSIONS
Hyperalgesia was demonstrated in children with RAP and IBS; sites of hyperalgesia appear to be associated with different symptom phenotypes; anxiety was common, and there was an association between the duration of symptoms and increased scores for both anxiety and depression.
Di Lorenzo
C
C
Division of Gastroenterology, Departments of Pediatrics and Medicine, University of Pittsburgh School of Medicine, Pennsylvania, USA.
Youssef
N N
NN
Sigurdsson
L
L
Scharff
L
L
Griffiths
J
J
Wald
A
A
D015746:Abdominal Pain / Q000150:complications / Q000503:physiopathology* / Q000523:psychology*; D000293:Adolescent; D001008:Anxiety Disorders / Q000150:complications / Q000503:physiopathology / Q000523:psychology; D002648:Child; D003109:Colonic Diseases, Functional / Q000150:complications / Q000503:physiopathology* / Q000523:psychology*; D003866:Depressive Disorder / Q000150:complications / Q000503:physiopathology / Q000523:psychology; D005260:Female; D006801:Humans; D006930:Hyperalgesia / Q000150:complications / Q000503:physiopathology* / Q000523:psychology*; D008297:Male; D010147:Pain Measurement; D017288:Pain Threshold / Q000502:physiology / Q000523:psychology; D012007:Rectum / Q000503:physiopathology; D012008:Recurrence; D012720:Severity of Illness Index; D013270:Stomach / Q000503:physiopathology; D014110:Touch / Q000502:physiology; D014781:Viscera / Q000503:physiopathology*