Rectal sensory threshold for pain is a diagnostic marker of irritable bowel syndrome and functional abdominal pain in children.
OBJECTIVE
To evaluate the diagnostic value of the rectal sensory threshold for pain (RSTP) in children and adolescents with chronic abdominal pain.


METHODS
Fifty-one patients (25 girls; median age 14.2 years; range 8.4-17.6) with abdominal pain >2 months underwent a series of rectal distensions with an electronic barostat. RSTP and viscerosomatic referrals were assessed. Three months after the barostat, the final diagnosis was documented.


RESULTS
Thirty-five patients had a functional gastrointestinal disorder (FGID) (irritable bowel syndrome or functional abdominal pain), and 16 had an organic disease. RSTP was lower in the FGID group than in the organic disease group (25.4mm Hg vs 37.1mm Hg; P = .0002). At the cutoff of 30mm Hg, the RSTP measurement for the diagnosis of FGID had a sensitivity of 94% and a specificity of 77%. Both groups similarly reported aberrant viscerosomatic projections.


CONCLUSIONS
In children, RSTP is a diagnostic marker of irritable bowel syndrome and functional abdominal pain. Viscerosomatic referrals are similar in children with FGID and organic diseases.
Division of Gastroenterology, Department of Pediatrics, Hôpital Sainte-Justine, Université de Montréal, Montréal, QC, Canada.
Ugur
U
Halac
Angela
A
Noble
Christophe
C
Faure
D015746:Abdominal Pain / Q000175:diagnosis* / Q000503:physiopathology; D000293:Adolescent; D002648:Child; D002908:Chronic Disease; D005260:Female; D005767:Gastrointestinal Diseases / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000175:diagnosis* / Q000503:physiopathology; D008297:Male; D053591:Referred Pain / Q000503:physiopathology; D012372:ROC Curve; D012007:Rectum / Q000503:physiopathology*; D012680:Sensitivity and Specificity; D012684:Sensory Thresholds; D011795:Surveys and Questionnaires