title: Increased pain sensitivity among adults reporting irritable bowel syndrome symptoms in a large population-based study.
abstract: The aim of this study was to examine whether irritable bowel syndrome (IBS) is associated with increased somatic pain sensitivity in a large population-based sample and to test whether this association was independent of sex, age, comorbid chronic pain, and psychological distress. Pain sensitivity tests included assessment of heat-pain threshold (N=4054) and pressure-pain threshold (N=4689) and of cold-pressor pain intensity and tolerance (N=10,487). Cox regression and analysis of variance (ANOVA) were used to assess the relationship between IBS and pain sensitivity in stepwise multivariate models. The prevalence of IBS symptoms meeting the ROME II criteria was 5.3%. Compared with control subjects, IBS cases had reduced cold-pressor tolerance (hazard ratio=1.4, P<.01), increased cold-pressor pain intensity ratings (z-score=+0.20, P<0.01), and lower heat-pain thresholds (z-score=-0.20, P<0.01), after adjusting for sex and age. These results were only slightly attenuated and remained significant when controlling for comorbid chronic pain and psychological distress. Results for pressure-pain threshold were not significant. Heat- and cold-pressor pain sensitivity was greatest for the IBS reporting severe chronic abdominal pain, indicating that hyperalgesia in IBS is related to degree of clinical pain rather than to the diagnosis per se. Because all pain tests were all carried out on the upper extremities, our findings indicate the presence of widespread hyperalgesia in IBS, which may be a contributing factor to the high rate of comorbid pain seen in this patient group.
authors: Department of Pediatrics, University Hospital of Northern Norway, Tromsø, Norway Department of Clinical Medicine, University of Tromsø, Tromsø, Norway Department of Pain Management and Research, Oslo University Hospital, Oslo, Norway Faculty of Medicine, University of Oslo, Oslo, Norway Norwegian Institute of Public Health, Division of Mental Health, Oslo, Norway.
authors: Niklas
authors: N
authors: Stabell
authors: Audun
authors: A
authors: Stubhaug
authors: Trond
authors: T
authors: Flægstad
authors: Christopher Sivert
authors: CS
authors: Nielsen
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001132:Arm; D059350:Chronic Pain / Q000453:epidemiology; D003080:Cold Temperature / Q000009:adverse effects; D015897:Comorbidity; D005260:Female; D006358:Hot Temperature / Q000009:adverse effects; D006801:Humans; D006930:Hyperalgesia / Q000453:epidemiology / Q000209:etiology*; D043183:Irritable Bowel Syndrome / Q000453:epidemiology / Q000503:physiopathology* / Q000523:psychology; D008297:Male; D008875:Middle Aged; D059225:Nociception; D010147:Pain Measurement; D017288:Pain Threshold / Q000502:physiology*; D011312:Pressure / Q000009:adverse effects; D016016:Proportional Hazards Models; D012720:Severity of Illness Index; D017678:Sex Distribution; D013315:Stress, Psychological / Q000453:epidemiology