title: Endogenous inhibition of somatic pain is impaired in girls with irritable bowel syndrome compared with healthy girls.
abstract: Endogenous pain inhibition is often deficient in adults with chronic pain conditions including irritable bowel syndrome (IBS). It is unclear whether deficiencies in pain inhibition are present in young children with IBS. The present study compared endogenous pain inhibition, somatic pain threshold, and psychosocial distress in young girls with IBS versus controls. Girls with IBS did not show significant endogenous pain inhibition of heat pain threshold during a cold-pressor task in contrast to controls, who had significant pain inhibition. Girls with IBS did not differ from peers on measures of somatic pain but had more symptoms of depression, somatization, and anxiety than controls. When psychological variables were included as covariates, the difference in pain inhibition was no longer significant, although poor achieved power limits interpretation of these results. Higher-order cognitive processes including psychological variables may be contributing to observed pain inhibition. In girls with IBS, pain inhibition was positively related to the number of days without a bowel movement. To our knowledge, this is the first study to demonstrate deficiencies of endogenous pain inhibition in young children with IBS. Findings have implications for better understanding of onset and maintenance of IBS and other chronic pain conditions.
  
  
  CONCLUSIONS
  This study found that young girls with IBS have deficient endogenous pain inhibition compared to healthy girls, which is consistent with the literature on adults. This information can facilitate clinicians in identification of risk factors for onset/maintenance of IBS and other chronic pain conditions.
authors.affiliation: Department of Psychiatry & Behavioral Neurosciences, Loyola University Medical Center, Maywood, Illinois. amyewilliams1@gmail.com
authors.forename: Amy E
authors.initials: AE
authors.lastname: Williams
authors.forename: Margaret
authors.initials: M
authors.lastname: Heitkemper
authors.forename: Mariella M
authors.initials: MM
authors.lastname: Self
authors.forename: Danita I
authors.initials: DI
authors.lastname: Czyzewski
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Shulman
mesh_terms: D000704:Analysis of Variance; D001007:Anxiety / Q000209:etiology; D002648:Child; D005260:Female; D006801:Humans; D006930:Hyperalgesia / Q000503:physiopathology; D007266:Inhibition, Psychological; D043183:Irritable Bowel Syndrome / Q000150:complications*; D059226:Nociceptive Pain / Q000209:etiology / Q000523:psychology / Q000534:rehabilitation; D010147:Pain Measurement; D017288:Pain Threshold / Q000502:physiology*; D010812:Physical Stimulation / Q000009:adverse effects; D011795:Surveys and Questionnaires; D013997:Time Factors
keywords: Diffuse noxious inhibitory controls; children; conditioned pain modulation; endogenous pain modulation; irritable bowel syndrome