Systematic review: instruments to assess abdominal pain in irritable bowel syndrome.
BACKGROUND
Consensus on standard methods to assess chronic abdominal pain in patients with irritable bowel syndrome (IBS) is currently lacking.


OBJECTIVE
To systematically review the literature with respect to instruments of measurement of chronic abdominal pain in IBS patients.


METHODS
Systematic literature search was performed in PubMed/Medline databases for studies using pain measurement instruments in patients with IBS.


RESULTS
One hundred and ten publications were reviewed. A multitude of different instruments is currently used to assess chronic abdominal pain in IBS patients. The single-item methods, e.g. the validated 10-point numeric rating scale (NRS), and questionnaires assessing gastrointestinal symptoms severity, focus mostly on the assessment of only the intensity of abdominal pain. Of these questionnaires, the validated IBS-Symptom Severity Scale includes the broadest measurement of pain-related aspects. General pain questionnaires and electronic momentary symptom assessment tools have been used to study abdominal pain in IBS patients, but have not yet been validated for this purpose. The evidence for the use of provocation tests, e.g. the rectal barostat with balloon distention, for measurement of abdominal pain in IBS is weak, due to the poor correlation between visceral pain thresholds assessed by provocation tests and abdominal pain as assessed by retrospective questionnaires.


CONCLUSIONS
The multitude of different instruments to measure chronic abdominal pain in IBS makes it difficult to compare endpoints of published studies. There is need for validated instruments to assess chronic abdominal pain in IBS patients, that overcome the limitations of the currently available methods.
Division Gastroenterology-Hepatology, Department of Internal Medicine, NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University Medical Center+, Maastricht, The Netherlands.
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Mujagic
Division Gastroenterology-Hepatology, Department of Internal Medicine, NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University Medical Center+, Maastricht, The Netherlands.
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Keszthelyi
Centre for Digestive Diseases, Blizard Institute of Cell & Molecular Science, Wingate Institute of Neurogastroenterology, Barts and the London School of Medicine & Dentistry, Queen Mary University of London, London, UK.
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Aziz
Department Internal Medicine III, Medical University of Vienna, Vienna, Austria.|McMaster University, Hamilton, ON, Canada.
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Reinisch
Medical Intelligence, Early Clinical Development, Grünenthal GmBH, Aachen, Germany.
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Quetglas
Medical Intelligence, Early Clinical Development, Grünenthal GmBH, Aachen, Germany.
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De Leonardis
Medical Intelligence, Early Clinical Development, Grünenthal GmBH, Aachen, Germany.|Department of Physiology and Pharmacology, Karolinska Institute, Stockholm, Sweden.
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Segerdahl
Division Gastroenterology-Hepatology, Department of Internal Medicine, NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University Medical Center+, Maastricht, The Netherlands.
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Masclee
D015746:Abdominal Pain / Q000175:diagnosis* / Q000523:psychology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016208:Databases, Factual; D006801:Humans; D043183:Irritable Bowel Syndrome; D008875:Middle Aged; D010147:Pain Measurement / Q000379:methods*; D011795:Surveys and Questionnaires; D059265:Visceral Pain