title: Relationships of abdominal pain, reports to visceral and temperature pain sensitivity, conditioned pain modulation, and heart rate variability in irritable bowel syndrome.
abstract: Irritable bowel syndrome (IBS) is a heterogeneous condition with a number of pathophysiological mechanisms that appear to contribute to symptom chronicity. One of these is altered pain sensitivity.
  
  
  
  Women between ages 18-45 were recruited the community. Of those enrolled, 56 had IBS and 36 were healthy control (HC) women. Participants completed questionnaires, kept a 4-week symptom diary and had a 12-h Holter placed to assess nighttime heart rate variability including high frequency power (HF), low frequency power (LF), and total power (TP). At mid-follicular phase approximately 80% of women completed a thermal pain sensitivity test with conditioned pain modulation and visceral pain sensitivity using a water load symptom provocation (WLSP) test.
  
  
  
  As expected, daily abdominal pain was significantly higher in the IBS compared to HC group. There were no differences between the bowel pattern subgroups (IBS-diarrhea [IBS-D], IBS-constipation plus mixed [IBS-CM]). Thermal pain sensitivity did not differ between the IBS and the HC groups, but was significantly higher in the IBS-CM group than the IBS-D group. In the WLSP test, the IBS group experienced significantly more symptom distress than HCs and the IBS-CM group was higher than the IBS-D group. Heart rate variability indicators did not differ between the groups or IBS subgroups. Daily abdominal pain was positively correlated with LF and TP in the IBS group.
  
  
  
  Despite similar levels of abdominal pain in IBS, the IBS-CM group demonstrated greater sensitivity to both thermal and visceral testing procedures.
authors.affiliation: Department of Biobehavioral Nursing and Health Systems, University of Washington, Seattle, WA, USA.
authors.forename: M E
authors.initials: ME
authors.lastname: Jarrett
authors.affiliation: Department of Biobehavioral Nursing and Health Systems, University of Washington, Seattle, WA, USA.
authors.forename: C J
authors.initials: CJ
authors.lastname: Han
authors.affiliation: Department of Biostatistics and Office of Nursing Research, University of Washington, Seattle, WA, USA.
authors.forename: K C
authors.initials: KC
authors.lastname: Cain
authors.affiliation: Department of Biobehavioral Nursing and Health Systems, University of Washington, Seattle, WA, USA.
authors.forename: R L
authors.initials: RL
authors.lastname: Burr
authors.affiliation: Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA.
authors.forename: R J
authors.initials: RJ
authors.lastname: Shulman
authors.affiliation: Department of Biobehavioral Nursing and Health Systems, University of Washington, Seattle, WA, USA.
authors.forename: P G
authors.initials: PG
authors.lastname: Barney
authors.affiliation: UCLA CNS: Center for Neurovisceral Sciences & Women's Health, UCLA, Los Angeles, CA, USA.
authors.forename: B D
authors.initials: BD
authors.lastname: Naliboff
authors.affiliation: Division of Gastroenterology, School of Medicine, University of Washington Medical Center, Seattle, WA, USA.
authors.forename: J
authors.initials: J
authors.lastname: Zia
authors.affiliation: Department of Biobehavioral Nursing and Health Systems, University of Washington, Seattle, WA, USA.
authors.forename: M M
authors.initials: MM
authors.lastname: Heitkemper
mesh_terms: D015746:Abdominal Pain / Q000175:diagnosis / Q000503:physiopathology* / Q000523:psychology; D000328:Adult; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D006358:Hot Temperature / Q000009:adverse effects; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000175:diagnosis / Q000503:physiopathology* / Q000523:psychology; D010147:Pain Measurement / Q000379:methods*; D017288:Pain Threshold / Q000502:physiology* / Q000523:psychology; D059265:Visceral Pain / Q000175:diagnosis / Q000503:physiopathology* / Q000523:psychology; D055815:Young Adult
keywords: autonomic nervous system; conditioned pain modulation; heart rate variability; irritable bowel syndrome; water load symptom provocation test