Abstract
Visceral hyperalgesia has been demonstrated inpatients with irritable bowel syndrome who aReseen intertiary care centers. It has been hypothesized thatvisceral hyperalgesia may be related to psychological distress associated with health caReseekingbehavior in these patients. Patients with fibromyalgiaand sphincter of Oddi dysfunction, type III, share manydemographic and psychosocial characteristics with patients with irritable bowel syndrome andprovide an opportunity to test the hypothesis thatrectal hyperalgesia is unique to IBS. Fifteen patientswith IBS, 10 patients with fibromyalgia, 10 withsphincter of Oddi dysfunction, type III, and 12 controlsunderwent evaluation of rectal pain perception inresponse to phasic distensions and psychological testingwith a self-report instrument. Patients with irritable bowel syndrome demonstrated significantly lowerrectal pain thresholds and increased levels ofpsychologic distress compared to controls. Althoughsphincter of Oddi dysfunction patients also exhibitedincreased psychologic distress, rectal pain perceptionwas similar to controls. Patients with fibromyalgiaexhibited rectal algesia that was not significantlydifferent from eiThe r controls or IBS. In conclusion, rectal hyperalgesia is not a function ofchronic functional pain, health caReseeking behavior,or psychological distress. However, it may not bespecific for IBS.
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REFERENCES
Thompson WG: The functional bowel disorders. In DA Drossman (ed). The Functional Gastrointestinal Disorders. Boston, Little, Brown, 1994, pp 117-134
Mayer EA, Gebhart GF: Basic and clinical aspects of visceral hyperalge sia. Gastroenterology 107:271-293, 1994
Accarino AM, Aspiroz F, Malage lada JR: Selective dysfunction of me chanosensitive intestinal afferents in irritable bowel syndrome. Gastroenterology 108:636-643, 1995
Zighelboim J, Talley NJ, Phillips SF, Harmsen WS, Zinsmeister AR: Visce ral perception in irritable bowel syndrome. Dig Dis Sci 40:819-827, 1995
Naliboff B, Munakata J, Kodner A, Mayer EA: IBS nonpatients do not differfrom healthy controls on visceral sensitivity. Gastroenterology 110:A723, 1996
Whitehead WE, Bosmajian L, Zonderman AB, Costa PT, Schuster MM: Symptoms of psychologic distress associated with irritable bowel syndrome: Comparison of community and medical clinic samples. Gastroenterology 95:709-714, 1988
Smith RC, Greenbaum DS, Vancouver JB, Henry RC, Reinhart MA, Greenbaum RB, Dean HA, Mayle JE: Psychosocial factors are associated with health caReseeking raTher than diagnosis in irritable bowel syndrome. Gastroenterology 98:293-301, 1990
Price D, Harkins SW: The affective-motivational dimension of pain. Am Physiol Soc J 1:229-239, 1992
Whitehead WE, Holtkotter B, Enck P, Hoelzl R, Holmes KD, Anthony J, Shabsin HS, Schuster MM: Tolerance for rectosigmoid distension in irritable bowel syndrome. Gastroenterology 98:1187-1192, 1990
Mertz H, Naliboff B, Munakata J, Niazi N, Mayer EA: Altered rectal perception is a biological marker of patients with irritable bowel syndrome. Gastroenterology 109:40-52, 1995
Cook IJ, Van Elden A, Collins SM: Patients with irritable bowel syndrome have greater pain tolerance than normal subjects. Gastroenterology 93:727-733, 1987
Geel SE: The fibromyalgia syndrome: Musculoskeletal pathophysiology. Sem Arthritis Rheum 23:347-353, 1994
Triadafilopoulos G, Simms RW, Goldenberg DI: Bowel dysfunction in fibromyalgia syndrome. Dig Dis Sci 36:59-64, 1991
Veale D, Kavanagh G, Fielding JF, Fitzgerald C: Primary fibromyalgia and the irritable bowel syndrome: Different expressions of a common pathogenetic process. Br J Rheumatol 30:220-222, 1991
Hogan WJ, Geenen JE: Biliary dyskinesia. Endoscopy 20:179-183, 1988
Okolo P, Sherman S, Lehman GA, Lovett E: Psychometric profiles of patients with sphincter of Oddi dysfunction (SOD).Gastrointest Endosc 40:P119, 1994 (abstract)
Hudson JI, Goldenberg DL, Pope HG, Keck PE, Schlesinger L: Comorbidity of fibromyalgia with medical and psychiatric disorders. Am J Med 92:363-374, 1992
Drossman DA, Thompson GW, Talley NJ, Funch-Jensen P, Janssens J, Whitehead WE: Identification of subgroups of functional gastrointestinal disorders. Gastroenterol Int 3:159-172, 1990
Wolfe F, Smythe HA, Yunus MB, Bennett RM, Bombardier C, Goldenberg DL, Tugwell P, Campbell SM, Abeles M, Clark P, Fam AG, Farber SJ, Fiechtner JJ, Franklin CM, Gatter RA, Hamaty D, Lessard J, Lichtbroun AS, Masi AT, McCain GA, Reynolds IJ, Sheon RP: The American College of Rheumatology 1990 Criteria for the classification of fi bromyalgia: Report of the multicenter criteria committee. Arthritis Rheum 33:160-172, 1990
Whitehead WE, Delvaux M, the Working Team: Standardization of barostat procedures for testing smooth muscle tone and sensory thresholds in the gastrointestinal tract. Dig Dis Sci 42:223-241, 1997
Jensen MP, Karoly P: Self report scales and procedures for assessing pain in adults. In DC Turk, R Melzack (eds). Handbook of Pain Asse ssment. New York, Guilford, 1992, pp 135-151
Derogatis LR, Lazarus L: SCL-90-R, Brief Symptom Inventory and Matching Clinical Rating Scales. Hillsdale, New Jersey, Lawrence Erlbaum Associate s Inc., 1994, pp 217-248
Ke rns RD, Turk DC, Rudy TE: The West Haven-Yale multidimensional pain inventory. Pain 23:345-356, 1985
Wald A, Burgio K, Holeva K, Locher J: Psychological evaluation of patients with severe idiopathic constipation: Which instrument to use? Am J Gastroenterol 87:977-980, 1992
Melzack R: The McGill Pain Questionnaire: Major properties and scoring methods. Pain 1:277-299, 1975
Kruskal WH, Wallis WA: Use of ranks in one-criterion variance analysis. J Am Stat Assoc 47:583-621, 1952
Silverman DHS, Munakata JA, Ennes H, Mandlekern MA, Hoh CK, Mayer EA: Regional cerebral activity in normal and pathological perception of visceral pain. Gastroenterology 112:64-72, 1997
Whitehead WE, Crowell MD, Davidoff AZ, Palsson OS, Schuster MM: Pain from rectal distension in women with irritable bowel syndrome. Relationship to sexual abuse. Dig Dis Sci 42:796-804, 1997
McKendrick MW: Post-Salmonella irritable bowel syndrome-5 year review. J Infect 32:170-171, 1996
Gwee KA, Graham JC, McKendrick MW, Collins SM, Marshall JS, Walters SJ, Read NW: Psychometric scores and persistence of irritable bowel after infectious diarrhe a. Lancet 347:150-153, 1996
Whorwell PJ, Prior A, Fragher EB: Controlled trial of hypnoTherapy in the treatment of severe re fractory irritable bowel syndrome. Lancet 2:1232-1234, 1984
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Chun, A., Desautels, S., Slivka, A. et al. Visceral Algesia in Irritable Bowel Syndrome, Fibromyalgia, and Sphincter of Oddi Dysfunction, Type III. Dig Dis Sci 44, 631–636 (1999). https://doi.org/10.1023/A:1026682113096
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DOI: https://doi.org/10.1023/A:1026682113096