Symptoms and Visceral Perception in Patients With Pain-Predominant Irritable Bowel Syndrome

Abstract

In a tertiary referral population of IBS patients: 1) abdominal pain is reported by only one third of patients as their most bothersome viscerosensory symptoms; and 2) pain-predominance correlates with development of rectal hypersensitivity after a noxious sigmoid stimulus.

Relationship between symptoms and hypersensitivity to rectal distension in patients with irritable bowel syndrome

“…13 Furthermore, it was also shown previously that patients with pain predominant IBS were more susceptible to rectal sensitization in response to repetitive sigmoid distension, compared with non-pain predominant IBS patients. 22 These findings suggest that there may be an association between pain and visceral hypersensitivity. To evaluate the possible predictive value of this symptom, we performed an A-ROC curve analysis.…”

Changing face of irritable bowel syndrome

“…Recently, it has been suggested that visceral hyperalgesia, the phenomenon whereby stimuli normally not experienced as painful become so, is highly specific for IBS [21] . Visceral hypersensitivity, visceral hyperalgesia and viscero-somatic referral (the phenomenon whereby stimuli are referred over wide areas) have, indeed, been confirmed, in IBS, in more recent studies, using a variety of methodologies and under controlled experimental conditions [22] . While visceral hyperalgesia has been postulated as being highly specific for IBS, it alone or in association with other manifestations of hypersensitivity cannot explain all of IBS; even the most celebrated enthusiasts for the sensory hypothesis concede that sensation is normal in some patients.…”

The problem of gas in irritable bowel syndrome

“…Recognition of this fact is important from a therapeutic point of view, as successful management is dependent on targeting the features that the patient finds most troublesome. It is becoming increasingly recognized that abdominal distension is very distressing for many patients (3), but the pathophysiology of this symptom is poorly understood, although the obvious explanation of excessive gas is unlikely to be the whole answer (4,5). Thus, although patients often attribute bloating to gas, this is not always the case.…”

“…Patients with irritable bowel syndrome (IBS) complain of a constellation of symptoms (1), of which abdominal pain is not necessarily the most intrusive (2,3). Recognition of this fact is important from a therapeutic point of view, as successful management is dependent on targeting the features that the patient finds most troublesome.…”