Widespread Hyperalgesia in Adolescents With Symptoms of Irritable Bowel Syndrome: Results From a Large Population-Based Study

Stabell, Niklas; Stubhaug, Audun; Flægstad, Trond; Mayer, Emeran A.; Naliboff, Bruce D.; Nielsen, Christopher Sivert

doi:10.1016/j.jpain.2014.05.007

Cited by 23 publications

(14 citation statements)

References 60 publications

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“…Pain is a common symptom when seeking medical assistance and is a crucial factor in how health workers recognize and assess the severity of a disease. An increasing body of evidence suggests that pain sensitivity modulates the clinical expression of disease . The present study adds to this by showing that pain sensitivity may be of importance in the recognition of MI and contributes with an important aspect to the further research of underlying reasons for unrecognized MI.…”

Section: Discussionsupporting

confidence: 50%

“…An increasing body of evidence suggests that pain sensitivity modulates the clinical expression of disease. 55,56 The present study adds to this by showing that pain sensitivity may be of importance in the recognition of MI and contributes with an important aspect to the further research of underlying reasons for unrecognized MI. We encourage researchers of future studies in this field to consider including variables associated with pain sensitivity.…”

Section: Pain Sensitivity and Clinical Implicationsmentioning

confidence: 52%

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Pain Tolerance in Persons With Recognized and Unrecognized Myocardial Infarction: A Population‐Based, Cross‐Sectional Study

Øhrn

Nielsen

Schirmer

et al. 2016

JAHA

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BackgroundUnrecognized myocardial infarction (MI) is a prevalent condition associated with a similar risk of death as recognized MI. It is unknown why some persons experience MI with few or no symptoms; however, one possible explanation is attenuated pain sensitivity. To our knowledge, no previous study has examined the association between pain sensitivity and recognition of MI.Methods and ResultsWe conducted a population‐based cross‐sectional study with 4849 included participants who underwent the cold pressor test (a common experimental pain assay) and ECG. Unrecognized MI was present in 387 (8%) and recognized MI in 227 (4.7%) participants. Participants with unrecognized MI endured the cold pressor test significantly longer than participants with recognized MI (hazard ratio for aborting the cold pressor test, 0.64; CI, 0.47–0.88), adjusted for age and sex. The association was attenuated and borderline significant after multivariable adjustment. The association between unrecognized MI and lower pain sensitivity was stronger in women than in men, and statistically significant in women only, but interaction testing was not statistically significant (P for interaction=0.14).ConclusionsOur findings suggest that persons who experience unrecognized MI have reduced pain sensitivity compared with persons who experience recognized MI. This may partially explain the lack of symptoms associated with unrecognized MI.

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Section: Discussionsupporting

confidence: 50%

Section: Pain Sensitivity and Clinical Implicationsmentioning

confidence: 52%

Pain Tolerance in Persons With Recognized and Unrecognized Myocardial Infarction: A Population‐Based, Cross‐Sectional Study

Øhrn

Nielsen

Schirmer

et al. 2016

JAHA

Self Cite

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“…For example, when compared to healthy peers, pre-adolescent girls with irritable bowel syndrome display impaired endogenous inhibition of somatic pain [59]. Adolescents with irritable bowel syndrome (IBS) symptoms are also more likely to experience widespread hyperalgesia [60]. CAPS in childhood and adolescence increases the risk for chronic primary pain disorder (abdominal pain, migraine/tension headache, and chronic musculoskeletal pain) in adulthood [61,62], and women with a pediatric history of functional abdominal pain display long-term vulnerability to pain [63].…”

Section: Pain Manifestations and Locations Of A Primary Pain Disordermentioning

confidence: 99%

Chronic Pain in Children and Adolescents: Diagnosis and Treatment of Primary Pain Disorders in Head, Abdomen, Muscles and Joints

et al. 2016

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Primary pain disorders (formerly “functional pain syndromes”) are common, under-diagnosed and under-treated in children and teenagers. This manuscript reviews key aspects which support understanding the development of pediatric chronic pain, points to the current pediatric chronic pain terminology, addresses effective treatment strategies, and discusses the evidence-based use of pharmacology. Common symptoms of an underlying pain vulnerability present in the three most common chronic pain disorders in pediatrics: primary headaches, centrally mediated abdominal pain syndromes, and/or chronic/recurrent musculoskeletal and joint pain. A significant number of children with repeated acute nociceptive pain episodes develop chronic pain in addition to or as a result of their underlying medical condition “chronic-on-acute pain.” We provide description of the structure and process of our interdisciplinary, rehabilitative pain clinic in Minneapolis, Minnesota, USA with accompanying data in the treatment of chronic pain symptoms that persist beyond the expected time of healing. An interdisciplinary approach combining (1) rehabilitation; (2) integrative medicine/active mind-body techniques; (3) psychology; and (4) normalizing daily school attendance, sports, social life and sleep will be presented. As a result of restored function, pain improves and commonly resolves. Opioids are not indicated for primary pain disorders, and other medications, with few exceptions, are usually not first-line therapy.

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“…In humans, using RIII refl ex, evidence of an alteration (facilitation) of spinal modulation of nociceptive processing has been shown in IBS [ 112 ]. These fi ndings are supporting the theory of central sensitization mechanism [ 115 ]. Adolescents with IBS symptoms had lower pain thresholds with widespread hyperalgesia.…”

Section: Central Sensitization and Altered Brain-gut Communicationmentioning

confidence: 69%

Visceral Sensitivity

Fauré¹,

Grunder²

2016

Pediatric Neurogastroenterology

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Cranial vagal innervation is provided by the vagus nerves which innervate the esophagus, stomach, small intestine, cecum, and proximal colon. Sensory afferent neurons predominate numerically in the vagus nerve. Cell bodies are located in nodose ganglion, and the central processes terminate in the nucleus of the solitary tract (NTS). Vagal afferents are believed as mainly mediating physiological rather than harmful sensations, transmitting information on nature and composition of the intestinal content and motility and contractile tension of the smooth muscle. Spinal InnervationVisceral afferents running in the spinal cord are referred as " spinal afferents " when the term " sympathetic innervation " is restricted to spinal efferent innervation [ 2 ]. Spinal innervation is provided by greater splanchnic nerve which forms three main ganglia from which they distribute to the viscera: the celiac ganglion

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Widespread Hyperalgesia in Adolescents With Symptoms of Irritable Bowel Syndrome: Results From a Large Population-Based Study

Cited by 23 publications

References 60 publications

Pain Tolerance in Persons With Recognized and Unrecognized Myocardial Infarction: A Population‐Based, Cross‐Sectional Study

Pain Tolerance in Persons With Recognized and Unrecognized Myocardial Infarction: A Population‐Based, Cross‐Sectional Study

Chronic Pain in Children and Adolescents: Diagnosis and Treatment of Primary Pain Disorders in Head, Abdomen, Muscles and Joints

Visceral Sensitivity

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