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. 2010 Mar;148(3):454-461.
doi: 10.1016/j.pain.2009.12.005. Epub 2010 Jan 13.

Central and peripheral hypersensitivity in the irritable bowel syndrome

QiQi Zhou  1 , Roger B Fillingim, Joseph L Riley 3rd, William B Malarkey, Nicholas G Verne
Affiliations

Central and peripheral hypersensitivity in the irritable bowel syndrome

QiQi Zhou et al. Pain. 2010 Mar.

Abstract

Previous investigations of somatic hypersensitivity in IBS patients have typically involved only a single stimulus modality, and little information exists regarding whether patterns of somatic pain perception vary across stimulus modalities within a group of patients with IBS. Therefore, the current study was designed to characterize differences in perceptual responses to a battery of noxious somatic stimuli in IBS patients compared to controls. A total of 78 diarrhea-predominant and 57 controls participated in the study. We evaluated pain threshold and tolerance and sensory and affective ratings of contact thermal, mechanical pressure, ischemic stimuli, and cold pressor stimuli. In addition to assessing perceptual responses, we also evaluated differences in neuroendocrine and cardiovascular responses to these experimental somatic pain stimuli. A subset of IBS patients demonstrated the presence of somatic hypersensitivity to thermal, ischemic, and cold pressor nociceptive stimuli. The somatic hypersensitivity in IBS patients was somatotopically organized in that the lower extremities that share viscerosomatic convergence with the colon demonstrate the greatest hypersensitivity. There were also changes in ACTH, cortisol, and systolic blood pressure in response to the ischemic pain testing in IBS patients when compared to controls. The results of this study suggest that a more widespread alteration in central pain processing in a subset of IBS patients may be present as they display hypersensitivity to heat, ischemic, and cold pressor stimuli.

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Conflict of interest statement

The authors have no financial or other relationship to report that might lead to a conflict of interest.

Figures

Fig. 1
Fig. 1
Timeline for experimental sessions. BS indicated blood sample draw.
Fig. 2
Fig. 2
Thermal threshold and tolerance by group.
Fig. 3
Fig. 3
Hand and foot thermal threshold and tolerance comparison by group.
Fig. 4
Fig. 4
Cortisol levels in response to pain testing.
Fig. 5
Fig. 5
Blood pressure levels in response to pain testing.
Fig. 6
Fig. 6
Distribution of subset IBS patients in response to thermal, ischemic and cold pressor stimuli.
Fig. 7
Fig. 7
Ischemic threshold and tolerance by group.
Fig. 8
Fig. 8
Cold pressor threshold and tolerance by group.
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