Abstract
Purpose: Recent studies have shown that patients with irritable bowel syndrome (IBS) exhibit both visceral and somatic hyperalgesia. This is similar in effect to the central hypersensitivity mechanism seen in patients with Fibromyalgia (FM). The aim of the present study was to compare the magnitude of visceral and thermal hypersensitivity in IBS patients and Fibromyalgia patients with IBS (FMS + IBS) compared to age/sex matched healthy controls. Methods: Fifteen patients (12 F, 3 M) with IBS, ten patients (10 F) with FMS, and seventeen control subjects (13 F, 4 M), rated pain intensity and unpleasantness to hot water immersion (45 and 47°C) of the hand/foot and phasic distension of the rectum (35, 55 mmHg) on a 0–10 M-VAS scale. The data was analyzed with 3 separate one-way ANOVA's with Post-hoc Tukey tests. Results: When comparing both thermal and visceral stimuli, the control group had lower pain ratings than either the IBS or FMS + IBS groups (p < 0.001). IBS patients rated rectal distension as more painful than the FMS +IBS group (p = 0.004). During hot water immersion of the foot, the FMS + IBS group had higher pain ratings than the IBS group (P = 0.027). During hand immersion, FMS + IBS and IBS patients did not significantly differ in their pain intensity ratings (P = 0.15). Both patient groups had higher scores than controls to somatic focus, state anxiety, and depression. No significant differences were found between the IBS and FMS + IBS groups on any psychological measures. Conclusions: FMS + IBS patients show greater thermal hypersensitivity compared to IBS patients. However, IBS patients exhibit higher pain ratings to rectal distension compared to FMS + IBS patients. These data suggest that regions of primary and secondary hyperalgesia are to some extent dependent on the primary pain complaint.
Published Version
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