The severity of irritable bowel syndrome or the presence of fibromyalgia influencing the perception of visceral and somatic stimuli.

Fabrizio Tremolaterra,Ennio Lubrano,Carolina Ciacci,Yvonne Morra,Paola Iovino,Serena Gallotta

doi:10.1186/1471-230x-14-182

Fabrizio Tremolaterra, Ennio Lubrano + Show 4 more

Open Access

https://doi.org/10.1186/1471-230x-14-182

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Abstract

BackgroundFibromyalgia Syndrome (FMS) is a frequent comorbidity in Irritable Bowel Syndrome (IBS) patients with a higher functional bowel disorder severity index (FBDSI). We tested the possibility that mild to severe IBS patients without FMS would have a graduated visceral and somatic perception, and the presence of FMS would further enhance somatic, but conversely attenuate visceral perception.Our aim was to study visceral and somatic sensitivity in mild IBS patients and in severe IBS patients with or without FMS.MethodsEleven mild IBS and 19 severe IBS with and without FMS patients were studied. Somatic and visceral stimuli were applied in each patient by means of electrical stimulations at active and control sites and by means of an electronic barostat in the rectum. Thresholds for discomfort and perception cumulative scores were measured.ResultsMild and severe IBS patients without FMS demonstrated a significantly lower somatic perception cumulative score than severe IBS patients with FMS at active site. Conversely only severe IBS patients without FMS had significantly lower visceral thresholds for discomfort than mild IBS patients and severe IBS patients with FMS.ConclusionsThe presence of co-existing FMS or greater FBDSI affects somatic and visceral perception in a graded fashion across IBS patients.

Highlights

Fibromyalgia Syndrome (FMS) is a frequent comorbidity in Irritable Bowel Syndrome (IBS) patients with a higher functional bowel disorder severity index (FBDSI)
The coexistence of IBS with FMS that corresponds to a greater illness severity lowered the thresholds to thermal [13] and electrical stimulation [14] at control and active sites
Severe IBS patients without FMS had significantly lower thresholds for discomfort than mild IBS patients [17,8 ± 1.4 (12–24) vs 29.3 ± 2.1 (19–37), Bonferroni test p < 0.05], and severe IBS patients with FMS [26.2 ± 2.1(20–35), Bonferroni test p < 0.05], whilst no differences were found between severe IBS patients with FMS and mild IBS

Summary

Introduction

Fibromyalgia Syndrome (FMS) is a frequent comorbidity in Irritable Bowel Syndrome (IBS) patients with a higher functional bowel disorder severity index (FBDSI). Our aim was to study visceral and somatic sensitivity in mild IBS patients and in severe IBS patients with or without FMS. Patients with IBS and another functional disorder, in comparison with patients with only IBS, have more severe IBS symptoms, a higher rate of psychological comorbidity such as depression, anxiety and somatization, greater impairment of quality of life, and more illnessrelated work absenteeism [4]. 35–60% of IBS patients had visceral hypersensitivity, whilst studies on somatic pain perception in IBS patients showed contrasting results. Subsequent studies have demonstrated normal skin sensitivity to electrical stimuli at control points [11] or even somatic hyperalgesia with electrical stimuli at active points and areas of pain referral and thermal stimuli on hand and foot. Peripheral and central neural dysregulation or both have been involved in explaining these abnormalities in visceral and somatic sensitivity

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