Visceral hyperalgesia in children with functional abdominal pain

Abstract

Objective: Our purpose was to evaluate visceral sensitivity and psychologic profiles in children with functional gastrointestinal disorders. Study design: We measured visceral perception in the stomach and in the rectum by using an electronic barostat. Psychologic questionnaires were completed. Ten children with recurrent abdominal pain (RAP)(8 female, mean age 11.3 ± 0.8 years), 10 children with irritable bowel syndrome (IBS) (8 female, mean age 13.0 ± 0.9 years), and 15 control children (8 female, mean age 12.7 ± 1.2 years) completed the study. Results: Thresholds for visceral perception in the rectum were decreased in patients with IBS ( P < .001 vs control patients) and in patients with RAP ( P < .05 vs control patients). Children with IBS had lower thresholds than children with RAP ( P < .01). In contrast, thresholds for perception were decreased in the stomach of children with RAP ( P < .005 vs control patients) but not in children with IBS. There were elevated anxiety scores in 45% of patients. Duration of symptoms was associated with higher scores of anxiety ( P < .001) and depression ( P < .02). Conclusions: Hyperalgesia was demonstrated in children with RAP and IBS; sites of hyperalgesia appear to be associated with different symptom phenotypes; anxiety was common, and there was an association between the duration of symptoms and increased scores for both anxiety and depression. (J Pediatr 2001;139:838–43)