Background and aims: Visceral pain sensitivity is influenced by psychological bias in perception reflected in the sensory decision theory index “B”. We sought to develop a noninvasive questionnaire to identify patients with visceral hyperalgesia by identifying questions correlated with the B index.Methods: 107 Rome III positive, clinically diagnosed IBS patients completed a barostat test of rectal pain sensitivity and the following questionnaires: Clinical symptoms of pain and bloating, Recent Physical Symptoms Questionnaire (RPSQ) somatization scale, Pennebaker Inventory of Limbic Languidness (PILL), Pain Vigilance and Awareness Questionnaire (PVAQ), Somatosensory Amplification Scale (SAS), Tellegen Absorption Scale, Visceral Sensitivity Index, and Dissociation, Anxiety, Depression, Sexual Abuse Trauma Index, and Sleep Disturbance subscales of the Trauma Symptoms Checklist 40. The B index and corrected pain threshold (subtracted pressure required to minimally inflate bag) were computed from barostat data. As planned a priori, we also pooled all 218 questions from all scales and used t-tests to identify items which separated the lowest from the highest third of B Index scores. The 26 non-redundant items so identified formed the Visceral Perception Bias Questionnaire (VPBQ), which was scored by summing individual items. Results: The sample was 79% females with average age of 37.2 years. The mean and range for the IOP-adjusted pain threshold was 15.9 (0-44) mmHg and for the B Index 3.3 (0.9-5.5). Clinical pain was not significantly correlated with the B Index or pain threshold, but bloating severity was correlated with pain threshold (-0.22, p<0.05). Conventionally computed scores for some questionnaires (RPSQ, Tellegen Absorption Scale, Dissociation scale, anxiety, depression, and sexual abuse) were significantly correlated with the B Index and pain threshold (PVAQ, Dissociation Scale); however, no correlation exceeded 0.27, which was not strong enough to permit identification of patients with low pain thresholds. The empirically derived VPBQ performed better: it correlated -0.31 with pain threshold and -0.48 with the B Index. A VPBQ score of 35 or higher (67th percentile) identified 51.5% of patients with pain thresholds below 12 mmHg and 64.5% of patients with B Index scores below 2.71 (most sensitive third of patients). Conclusion: The empirically derived VPBQ identified more than half of the most pain sensitive IBS patients, indicating that this is a promising approach. However, further refinement and testing in a new sample of subjects including healthy controls is needed. [Supported by a grant from Takeda Pharmaceuticals and R24 DK067674]