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Characteristics of rectal perception are altered in irritable bowel syndrome.
Pain. 2005 Jan; 113(1-2):160-71.PAIN

Abstract

A hallmark symptom of irritable bowel syndrome (IBS) is a lower pain threshold during rectal distension, but the mechanism underlying this disorder remains unclear. Examining the relationship between physiological and perceptual responses to rectal distension can provide insight into the underlying peripheral or central dysfunction in IBS. Therefore, we carried out a study of the rectal sensations of urge to defecate, pain and unpleasantness in relation to the varying states of the rectum. Ten IBS patients and 13 healthy controls underwent six sets of isobaric rectal distensions. The first set was ascending stepwise distensions terminating upon report of moderate pain where verbal ratings of urge, pain, and unpleasantness were acquired. The remaining sets were phasic or tonic distensions at a single pressure eliciting either moderate urge or moderate pain intensity where subjects gave continuous ratings of urge or pain percepts. The McGill Pain Questionnaire (MPQ) was used to assess different qualities of the pain experience during single pressure distensions. Abnormalities in IBS patients included: (1) higher incidence of distensions where unpleasantness is greater than pain intensity, (2) significantly longer persistence of ratings after stimulus termination during phasic distensions eliciting either moderate urge or moderate pain, (3) significantly smaller ratings fluctuations during tonic distensions, and (4) significantly higher MPQ scores for painful tonic distensions. Our study demonstrates that IBS patients have abnormal temporal and intensity properties of rectal sensation. These can be accounted for by either altered peripheral neuromuscular processing and/or processing of ascending rectal input in the central nervous system.

Authors+Show Affiliations

Institute of Medical Science, University of Toronto, Toronto, Ont., Canada.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15621377

Citation

Kwan, Chun L., et al. "Characteristics of Rectal Perception Are Altered in Irritable Bowel Syndrome." Pain, vol. 113, no. 1-2, 2005, pp. 160-71.
Kwan CL, Diamant NE, Mikula K, et al. Characteristics of rectal perception are altered in irritable bowel syndrome. Pain. 2005;113(1-2):160-71.
Kwan, C. L., Diamant, N. E., Mikula, K., & Davis, K. D. (2005). Characteristics of rectal perception are altered in irritable bowel syndrome. Pain, 113(1-2), 160-71.
Kwan CL, et al. Characteristics of Rectal Perception Are Altered in Irritable Bowel Syndrome. Pain. 2005;113(1-2):160-71. PubMed PMID: 15621377.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Characteristics of rectal perception are altered in irritable bowel syndrome. AU - Kwan,Chun L, AU - Diamant,Nicholas E, AU - Mikula,Kristi, AU - Davis,Karen D, PY - 2004/07/16/received PY - 2004/10/05/revised PY - 2004/10/05/accepted PY - 2004/12/29/pubmed PY - 2005/4/19/medline PY - 2004/12/29/entrez SP - 160 EP - 71 JF - Pain JO - Pain VL - 113 IS - 1-2 N2 - A hallmark symptom of irritable bowel syndrome (IBS) is a lower pain threshold during rectal distension, but the mechanism underlying this disorder remains unclear. Examining the relationship between physiological and perceptual responses to rectal distension can provide insight into the underlying peripheral or central dysfunction in IBS. Therefore, we carried out a study of the rectal sensations of urge to defecate, pain and unpleasantness in relation to the varying states of the rectum. Ten IBS patients and 13 healthy controls underwent six sets of isobaric rectal distensions. The first set was ascending stepwise distensions terminating upon report of moderate pain where verbal ratings of urge, pain, and unpleasantness were acquired. The remaining sets were phasic or tonic distensions at a single pressure eliciting either moderate urge or moderate pain intensity where subjects gave continuous ratings of urge or pain percepts. The McGill Pain Questionnaire (MPQ) was used to assess different qualities of the pain experience during single pressure distensions. Abnormalities in IBS patients included: (1) higher incidence of distensions where unpleasantness is greater than pain intensity, (2) significantly longer persistence of ratings after stimulus termination during phasic distensions eliciting either moderate urge or moderate pain, (3) significantly smaller ratings fluctuations during tonic distensions, and (4) significantly higher MPQ scores for painful tonic distensions. Our study demonstrates that IBS patients have abnormal temporal and intensity properties of rectal sensation. These can be accounted for by either altered peripheral neuromuscular processing and/or processing of ascending rectal input in the central nervous system. SN - 0304-3959 UR - https://www.unboundmedicine.com/medline/citation/15621377/Characteristics_of_rectal_perception_are_altered_in_irritable_bowel_syndrome_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0304-3959(04)00485-3 DB - PRIME DP - Unbound Medicine ER -