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Relationships of abdominal pain, reports to visceral and temperature pain sensitivity, conditioned pain modulation, and heart rate variability in irritable bowel syndrome
Author(s) -
Jarrett M. E.,
Han C. J.,
Cain K. C.,
Burr R. L.,
Shulman R. J.,
Barney P. G.,
Naliboff B. D.,
Zia J.,
Heitkemper M. M.
Publication year - 2016
Publication title -
neurogastroenterology and motility
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.489
H-Index - 105
eISSN - 1365-2982
pISSN - 1350-1925
DOI - 10.1111/nmo.12812
Subject(s) - irritable bowel syndrome , medicine , abdominal pain , constipation , heart rate variability , visceral pain , gastroenterology , diarrhea , heart rate , defecation , physical therapy , nociception , blood pressure , receptor
Background Irritable bowel syndrome ( IBS ) is a heterogeneous condition with a number of pathophysiological mechanisms that appear to contribute to symptom chronicity. One of these is altered pain sensitivity. Methods Women between ages 18–45 were recruited the community. Of those enrolled, 56 had IBS and 36 were healthy control ( HC ) women. Participants completed questionnaires, kept a 4‐week symptom diary and had a 12‐h Holter placed to assess nighttime heart rate variability including high frequency power ( HF ), low frequency power ( LF ), and total power ( TP ). At mid‐follicular phase approximately 80% of women completed a thermal pain sensitivity test with conditioned pain modulation and visceral pain sensitivity using a water load symptom provocation ( WLSP ) test. Key Results As expected, daily abdominal pain was significantly higher in the IBS compared to HC group. There were no differences between the bowel pattern subgroups ( IBS ‐diarrhea [ IBS ‐D], IBS ‐constipation plus mixed [ IBS ‐ CM ]). Thermal pain sensitivity did not differ between the IBS and the HC groups, but was significantly higher in the IBS ‐ CM group than the IBS ‐D group. In the WLSP test, the IBS group experienced significantly more symptom distress than HC s and the IBS ‐ CM group was higher than the IBS ‐D group. Heart rate variability indicators did not differ between the groups or IBS subgroups. Daily abdominal pain was positively correlated with LF and TP in the IBS group. Conclusions & Inferences Despite similar levels of abdominal pain in IBS , the IBS ‐ CM group demonstrated greater sensitivity to both thermal and visceral testing procedures.