Patients with irritable bowel syndrome (IBS) have reduced pain thresholds for rectal distension.
The prevalence of sexual or physical abuse in referred IBS patients is high. This is associated with greater pain reporting, poorer health status, and poorer outcome.
In this study, physicians from North America assessed whether abuse history may sensitize patients to report pain at a lower threshold.
|Patients with a history of abuse had significantly higher rectal pain thresholds.|
The team compared rectal pain thresholds in 74 women with IBS who had a history of severe abuse with thresholds in 85 women with IBS who had no history of abuse.
They assessed abuse history using a previously validated self-report abuse screening questionnaire.
Rectal sensory thresholds were measured using an electronic barostat and determined by the ascending method of limit (AML) and by the tracking technique.
The physicians found that IBS patients with a history of abuse had significantly higher rectal pain thresholds.
These patients also reported a significantly higher threshold for urgency to defecate.
Dr Ringel's team concluded, "Severe sexual/physical abuse is associated with higher urge and pain thresholds for rectal distension in IBS patients".
"This suggests that the greater pain reporting and poorer health status in IBS patients with abuse history are not related to increased rectal pain sensitivity".
"Further studies are needed to determine the causes of these findings".