Widespread Hyperalgesia in Adolescents With Symptoms of Irritable Bowel Syndrome: Results From a Large Population-Based Study

被引:16
作者
Stabell, Niklas [1 ,2 ]
Stubhaug, Audun [3 ]
Flaegstad, Trond [1 ,2 ]
Mayer, Emeran [4 ]
Naliboff, Bruce D. [5 ]
Nielsen, Christopher S. [6 ]
机构
[1] Univ Tromso, Dept Pediat, Univ Hosp Northern Norway, Tromso, Norway
[2] Univ Tromso, Dept Clin Med, Tromso, Norway
[3] Univ Oslo, Oslo Univ Hosp, Dept Pain Management & Res, Oslo, Norway
[4] Univ Calif Los Angeles, Div Digest Dis, Oppenheimer Family Ctr Neurobiol Stress, Los Angeles, CA USA
[5] Univ Calif Los Angeles, David Geffen Sch Med, Dept Med & Psychiat & Biobehav Sci, Los Angeles, CA 90095 USA
[6] Norwegian Inst Publ Hlth, Div Mental Hlth, Oslo, Norway
关键词
Widespread hyperalgesia; irritable bowel syndrome; comorbidity; quantitative pain sensitivity testing; adolescents; FUNCTIONAL GASTROINTESTINAL DISORDERS; RECURRENT ABDOMINAL-PAIN; QUALITY-OF-LIFE; ROME III CRITERIA; BRAIN-GUT AXIS; ANXIETY SENSITIVITY; SOMATIC COMPLAINTS; LABORATORY PAIN; FEMALE-PATIENTS; MENTAL-HEALTH;
D O I
10.1016/j.jpain.2014.05.007
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Widespread hyperalgesia is well documented among adult patients with irritable bowel syndrome (IBS), but little is known about pain sensitivity among adolescents with IBS. We examined pain sensitivity in 961 adolescents from the general population (mean age 16.1 years), including pain threshold and tolerance measurements of heat (forearm) and pressure pain (fingernail and shoulder) and cold pressor tolerance (hand). Adolescents with IBS symptoms (Rome III criteria) had lower heat pain thresholds compared to controls after adjustments for sex, comorbid pain, and psychological distress (mean difference = -.8 degrees C; 95% confidence interval [CI] = -1.6 to -.04). Similar results were found for pressure pain threshold at the shoulder (mean difference = -46 kPa; 95% CI = -78 to -13) and fingernail (mean difference = -62 kPa; 95% CI = -109 to -15), and for an aggregate of all 3 threshold measures (z-score difference = -.4; 95% CI = -.6 to -.2), though pressure pain threshold differences were nonsignificant after the final adjustments for psychological distress. No difference of pain tolerance was found between the IBS cases and controls. Our results indicate that adolescents in the general population with IBS symptoms, like adults, have widespread hyperalgesia. Perspective: This is the first report of widespread hyperalgesia among adolescents with IBS symptoms in the general population, with lower pain thresholds found to be independent of sex and comorbid pain. Our results suggest that central pain sensitization mechanisms in IBS may contribute to triggering and maintaining chronic pain symptoms. (C) 2014 by the American Pain Society
引用
收藏
页码:898 / 906
页数:9
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