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ARS Home » Plains Area » Houston, Texas » Children's Nutrition Research Center » Research » Publications at this Location » Publication #312519
Title: Conditioned pain modulation in women with irritable bowel syndrome

Author
item JARRETT, MONICA - University Of Washington
item SHULMAN, ROBERT - Children'S Nutrition Research Center (CNRC)
item CAIN, KEVIN - University Of Washington
item DEECHAKAWAN, WIMON - University Of Washington
item SMITH, LYNNE - University Of Washington
item RICHEBE, PHILIPPE - University Of Washington
item EUGENIO, MARGARET - Seattle Pacific University
item HEITKEMPER, MARGARET - University Of Washington

Submitted to: Biological Research for Nursing
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 1/24/2014
Publication Date: 1/24/2014
Citation: Jarrett, M.E., Shulman, R.J., Cain, K.C., Deechakawan, W., Smith, L.T., Richebe, P., Eugenio, M., Heitkemper, M.M. 2014. Conditioned pain modulation in women with irritable bowel syndrome. Biological Research for Nursing. 16(4):368-377.

Interpretive Summary: Many children and adults suffer from gastrointestinal disorders such as irritable bowel syndrome that can be made worse or improved by changes in the diet. We tested whether children with irritable bowel syndrome have a defect in their ability to inhibit pain sensations. In this study, we showed that the normal pathways that inhibit pain are faulty in some individuals with this disorder. The results of our study may explain why some individuals have abdominal pain related to eating. The data will help us understand better how diet composition causes symptoms in some people.

Technical Abstract: Evidence suggests that patients with irritable bowel syndrome (IBS) are more vigilant to pain-associated stimuli. The aims of this study were to compare women with IBS (n = 20) to healthy control (HC, n = 20) women on pain sensitivity, conditioned pain modulation (CPM) efficiency, and salivary cortisol levels before and after the CPM test and to examine the relationship of CPM efficiency with gastrointestinal pain, somatic pain, psychological distress symptoms, and salivary cortisol levels in each group. Women, aged 20-42 years, gave consent, completed questionnaires, and kept a symptom diary for 2 weeks. CPM efficiency was tested with a heat test stimulus and cold water condition stimulus in a laboratory between 8 and 10 a.m. on a follicular phase day. Salivary cortisol samples were collected just before and after the experimental testing. Compared to the HC group, women with IBS reported more days with gastrointestinal and somatic pain/discomfort, psychological distress, fatigue, and feeling stressed. During the CPM baseline testing, women with IBS reported greater pain sensitivity compared to the HC group. There was no significant group difference in salivary cortisol levels nor in CPM efficiency, though a post-hoc analysis showed a higher prevalence of impaired CPM efficiency among IBS subjects with more severe lower-GI symptoms. In the IBS group, reduced CPM efficiency was associated with daily abdominal pain/discomfort and psychological distress. Overall, women with IBS exhibited an increased sensitivity to thermal stimuli. Impaired CPM was present in a subset of women with IBS.