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ARS Home » Plains Area » Houston, Texas » Children's Nutrition Research Center » Research » Publications at this Location » Publication #307471
Title: Endogenous inhibition of somatic pain is impaired in girls with irritable bowel syndrome compared with healthy girls

Author
item WILLIAMS, AMY - Loyola University Medical Center
item HEITKEMPER, MARGARET - University Of Washington
item SELF, MARIELLA - Baylor College Of Medicine
item CZYZEWSKI, DANITA - Baylor College Of Medicine
item SHULMAN, ROBERT - Children'S Nutrition Research Center (CNRC)

Submitted to: The Journal of Pain
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 3/11/2013
Publication Date: 5/1/2013
Citation: Williams, A.E., Heitkemper, M., Self, M.M., Czyzewski, D.I., Shulman, R.J. 2013. Endogenous inhibition of somatic pain is impaired in girls with irritable bowel syndrome compared with healthy girls. The Journal of Pain. 14:921-930.

Interpretive Summary: Like adults, children can have irritable bowel syndrome (IBS). IBS causes belly pain and changes in how often people move their bowels and what their bowel movements look like (hard or loose). The cause(s) are not known. Different types of foods can make the symptoms worse in some people. Studies suggest that this is caused, in part, by intestines that are extra sensitive to pain. People with IBS cannot stop pain sensations going from the intestines to the brain as well as can people without IBS. It is unclear if people with IBS also have a problem stopping pain from areas outside of the intestines. The goal of this study was to find out if girls with IBS could stop pain sensations from the skin as well as can healthy girls. We found out that girls with IBS have difficulty stopping painful skin sensations from reaching their brain compared to healthy girls. Our results reveal that inhibiting pain sensations is a problem in girls with IBS that affects areas besides the intestines. These findings give researchers a better undestanding of IBS and other chronic pain conditions.

Technical Abstract: Endogenous pain inhibition is often deficient in adults with chronic pain conditions including irritable bowel syndrome (IBS). It is unclear whether deficiencies in pain inhibition are present in young children with IBS. The present study compared endogenous pain inhibition, somatic pain threshold, and psychosocial distress in young girls with IBS versus controls. Girls with IBS did not show significant endogenous pain inhibition of heat pain threshold during a cold-pressor task in contrast to controls, who had significant pain inhibition. Girls with IBS did not differ from peers on measures of somatic pain but had more symptoms of depression, somatization, and anxiety than controls. When psychological variables were included as covariates, the difference in pain inhibition was no longer significant, although poor achieved power limits interpretation of these results. Higher-order cognitive processes including psychological variables may be contributing to observed pain inhibition. In girls with IBS, pain inhibition was positively related to the number of days without a bowel movement. To our knowledge, this is the first study to demonstrate deficiencies of endogenous pain inhibition in young children with IBS. Findings have implications for better understanding of onset and maintenance of IBS and other chronic pain conditions.