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The severity of irritable bowel syndrome or the presence of fibromyalgia influencing the perception of visceral and somatic stimuli.

Tremolaterra F, Gallotta S, Morra Y, Lubrano E, Ciacci C, Iovino P - BMC Gastroenterol (2014)

Bottom Line: Mild and severe IBS patients without FMS demonstrated a significantly lower somatic perception cumulative score than severe IBS patients with FMS at active site.Conversely only severe IBS patients without FMS had significantly lower visceral thresholds for discomfort than mild IBS patients and severe IBS patients with FMS.The presence of co-existing FMS or greater FBDSI affects somatic and visceral perception in a graded fashion across IBS patients.

View Article: PubMed Central - PubMed

Affiliation: Gastrointestinal Unit, Department of Medicine and Surgery, University of Salerno, Via S, Allende, 84081 Baronissi, SA, Italy. piovino@unisa.it.

ABSTRACT

Background: Fibromyalgia Syndrome (FMS) is a frequent comorbidity in Irritable Bowel Syndrome (IBS) patients with a higher functional bowel disorder severity index (FBDSI). We tested the possibility that mild to severe IBS patients without FMS would have a graduated visceral and somatic perception, and the presence of FMS would further enhance somatic, but conversely attenuate visceral perception.Our aim was to study visceral and somatic sensitivity in mild IBS patients and in severe IBS patients with or without FMS.

Methods: Eleven mild IBS and 19 severe IBS with and without FMS patients were studied. Somatic and visceral stimuli were applied in each patient by means of electrical stimulations at active and control sites and by means of an electronic barostat in the rectum. Thresholds for discomfort and perception cumulative scores were measured.

Results: Mild and severe IBS patients without FMS demonstrated a significantly lower somatic perception cumulative score than severe IBS patients with FMS at active site. Conversely only severe IBS patients without FMS had significantly lower visceral thresholds for discomfort than mild IBS patients and severe IBS patients with FMS.

Conclusions: The presence of co-existing FMS or greater FBDSI affects somatic and visceral perception in a graded fashion across IBS patients.

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Related in: MedlinePlus

Visceral thresholds for discomfort were significantly different among groups (p < 0.001). Severe IBS patients without FMS had significantly lower thresholds for discomfort than mild IBS patients (p < 0.05), and severe IBS patients with FMS (p < 0.05), whilst no differences were found between severe IBS patients with FMS and mild IBS. The visceral perception cumulative score was significantly different among groups (p = 0.03). In detail, severe IBS patients without FMS had a significantly higher visceral perception cumulative score than mild IBS patients (p < 0.05).
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Fig2: Visceral thresholds for discomfort were significantly different among groups (p < 0.001). Severe IBS patients without FMS had significantly lower thresholds for discomfort than mild IBS patients (p < 0.05), and severe IBS patients with FMS (p < 0.05), whilst no differences were found between severe IBS patients with FMS and mild IBS. The visceral perception cumulative score was significantly different among groups (p = 0.03). In detail, severe IBS patients without FMS had a significantly higher visceral perception cumulative score than mild IBS patients (p < 0.05).

Mentions: Isobaric rectal distensions induced increased perception of symptoms in all IBS patients. Thresholds for discomfort were significantly different among groups after adjusting for covariates: gender and age (ANOVA p < 0.001). Gender and age did not significantly relate to the thresholds for discomfort. In detail, severe IBS patients without FMS had significantly lower thresholds for discomfort than mild IBS patients [17,8 ± 1.4 (12–24) vs 29.3 ± 2.1 (19–37), Bonferroni test p < 0.05], and severe IBS patients with FMS [26.2 ± 2.1(20–35), Bonferroni test p < 0.05], whilst no differences were found between severe IBS patients with FMS and mild IBS.Two patients experienced discomfort at 12 mmHg above MDP, which was used as the upper limit for the calculation of visceral perception cumulative score and compliance. The visceral perception cumulative score was significantly different among groups after adjusting for covariates: gender and age (ANOVA, p = 0.03). Gender and age did not significantly relate to the visceral perception cumulative score. In detail, severe IBS patients without FMS had a significantly higher visceral perception cumulative score than mild IBS patients [23.2 ± 2.9 (11.5-37) vs 12.3 ± 1.98 (2.5-19.5), Bonferroni test p < 0.05] (Figure 2), whilst no significant difference was reached in comparison to severe IBS patients with FMS [14.3 ± 2.8 (5–23)].Figure 2


The severity of irritable bowel syndrome or the presence of fibromyalgia influencing the perception of visceral and somatic stimuli.

Tremolaterra F, Gallotta S, Morra Y, Lubrano E, Ciacci C, Iovino P - BMC Gastroenterol (2014)

Visceral thresholds for discomfort were significantly different among groups (p < 0.001). Severe IBS patients without FMS had significantly lower thresholds for discomfort than mild IBS patients (p < 0.05), and severe IBS patients with FMS (p < 0.05), whilst no differences were found between severe IBS patients with FMS and mild IBS. The visceral perception cumulative score was significantly different among groups (p = 0.03). In detail, severe IBS patients without FMS had a significantly higher visceral perception cumulative score than mild IBS patients (p < 0.05).
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4288631&req=5

Fig2: Visceral thresholds for discomfort were significantly different among groups (p < 0.001). Severe IBS patients without FMS had significantly lower thresholds for discomfort than mild IBS patients (p < 0.05), and severe IBS patients with FMS (p < 0.05), whilst no differences were found between severe IBS patients with FMS and mild IBS. The visceral perception cumulative score was significantly different among groups (p = 0.03). In detail, severe IBS patients without FMS had a significantly higher visceral perception cumulative score than mild IBS patients (p < 0.05).
Mentions: Isobaric rectal distensions induced increased perception of symptoms in all IBS patients. Thresholds for discomfort were significantly different among groups after adjusting for covariates: gender and age (ANOVA p < 0.001). Gender and age did not significantly relate to the thresholds for discomfort. In detail, severe IBS patients without FMS had significantly lower thresholds for discomfort than mild IBS patients [17,8 ± 1.4 (12–24) vs 29.3 ± 2.1 (19–37), Bonferroni test p < 0.05], and severe IBS patients with FMS [26.2 ± 2.1(20–35), Bonferroni test p < 0.05], whilst no differences were found between severe IBS patients with FMS and mild IBS.Two patients experienced discomfort at 12 mmHg above MDP, which was used as the upper limit for the calculation of visceral perception cumulative score and compliance. The visceral perception cumulative score was significantly different among groups after adjusting for covariates: gender and age (ANOVA, p = 0.03). Gender and age did not significantly relate to the visceral perception cumulative score. In detail, severe IBS patients without FMS had a significantly higher visceral perception cumulative score than mild IBS patients [23.2 ± 2.9 (11.5-37) vs 12.3 ± 1.98 (2.5-19.5), Bonferroni test p < 0.05] (Figure 2), whilst no significant difference was reached in comparison to severe IBS patients with FMS [14.3 ± 2.8 (5–23)].Figure 2

Bottom Line: Mild and severe IBS patients without FMS demonstrated a significantly lower somatic perception cumulative score than severe IBS patients with FMS at active site.Conversely only severe IBS patients without FMS had significantly lower visceral thresholds for discomfort than mild IBS patients and severe IBS patients with FMS.The presence of co-existing FMS or greater FBDSI affects somatic and visceral perception in a graded fashion across IBS patients.

View Article: PubMed Central - PubMed

Affiliation: Gastrointestinal Unit, Department of Medicine and Surgery, University of Salerno, Via S, Allende, 84081 Baronissi, SA, Italy. piovino@unisa.it.

ABSTRACT

Background: Fibromyalgia Syndrome (FMS) is a frequent comorbidity in Irritable Bowel Syndrome (IBS) patients with a higher functional bowel disorder severity index (FBDSI). We tested the possibility that mild to severe IBS patients without FMS would have a graduated visceral and somatic perception, and the presence of FMS would further enhance somatic, but conversely attenuate visceral perception.Our aim was to study visceral and somatic sensitivity in mild IBS patients and in severe IBS patients with or without FMS.

Methods: Eleven mild IBS and 19 severe IBS with and without FMS patients were studied. Somatic and visceral stimuli were applied in each patient by means of electrical stimulations at active and control sites and by means of an electronic barostat in the rectum. Thresholds for discomfort and perception cumulative scores were measured.

Results: Mild and severe IBS patients without FMS demonstrated a significantly lower somatic perception cumulative score than severe IBS patients with FMS at active site. Conversely only severe IBS patients without FMS had significantly lower visceral thresholds for discomfort than mild IBS patients and severe IBS patients with FMS.

Conclusions: The presence of co-existing FMS or greater FBDSI affects somatic and visceral perception in a graded fashion across IBS patients.

Show MeSH
Related in: MedlinePlus