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Visce ral hype ralge sia has been demonstrate d in patie nts with irritable bowel syndrome who are seen in tertiary care centers. It has been hypothe sized that visce ral hype ralge sia may be related to psychological distress associated with health care seeking behavior in the se patie nts. Patients with (R) bromyalgia and sphincte r of Oddi dysfunction, type III, share many demographic and psychosocial characte ristics with patients with irritable bowel syndrome and provide an opportunity to te st the hypothe sis that rectal hype ralge sia is unique to IBS. Fifte en patie nts with IBS, 10 patie nts with (R) bromyalgia, 10 with sphincte r of Oddi dysfunction, type III, and 12 controls unde rwent evaluation of rectal pain pe rception in response to phasic distensions and psychological te sting with a self-report instrument. Patients with irritable bowel syndrome demonstrate d signi(R) cantly lower rectal pain thre sholds and incre ased leve ls of psychologic distress compared to controls. Although sphincte r of Oddi dysfunction patie nts also exhibited increased psychologic distre ss, rectal pain perception was similar to controls. Patients with (R) bromyalgia exhibited rectal alge sia that was not signi(R) cantly different from eithe r controls or IBS. In conclusion, rectal hype ralge sia is not a function of chronic functional pain, health care seeking behavior, or psychological distress. Howeve r, it may not be spe ci(R) c for IBS.
KEY WORDS: functional bowel disorder; visce ral hype ralge sia; (R) bromyalgia.
Irritable bowel syndrome (IBS) and similar functional bowel complaints account for 25+ or - 50% of all gastroente rology of(R) ce visits in the United State s (1) . Patients suffer from chronic or recurrent abdominal pain associate d with alte red bowel habit and, often, abdominal bloating and passage of mucus in the stool. Recent studie s have sugge sted that hype rsensitization of visce ral afferent ne rve (R) bers is a possible factor in the pathophysiology of IBS (2+ or - 4) . Howeve r, similar (R) ndings were not found in community subje cts with IBS symptoms who had not sought medical attention (5) .
Patients with IBS who seek health care in tertiary medical cente rs exhibit high...