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Pain perception in irritable bowel syndrome
Kirsten Tillisch1, Emeran A Mayer
1Center for Neurovisceral Sciences and Women's Health, David Geffen School of Medicine, University of California-Los Angeles, 11301 Wilshire Boulevard, Los Angeles, CA 90073, USA. ktillisch@mednet.ucla.edu
CNS Spectrums
|November 8, 2005
Summary
Irritable bowel syndrome (IBS) involves chronic abdominal pain due to visceral hypersensitivity. Central pain modulation circuits, not peripheral pathways, are altered in IBS, potentially linked to psychiatric disorders.
Area of Science:
- Gastroenterology
- Neuroscience
- Psychiatry
Background:
- Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder.
- It causes chronic abdominal discomfort without organic disease, significantly impacting quality of life.
- Visceral hypersensitivity is a key pathophysiological mechanism in IBS.
Purpose of the Study:
- To explore the pathophysiological mechanisms of IBS.
- To investigate the role of central pain modulation in IBS.
- To examine potential shared mechanisms with psychiatric disorders.
Main Methods:
- Review of early functional brain imaging studies in IBS patients.
- Analysis of evidence for visceral hypersensitivity.
- Consideration of comorbidity with psychiatric disorders.
Main Results:
- Functional brain imaging suggests alterations in central pain modulation circuits in IBS.
- Evidence points away from increased peripheral visceral pain pathway sensitivity.
- High comorbidity with psychiatric disorders suggests shared underlying factors.
Conclusions:
- Central pain processing alterations are implicated in IBS pathophysiology.
- Visceral hypersensitivity in IBS may stem from central mechanisms.
- Further research into shared pathophysiological and etiologic factors between IBS and psychiatric disorders is warranted.