Widespread hyperalgesia in adolescents with symptoms of irritable bowel syndrome: results from a large population-based study

This article is part of Niklas Stabell's doctoral thesis, which is available in Munin at http://hdl.handle.net/10037/6798 ; Widespread hyperalgesia is well documented among adult patients with Irritable Bowel Syndrome (IBS), but little is known about pain sensitivity among adolescents with IBS. We examined pain sensitivity in 961 adolescents from the general population (mean age 16.1 years), including pain threshold and tolerance measurements of heat (forearm) and pressure pain (fingernail and shoulder), and cold-pressor tolerance (hand). Adolescents with IBS symptoms (Rome III criteria) had lower heat pain thresholds compared to controls after adjustments for sex, co-morbid pain and psychological distress (mean difference = -0.8 oC; 95% CI = -1.6 to -0.04). Similar results were found for pressure pain threshold at the shoulder (mean difference = -46 kPa; 95% CI = -78 to -13) and fingernail (mean difference = -62 kPa; 95% CI = -109 to -15), and for an aggregate of all three threshold measures (z-score difference = -0.4; 95% CI = -0.6 to -0.2), though pressure pain threshold differences were non-significant after the final adjustments for psychological distress. No difference of pain tolerance was found between the IBS cases and controls. Our results indicate that adolescents in the general population with IBS symptoms, like adults, have widespread hyperalgesia.