Abstract
The aims of this study were to determine whetherincreased pain sensitivity in patients with irritablebowel is due to physiological differences in perceptualsensitivity or psychological influences on perception, and whether prior sexual abuseaccounts for increased pain sensitivity. Seventeensexually abused and 15 nonabused women with irritablebowel were compared to 13 sexually abused and 14nonabused women without irritable bowel. Among thenonabused subjects, the volume of rectal distension thatproduced moderate pain was lower in IBS patients than incontrols, replicating earlier studies, but these thresholds were correlated with psychologicalmeasures of anxiety and somatization. The ability todiscriminate between painful distensions (perceptualsensitivity) was not different between groups. Sexual abuse was not associated with lower painthresholds. Thus, differences in pain sensitivity appearto be due to psychological influences on perception, buta history of sexual abuse does not contributesignificantly to this pain sensitivity.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
REFERENCES
Mertz H, Naliboff B, Munakata J, Niazi N, Mayer EA: Altered rectal perception is a biological marker of patients with irritable bowel syndrome. Gastroenterology 109:40–52, 1995
Ritchie J: Pain from distension of the pelvic colon by inflating a balloon in the irritable colon syndrome. Gut 14:125–132, 1973
Whitehead WE, Holtkotter B, Enck P, Hoelzl R, Holmes KD, Anthony J, Shabsin HS, Schuster MM: Tolerance for rectosigmoid distention in irritable bowel syndrome. Gastroenterology 98:1187–1192, 1990
Bradette M, Delvaux M, Staumont G, Fioramonti J, Bueno L, Frexinos J: Evaluation of colonic sensory thresholds in IBS patients using a barostat: Definition of optimal conditions and comparison with healthy subjects. Dig Dis Sci 39:449–457, 1994
Whitehead WE, Delvaux M, Azpiroz F, Barlow J, et al: Standardization of barostat procedures for testing smooth muscle tone and sensory thresholds in the gastrointestinal tract. Dig Dis Sci (in press)
McNicol D: A primer of signal detection theory. London, George Allen and Unwin Ltd, 1972
Drossman DA, Leserman J, Nachman G, Li Z, Gluck H, Toomey TC, Mitchell CM: Sexual and physical abuse in women with functional or organic gastrointestinal disorders. Ann Intern Med 113:828–833, 1990
Drossman DA, Talley NJ, Leserman J, Olden KW, Barreiro MA: Sexual and physical abuse and gastrointestinal illness: Review and recommendations. Ann Intern Med 123:782–784, 1995
Longstreth GF, Wolde-Tsadik G: Irritable bowel-type symptoms in HMO examinees: Prevalence, demographics, and clinical correlates. Dig Dis Sci 38:1581–1589, 1993
Talley NJ, Fett SL, Zinsmeister AR, Melton LJ III: Gastrointestinal tract symptoms and self-reported abuse: A population-based study. Gastroenterology 104:1040–1049, 1994
Lechner ME, Vogel ME, Garcia-Shelton LM, Leichter JL, Steibel KR: Self-reported medical problems of adult female survivors of childhood sexual abuse. J Fam Pract 36:633–638, 1993
Manning AP, Thompson WG, Heaton KW, Morris AF: Towards positive diagnosis of the irritable bowel. Br Med J 2:653–654, 1978
Thompson WG, Creed F, Drossman DA, Heaton K, Mazzacca G: Functional bowel disorders and functional abdominal pain. In The Functional Gastrointestinal Disorders. DA Drossman et al (eds). Boston: Little, Brown, 1994, pp 115–173
Leserman J, Drossman DA, Li Z, Toomey TC, Nachman G, Glogau L: Sexual and physical abuse in gastrointestinal practice: How types of abuse impact health status. Psychosom Med 58:4–15, 1996
Leserman J, Li Z, Drossman DA, Toomey TC, Nachman G, Glogau L: Impact of sexual and physical abuse dimensions on health status: Development of an abuse severity measure. Psychosom Med (in press)
Broadman K, Erdmann AJ Jr, Large I, Wolff HG: The Cornell Medical Index: An adjunct to medical interview. J Am Med Assoc 140:530–534, 1949
Elliott DM, Briere J: Sexual abuse trauma among professional women: Validating the trauma symptom checklist-40 (TSC-40). Child Abuse Neglect 16:391–398, 1992
Azpiroz F, Malagelada JR: Physiological variations in canine gastric tone measured by an electronic barostat. Am J Physiol 248:G229–G237, 1985
Gracely RH, McGrath P, Dubner R: Ratio scales of sensory and affective verbal pain descriptors. Pain 5:5–18, 1978
Bradley LA, Scarinci IC, Richter JE: Pain threshold levels and coping strategies among patients who have chest pain and normal coronary arteries. Med Clin North Am 75:1189–1202, 1991
Ness TJ, Metcalf AM, Gebhart GF: A psychophysiological study in humans using phasic colonic distension as a noxious visceral stimulus. Pain 43:377–386, 1990
Notivol R, Coffin B, Azpiroz F, Mearin F, Serra J, Malagelada J-R: Gastric tone determines the sensitivity of the stomach to distention. Gastroenterology 108:330–336, 1995
Lembo T, Munakata J, Mertz H, Niazi N, Kodner A, Nikas V, Mayer EA: Evidence for the hypersensitivity of lumbar splanchnic afferents in irritable bowel syndrome. Gastroenterology 107:1686–1696, 1994
Drosman DA, McKee DC, Sandler RS, Mitchell CM, Cramer EM, Lowman BC, Burger AL: Psychological factors in the irritable bowel syndrome. A multivariate study of patients and nonpatients with irritable bowel syndrome. Gastroenterology 95:701–708, 1988
Whitehead WE, Bosmajian L, Zonderman Ab, Costa PT Jr, Schuster MM: Symptoms of psychologic distress associated with irritable bowel syndrome. Gastroenterology 95:709–714, 1988
Rights and permissions
About this article
Cite this article
Whitehead, W.E., Crowell, M.D., Davidoff, A.L. et al. Pain from Rectal Distension in Women with Irritable Bowel Syndrome (Relationship to Sexual Abuse). Dig Dis Sci 42, 796–804 (1997). https://doi.org/10.1023/A:1018820315549
Issue Date:
DOI: https://doi.org/10.1023/A:1018820315549