Visceral algesia in irritable bowel syndrome, fibromyalgia, and sphincter of oddi dysfunction, type III.

Visceral hyperalgesia has been demonstrated inpatients with irritable bowel syndrome who aReseen intertiary care centers. It has been hypothesized thatvisceral hyperalgesia may be related to psychological distress associated with health caReseekingbehavior in these patients. Patients with fibromyalgiaand sphincter of Oddi dysfunction, type III, share manydemographic and psychosocial characteristics with patients with irritable bowel syndrome andprovide an opportunity to test the hypothesis thatrectal hyperalgesia is unique to IBS. Fifteen patientswith IBS, 10 patients with fibromyalgia, 10 withsphincter of Oddi dysfunction, type III, and 12 controlsunderwent evaluation of rectal pain perception inresponse to phasic distensions and psychological testingwith a self-report instrument. Patients with irritable bowel syndrome demonstrated significantly lowerrectal pain thresholds and increased levels ofpsychologic distress compared to controls. Althoughsphincter of Oddi dysfunction patients also exhibitedincreased psychologic distress, rectal pain perceptionwas similar to controls. Patients with fibromyalgiaexhibited rectal algesia that was not significantlydifferent from eiThe r controls or IBS. In conclusion, rectal hyperalgesia is not a function ofchronic functional pain, health caReseeking behavior,or psychological distress. However, it may not bespecific for IBS.