Why Irritable Bowel Syndrome sufferers feel more pain

Understanding the real causes of IBS symptoms may result in more effective treatment

The cramps and abdominal pain associated with Irritable Bowel Syndrome (IBS) may have a significant psychological component, according to a study published in the medical journal Gut.

Scientists at the University of North Carolina in the US have found that increased colon pain in IBS patients seems to be a result of a tendency to report pain rather than actually feeling more pain than others.

The researchers carried out a number of psychological and physical tests on 121 IBS patients and 28 healthy people. The volunteers underwent a procedure called ‘balloon distension’ in their colons, which allowed the scientists to measure pain thresholds. A whole series of tests were also carried out to determine what pain was physical and what was psychological.

Lower pain thresholds

The team found that the IBS patients had significantly lower pain thresholds than the healthy control group. The IBS sufferers were also quicker to say they were in pain than their healthy peers.

"Increased colonic sensitivity in IBS is strongly influenced by a psychological tendency to report pain ... rather than increased neurosensory sensitivity," according to lead author Dr William E Whitehead and his colleagues.

The researchers believe that this study could have far reaching implications for the management of IBS. They suggest that treatments should look at the mental aspects of the disease before tackling the physical symptoms.

Treatments for IBS

"Psychological factors play a huge role in pain sensitivity," says Dr Nick Read, medical adviser to the IBS Network. "If a person is anxious or upset, the mechanisms that dampen down pain from the gut are blocked and so sufferers feel pain more acutely. People also focus more on pain when they are stressed."

Dr Read recommends treatments that deal with the psychological causes of IBS. He has found that techniques like hypnotherapy, cognitive behavioural therapy (CBT) and psychotherapy can be extremely beneficial for IBS sufferers. Other treatments that have proved successful include acupuncture and massage.

"Any therapy that acts in a way to promote relaxation and reduce stress will be very helpful," says Dr Nick Read. "Drugs that treat the physical symptoms may help in the short term but it is important to address the underlying psychological issues if you want to find a long term solution."

Sick and Tired: Healing the Illnesses Doctor’s Can’t Cure by Dr Nick Read, published by Phoenix £7.99 available in book shops.

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