The DOI matches its Crossref record; 84 of the 85 references it cites were found in a registry or an index.
Is rectal pain sensitivity a biological marker for irritable bowel syndrome: psychological influences on pain perception.
Open accessAbstract
Background & aims Rectal pain sensitivity has been called a biological marker for irritable bowel syndrome, but this conclusion may be premature. This article is a critical review of the evidence for psychological influences on perception.Methods The world literature accessible through Index Medicus from 1973 to 1997 was systematically reviewed.Results Evidence favoring a biological basis for pain sensitivity is that two thirds of patients report pain at abnormally low thresholds of rectal distention despite normal somatic pain thresholds. Pain thresholds are not correlated with anxiety or depression. Evidence favoring psychological influences on perception is that patients with the irritable bowel syndrome rate even sham distentions as more painful, and when perception tests that minimize psychological influences are used, they have normal sensory thresholds. Also, stress alters sensory thresholds. Sensitization by repeated distention has been cited as evidence of a biological basis for hyperalgesia, but it is not unique to patients with irritable bowel. Brain imaging shows that different regions are activated by painful distention in patients with irritable bowel syndrome, but this is consistent with psychological influences on perception.Conclusions Psychological factors influence pain thresholds in patients with the irritable bowel syndrome. Two cognitive traits, selective attention to gastrointestinal sensations and disease attribution, may account for increased pain sensitivity.
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“Recent investigations have found that mindfulness meditation induces changes in the activation of neural circuits implicated in interoception (awareness of stimuli originating inside the body (21)) and emotion regulation (22,23), while improving attentional control (24–27).”
From Mindfulness training reduces the severity of irritable bowel syndrome in women: Results of a randomized controlled trial (2011) · cites this paper as [25]
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Drossman, D. A., Camilleri, M., Mayer, E. A., & Whitehead, W. E. (2002) · Gastroenterology · doi:10.1053/gast.2002.37095 · Cited by 1,384
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Metadata
- Authors
- WHITEHEAD, W., & PALSSON, O.
- Affiliations
- University of North Carolina at Chapel Hill (US)
- Eastern Virginia Medical School (US)
- ORCID
- PALSSON, O
- Venue
- Gastroenterology
- Publisher
- Elsevier BV
- Published
- 1998-11
- Volume
- 115
- Issue
- 5
- Pages
- 1263-1271
- ISSN
- 0016-5085 (ISSN-L)
- OpenAlex
- W2150287168
- Cited by
- 314
- References
- 85
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 1 · 2023: 2 · 2022: 3 · 2021: 3 · 2020: 4 · 2019: 5 · 2018: 4 · 2017: 4 · 2016: 12 · 2015: 10 · 2014: 8 · 2013: 6 · 2012: 10
- FWCI
- 2.84
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Gastroenterology (publishedVersion)
- PubMed (publishedVersion)
- Carolina Digital Repository (University of North Carolina at Chapel Hill) (submittedVersion)
- UNC Libraries
- Funders
- National Institutes of Health (2k05mh000133-17)
- National Institute of Mental Health (KO5 MH00133)
- National Institute of Diabetes and Digestive and Kidney Diseases (R01DK031369, R01 DK31369)
- Topics
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Health Sciences › Medicine › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
- Keywords
- irritable bowel syndrome, pain threshold, rectal distension, hyperalgesia, anxiety, depression, stress, sensitization, neuroimaging, selective attention, disease attribution, biomarkers
- MeSH terms
- Colonic Diseases, Functional, Humans, Pain, Rectum, Biomarkers, Pain Threshold
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