Pain from distension of the pelvic colon by inflating a balloon in the irritable colon syndrome
Open accessAbstract
The effects of inflating a balloon introduced through a sigmoidoscope to 35 cm in the pelvic colon have been observed and compared in 67 patients with the irritable colon syndrome and in 16 normal and constipated subjects acting as controls. Inflation to 60 ml caused pain in 6% of the controls at a mean diameter of 3·8 cm and in 55% of patients with the irritable colon syndrome (diameter 3·4 cm). An estimate of gut wall tension at this volume of inflation showed it to be normal in patients with the irritable colon syndrome; the incidence of pain in relation to wall tension was increased nearly tenfold in the irritable colon group. Inflation of the balloon to different volumes was normally painless to a maximum acceptable diameter which remained constant for each study under constant conditions; continued inflation eventually gave rise to pain without increasing the diameter. The pain was felt in the hypogastrium in 40%, in one or both iliac fossae in 31%, and in the rectum in 21%; the other 8% felt pain in the back or elsewhere and there were no significant differences between clinical groups. Exceptionally, in 6% of the controls, and in 52% of patients with the irritable colon syndrome, pain occurred at balloon diameters that could still be increased by 10% or more with further inflation. This was probably the outcome of a low threshold for visceral pain in the section of bowel in contact with the balloon. Colonic hyperalgesia of this kind, possibly a random occurrence, may be an important contributory factor in the aetiology of the irritable colon syndrome.
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Accumulation of different mechanisms (psychological, sensory, and motor) increases both gastrointestinal and non-gastrointestinal symptom severity, as well as impairments in quality of life.
“Accumulation of different mechanisms (psychological, sensory, and motor) increases both gastrointestinal and non-gastrointestinal symptom severity, as well as impairments in quality of life. 31,32”
From Irritable bowel syndrome (2020) · cites this paper as [32]
The section “Hyperalgesia in the Irritable Colon Syndrome” links a low visceral pain threshold and motor dysfunction to a greater likelihood of abdominal pain. It does not address an accumulation of psychological, sensory, and motor mechanisms, or show that such an accumulation increases non-gastrointestinal symptoms or impairs quality of life. Page numbers were not available in our copy. (LLM, conf=0.88)
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- Authors
- Ritchie, J.
- Affiliations
- John Radcliffe Hospital (GB)
- Corresponding author
- Ritchie, James
- Venue
- Gut
- Publisher
- BMJ
- Published
- 1973-02
- Volume
- 14
- Issue
- 2
- Pages
- 125-132
- ISSN
- 0017-5749 (ISSN-L)
- 1468-3288
- PMC
- PMC1412559
- OpenAlex
- W2045099397
- Cited by
- 832
- References
- 0
- Citations by year
- 2026: 6 · 2025: 6 · 2024: 13 · 2023: 13 · 2022: 16 · 2021: 12 · 2020: 9 · 2019: 11 · 2018: 19 · 2017: 10 · 2016: 19 · 2015: 23 · 2014: 25 · 2013: 17 · 2012: 24
- FWCI
- 4.42
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Gut (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Health Sciences › Health Professions › Pharmacy › Infant Health and Development
- Health Sciences › Medicine › Rheumatology › Pelvic floor disorders treatments
- Keywords
- irritable colon, irritable bowel syndrome, balloon distension, visceral pain, sigmoid colon, pain threshold
- MeSH terms
- Anthropometry, Cineradiography, Colon, Colonic Diseases, Functional, Constipation, Humans, Hyperesthesia, Methods, Pain, Pressure, Sigmoidoscopy
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