Is rectal pain sensitivity a biological marker for irritable bowel syndrome: psychological influences on pain perception.
Is rectal pain sensitivity a biological marker for irritable bowel syndrome: psychological influences on pain perception.
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DOI：
10.1016/s0016-5085(98)70099-x
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发表时间：
1998-11
期刊：
影响因子：
29.4
通讯作者：
W. Whitehead;O. Palsson
中科院分区：
文献类型：
--
作者：
W. Whitehead;O. Palsson
背景与目的直肠疼痛敏感性被认为是肠易激综合征的生物学标志物，但这一结论可能为时过早。这篇文章是一个关键的审查证据的心理影响perception.MethodsThe世界文学访问通过索引Medicus从1973年至1997年进行了系统review.ResultsEvidence有利于疼痛敏感性的生物学基础是，三分之二的患者报告疼痛异常低阈值的直肠扩张，尽管正常的躯体疼痛阈值。疼痛阈值与焦虑或抑郁无关。支持心理因素影响感知的证据是，肠易激综合征患者甚至认为假扩张更痛苦，当使用最小化心理影响的感知测试时，他们的感觉阈值正常。此外，压力会改变感觉阈值。重复扩张的致敏作用被认为是痛觉过敏的生物学基础，但这并不是肠易激综合征患者所独有的。脑成像显示，不同的区域被激活的肠易激综合征患者的痛苦扩张，但这是一致的心理影响perception.ConclusionsPsychological factors affect pain thresholds in patients with the Irritable bowel syndrome.两个认知特征，选择性注意胃肠道感觉和疾病归因，可能会导致疼痛敏感性增加。《胃肠病学》1998;115：1263-1271
Background & AimsRectal 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.MethodsThe world literature accessible through Index Medicus from 1973 to 1997 was systematically reviewed.ResultsEvidence 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.ConclusionsPsychological 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. GASTROENTEROLOGY 1998;115:1263-1271