Irritable Bowel Syndrome

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Project Abstract   Intense, recurrent abdominal (visceral) pain is a predominant symptom of irritable bowel syndrome (IBS), a functional gut disorder that typically manifests in the early adult years1. IBS is common with prevalence reaching over 20% in some regions of the world, and affects more women than men2,3. While women report more severe IBS-related pain, both younger men and women report more severe pain compared to older adult cohorts4,5. Direct costs of care and lost productivity in the U.S. exceed $21 billion annually, and individuals with IBS utilize more healthcare services than the general population, including outpatient visits, diagnostic testing and over-the-counter and prescription medications6. Individuals with IBS report that pain is the most distressing symptom and has the greatest impact on quality of life1, however, current approaches to improve self- management of IBS-related pain do not target individual, context-specific factors of pain. Therefore, individuals with IBS-related pain often endure a long and frustrating course of learning how to manage pain on their own accord. The proposed pilot project was developed based on this common situation and will provide feasibility data about the influence of providing a personalized pain SM intervention to individuals with IBS-related pain. IBS-related pain is associated with sensitization of the central nervous system, and approximately half of all patients with IBS have visceral hypersensitivity7-9. These alterations in pain processing escalate pain perception, and can increase vulnerability to other comorbid pain disorders which individuals with IBS frequently suffer7,8. Pain sensitization is influenced by pain-sensitivity genes and, specific to IBS-related pain, the gut microbiome10-13. Therefore, as contextual factors of pain associated with IBS, we will measure peripheral and central sensitivity, single-nucleotide polymorphisms (SNPs) of candidate pain-sensitivity genes and the gut microbiome. The SM intervention was designed to provide factual information about IBS pain, triggers of pain and pain SM skills. The experimental group will receive one-on-one consultation tailored around the individual's assessment results of peripheral and central pain sensitivity as measured by quantitative sensory testing (QST) and targeted toward increasing pain self-efficacy and self-regulation skills and abilities.   The proposed pilot project will provide foundational information about the contextual factors of IBS pain (pain catastrophizing, perceived stress, reactivity pain sensitivity, genetic and microbiome) on pain SM process and outcomes. In addition, we will gain insight on the potential impact of the personalized IBS-pain SM approach on pain SM behaviors and health outcomes. The knowledge gained from this pilot study will position the PPI and her team for future work in the area of precision pain SM, using innovative methods to improve quality of life and costs of care for individuals and families with IBS pain.