Irritable Bowel Syndrome

项目摘要 -- 剧烈、反复的腹部(内脏)疼痛是肠易激综合征(IBS)的主要症状。 典型表现在成人早期的功能性肠道疾病1。肠易激综合征在流行中很常见 在世界一些地区达到20%以上，影响女性的人数超过男性2，3。 更严重的IBS相关疼痛，年轻男性和女性报告的疼痛比老年人更严重 队列4、5.在美国，医疗保健和生产力损失的直接成本每年超过210亿美元， 与普通人群相比，IBS使用更多的医疗服务，包括门诊、诊断测试 以及非处方药和处方药。患有IBS的人报告说，疼痛是最令人苦恼的 症状和对生活质量的最大影响1然而，目前改善自我的方法 IBS相关疼痛的治疗不针对个体、特定于环境的疼痛因素。因此，个人 与IBS相关的疼痛通常要忍受一个漫长而令人沮丧的学习过程，才能学会如何自己管理疼痛 一致。拟议的试点项目就是在这种普遍情况下开发的，并将提供可行性 关于为患有IBS相关疼痛的个人提供个性化疼痛SM干预的影响的数据。 与IBS相关的疼痛与中枢神经系统的敏感化有关，大约有一半 IBS患者有内脏过敏7-9。疼痛处理过程中的这些变化会加剧疼痛 知觉，并会增加IBS患者患其他共病疼痛障碍的易感性 疼痛敏感化受疼痛敏感基因的影响，尤其是与IBS相关的疼痛， 肠道微生物10-13。因此，作为与IBS相关的疼痛的背景因素，我们将测量 疼痛敏感候选基因的外周和中枢敏感性、单核苷酸多态(SNPs) 还有肠道微生物群。SM干预旨在提供有关IBS疼痛的事实信息， 痛苦的触发者和痛苦SM技能。试验组将接受量身定做的一对一咨询 围绕个人对外周和中枢疼痛敏感度的评估结果 定量感觉测试(QST)，旨在提高疼痛自我效能和自我调节技能 和能力。 -- 拟议的试点项目将提供有关IBS疼痛(Pain)背景因素的基本信息 灾难、感知压力、反应性疼痛敏感性、遗传和微生物群)对疼痛SM过程和 结果。此外，我们还将深入了解个性化IBS-Pain SM方法的潜在影响 关于疼痛、SM行为和健康结果。从这项试点研究中获得的知识将使PPI 和她的团队未来在Precision Pain SM领域的工作，使用创新的方法来提高 IBS疼痛患者和家庭的生命和护理费用。

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.