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Colonoscopy as an adjunctive method for the diagnosis of irritable bowel syndrome: focus on pain perception

Authors
 Eun Soo Kim  ;  Jae Hee Cheon  ;  Jae Jun Park  ;  Chang Mo Moon  ;  Sung Pil Hong  ;  Tae Il Kim  ;  Won Ho Kim 
Citation
 JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Vol.25(7) : 1232-1238, 2010 
Journal Title
 JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY 
ISSN
 0815-9319 
Issue Date
2010
MeSH
Adult ; Aged ; Case-Control Studies ; Chi-Square Distribution ; Colon/pathology* ; Colonoscopes/adverse effects* ; Female ; Humans ; Irritable Bowel Syndrome/diagnosis* ; Irritable Bowel Syndrome/psychology ; Logistic Models ; Male ; Middle Aged ; Pain/etiology* ; Pain/psychology ; Pain Measurement ; Pain Threshold* ; Perception* ; Predictive Value of Tests ; Republic of Korea ; Sensitivity and Specificity ; Surveys and Questionnaires
Keywords
colonoscopy ; functional gastrointestinal disorder ; irritable bowel syndrome ; pain, visceral hypersensitivity
Abstract
BACKGROUND AND AIM: Visceral hypersensitivity is an important component of the pathophysiology of irritable bowel syndrome (IBS). In the present study, we investigated differences in pain perception during colonoscopy between IBS patients and non-IBS patients. We further assessed the sensitivity, specificity, and predictive values of pain scores to diagnose IBS. METHODS: Patients who underwent colonoscopy for the evaluation of gastrointestinal symptoms or for screening purposes were included. All patients completed Rome III criteria questionnaires and reported pain scores on 0-100-mm visual analog scales after colonoscopy. The patients were divided into three groups: (i) IBS; (ii) other functional gastrointestinal disorders (FGID), including functional bloating, functional diarrhea, and functional constipation; and (iii) healthy controls. RESULTS: A total of 217 patients were included. The pain scores (median, interquartile range) of IBS patients (52, 34-71) were higher than those of the healthy controls (22, 12-35) or other FGID patients (18, 10-29) (P < 0.001). Upper gastrointestinal symptoms were observed more often in the IBS group than in the non-IBS group (83.2% vs 34.5%, P < 0.001). At the pain score level of 31, the sensitivity, specificity, positive predictive value, and negative predictive value for IBS diagnosis were 86.1%, 75.9%, 75.7%, and 86.3%, respectively. CONCLUSIONS: The degree of pain perception during colonoscopy was higher in IBS patients than in non-IBS patients. We concluded that colonoscopy can be useful in identifying IBS patients, with the additional benefit of excluding organic disorders of the lower gastrointestinal tract
Full Text
http://onlinelibrary.wiley.com/doi/10.1111/j.1440-1746.2010.06338.x/abstract
DOI
10.1111/j.1440-1746.2010.06338.x
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Won Ho(김원호) ORCID logo https://orcid.org/0000-0002-5682-9972
Kim, Tae Il(김태일) ORCID logo https://orcid.org/0000-0003-4807-890X
Cheon, Jae Hee(천재희) ORCID logo https://orcid.org/0000-0002-2282-8904
Hong, Sung Pil(홍성필)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/101366
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