Overcoming the pain of IBS

March 26, 2008 9:02:39 AM PDT
Irritable bowel syndrome (IBS) is the most common digestive disorder, affecting between 10 percent and 15 percent of the population. Painful abdominal cramps, nausea, diarrhea and/or constipation are characteristic of the disorder, which affects women more than men. There is no cure for IBS and the exact cause of the disease continues to stump the medical community. Because the condition is so misunderstood, many doctors don't know how to diagnose patients complaining of these symptoms. One of the biggest frustrations for IBS sufferers is dismissal of their symptoms or being told the condition is simply psychological.

UNDERSTANDING THE PAIN: New findings from researchers at the University of California, Los Angeles reveal women with IBS are not able to effectively "turn-off" a pain modulation mechanism in the brain, which causes them to be more sensitive to the abdominal pain. Previous research shows the brain can prepare for pain in ways that either amplify or inhibit the sensory experience. When expected pain is tolerable, inescapable or will have a reward -- like getting an injection at the doctor or going to the dentist -- most people will tell their brains to reduce the intensity of the pain experience with brain circuits that process pain signals.

Then, when the pain is perceived as escapable or potentially dangerous -- like burning yourself on the stove -- most people tell their brain to amplify the pain response. However, UCLA researchers found female IBS patients could not turn down the pain response, even when the pain was expected and not dangerous, thus making them sensitive to even mild discomfort.

Researchers emphasize that these results do not support the psychological theory of IBS. In fact, Emeran Mayer, M.D., a gastroenterologist and neuroscientist at UCLA Medical Center, says these findings re-enforce the argument that IBS is a disorder of brain-gut interaction.

THE CHICKEN OR THE EGG? Researchers say these findings bring up an interesting question: which came first -- the IBS or the brain glitch? Was the brain dysfunction caused by the long history of abdominal pain, or did it always exist and cause their symptoms?

"Additional research may reveal that some pain patients have a primary different in their brain's reaction to pain," Dr. Mayer was quoted as saying. "If we can identify pain receptors and genes associated with these abnormal brain responses, we should improve both identification of predisposed patients and development of effective remedies."