Predictors of abdominal pain severity in patients with constipation-prevalent irritable bowel syndrome

J Basic Clin Physiol Pharmacol. 2022 Jun 6. doi: 10.1515/jbcpp-2022-0081. Online ahead of print.


Sara Rurgo 1Viviana Vaino 1Marta Andreozzi 1Marta Pagliaro 1Piera Senneca 1Gianmarco Di Giorgio 1Eleonora Efficie 1Giovanni Sarnelli 1Marcella Pesce 1


Author information

1Department of Clinical Medicine and Surgery, University of Naples "Federico II", Napoli, Italy.


Background: Symptoms of irritable bowel syndrome (IBS) have been associated to altered colonic motility and sensation. Smoking affects pain perception and is a risk factor in the development of post-infectious IBS, but its effect on abdominal pain and colonic transit remains to be elucidated in IBS.

Methods: Forty patients with IBS-C and 28 with IBS-M were selected based on Rome IV criteria. Colonic transit time was studied and smoking habit was recorded. Presence of mild or severe abdominal pain and the prevalent pain characteristics (diffuse or localized, chronic or acute, with cramps or gradually distending) were recorded. Data were analyzed by univariate and stepwise multiple logistic regression analysis to verify the risk association between pain and all other variables.

Results: IBS-C patients had a longer transit time in the right colon and scored more chronic pain than IBS-M patients. When severity of abdominal pain was used as discriminating factor, a significant number of subjects reporting severe pain were males and smokers (16/30 vs. 4/38 and 20/30 vs. 4/38, both ?<0.001). Multivariate analysis confirmed that smoking was an independent factor associated with severe abdominal pain (OR 14.3, CI 2-99, p=0.007). Smoking was not associated with colonic transit times and colonic transit was not associated with IBS symptoms' severity (both ?=N.S.).

Conclusions: Smoking was the only factor independently associated with severe abdominal pain. As smoking does not seem to affect colonic transit time, we suggest that smoking may influence visceral perception and symptoms severity in IBS patients.


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