The severity of irritable bowel syndrome or the presence of fibromyalgia influencing the perception of visceral and somatic stimuli

BACKGROUND: Fibromyalgia Syndrome (FMS) is a frequent comorbidity in Irritable Bowel Syndrome (IBS) patients with a higher functional bowel disorder severity index (FBDSI). We tested the possibility that mild to severe IBS patients without FMS would have a graduated visceral and somatic perception, and the presence of FMS would further enhance somatic, but conversely attenuate visceral perception. Our aim was to study visceral and somatic sensitivity in mild IBS patients and in severe IBS patients with or without FMS. METHODS: Eleven mild IBS and 19 severe IBS with and without FMS patients were studied. Somatic and visceral stimuli were applied in each patient by means of electrical stimulations at active and control sites and by means of an electronic barostat in the rectum. Thresholds for discomfort and perception cumulative scores were measured. RESULTS: Mild and severe IBS patients without FMS demonstrated a significantly lower somatic perception cumulative score than severe IBS patients with FMS at active site. Conversely only severe IBS patients without FMS had significantly lower visceral thresholds for discomfort than mild IBS patients and severe IBS patients with FMS. CONCLUSIONS: The presence of co-existing FMS or greater FBDSI affects somatic and visceral perception in a graded fashion across IBS patients.