Is there a difference between abdominal pain and discomfort in moderate to severe IBS patients?

Objectives: The aims of this study were to: 1) determine the relative prevalence of self-reported pain-predominant and discomfort-predominant symptom patterns in irritable bowel syndrome (IBS) patients; and 2) test the hypotheses that pain-predominant patients report higher GI symptom severity, show higher psychological symptom severity, show worse quality of life, and demonstrate higher health care use.

Methods: A total of 256 consecutive ROME I-positive IBS patients with moderate to severe symptoms were classified according to whether they rated their predominant IBS symptoms as pain (n = 52), or as nonpainful discomfort (n = 128) on the Irritable Bowel Syndrome Quality of Life questionnaire. The validity of this classification scheme was confirmed by interview in a subsample of 45 patients.

Irritable Bowel Syndrome.

Because treatment of irritable bowel syndrome (IBS) patients can be frustrating to the clinician and patient as well, the physician should strive to gain the patient's confidence with a concise, appropriate work-up and by offering reassurance and education that IBS is a functional disorder without significant long-term health risks. First-line treatment should be aimed at treating the most bothersome symptom. Tricyclic antidepressants are superior to placebo in reducing abdominal pain scores, as well as improving global symptom severity.