This nationwide, population-based study used data from the National GI Survey to evaluate abdominal pain characteristics across IBS subtypes using the validated GI-PROMIS instrument. Of the 71,812 survey participants, 1,158 met modified Rome III criteria for IBS and reported abdominal pain within the past 7 days. These participants were stratified into IBS-D, IBS-C, and IBS-M groups. Compared to IBS-D, individuals with IBS-C reported significantly more bothersome, frequent, and interfering abdominal pain. IBS-C and IBS-M also showed more diffuse pain patterns and involvement of a greater number of abdominal regions. IBS-C had the highest composite GI-PROMIS scores, indicating greater pain burden.

The study highlights that abdominal pain manifests differently across IBS subtypes, with patients with IBS-C experiencing the most severe and diffuse symptoms. These differences may reflect distinct underlying mechanisms, including variations in visceral hypersensitivity and neural pain processing. The findings suggest that abdominal and bowel symptoms differ not only in frequency but in qualitative experience across subtypes, potentially supporting a move toward subtype-specific management strategies. Limitations included lack of medication and mood disorder assessments, but strengths included use of a validated, symptom-specific tool and a nationally representative cohort.

Reference: Shah ED, Almario CV, Spiegel BM, et al. Presentation and Characteristics of Abdominal Pain Vary by Irritable Bowel Syndrome Subtype: Results of a Nationwide Population-Based Study. Am J Gastroenterol. 2020 Feb;115(2):294-301. doi: 10.14309/ajg.0000000000000502. PMID: 31913193; PMCID: PMC7469977.