Visceral hypersensitivity in endometriosis: a new target for treatment?

B Issa, T S Onon, Toli S. Onon, A Agrawal, Anurag K. Agrawal, Chander Shekhar, C Shekhar, J.A. Morris, J Morris, Shaheen Hamdy, S Hamdy, P J Whorwell, Peter J. Whorwell
Gut · 2011 · vol. 61(3) , pp. 367–372 · doi:10.1136/gutjnl-2011-300306 · PMID:21868492 · W2142029312
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This study found that visceral hypersensitivity is common in women with endometriosis, regardless of disease severity, and may intensify their abdominal pain.

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Abstract

OBJECTIVE: In women presenting to gynaecological clinics with lower abdominal pain, the cause is frequently attributed to endometriosis irrespective of whether it is found to be minimal or extensive at laparoscopy. Irritable bowel syndrome (IBS) is also common in this setting, and it was speculated that the visceral hypersensitivity associated with this condition might be amplifying the symptoms of endometriosis. METHODS: Visceral sensitivity to balloon distension, symptoms and psychological status were assessed following laparoscopy in 20 women with minimal to mild endometriosis, 20 with moderate to severe endometriosis, 20 with laparoscopy negative abdominal pain and 20 asymptomatic women undergoing laparoscopic sterilisation who acted as controls, and compared with 20 women with IBS. RESULTS: Compared with controls, patients with minimal to mild and moderate to severe endometriosis had a higher prevalence of symptoms consistent with IBS (0% vs 65% and 50%, respectively, p<0.001) with significantly lower mean pain thresholds (39.5 mm Hg (95% CI 36.0 to 43.0) vs 28.1 mm Hg (95% CI 24.5 to 31.6), p=0.001 and 28.8 mm Hg (95% CI 24.9 to 32.6), p=0.002) not explained by differences in rectal compliance. Patients with laparoscopy negative pain had symptoms and visceral sensitivity similar to patients with IBS. Controls undergoing laparoscopy had normal sensitivity, indicating that the laparoscopic procedure was not inducing hypersensitivity. CONCLUSION: Visceral hypersensitivity is extremely common in endometriosis and could be intensifying the pain. This finding might explain why mildly affected individuals often complain of severe symptoms out of proportion to the extent of their disease. This study has introduced a completely new concept into the understanding of pain in endometriosis and could open up new opportunities for treatment.

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Condition tags

mesh:D004715endometriosisirritable_bowel_syndrome

MeSH descriptors

Endometriosis Hyperalgesia Viscera Adult Case-Control Studies Dilatation Dilatation Endometriosis Endometriosis Female Humans Hyperalgesia Hyperalgesia Irritable Bowel Syndrome Irritable Bowel Syndrome Laparoscopy Laparoscopy Middle Aged Pain Measurement Pain Measurement

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

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Cited by (50)

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