Cognition of Abdominal Pain and Abdominal Discomfort in Patients with Irritable Bowel Syndrome with Diarrhea of China

Abstract Background In Asia, the proportion of patients with irritable bowel syndrome (IBS) with abdominal discomfort alone is significantly higher than that in western countries. The purpose of this study is to understand the cognition of abdominal pain and abdominal discomfort in patients with IBS in China, and to compare the clinical characteristics of patients with abdominal pain alone and abdominal discomfort alone.Methods Patients with IBS with diarrhea (IBS-D) who met Rome III diagnostic criteria and had episodes of at least one day/week were consecutively enrolled. The cognition of abdominal pain and abdominal discomfort were investigated through face-to-face unstructured interview. Patients were divided into pain group and discomfort group according to the cognition interviews, then the characteristics and severity of symptoms (IBS symptom severity scale, IBS-SSS), IBS quality of life (IBS-QOL) and psychological state were compared between groups.Results A total of 88 patients with IBS-D were enrolled. Most of the patients with self-reported abdominal pain described pain as spasm/cramping; patients with self-reported abdominal discomfort had as many as 24 kinds of descriptions to report their discomfort. Most patients having abdominal pain and discomfort could accurately distinguish the two symptoms. The degree of abdominal pain in pain group was higher than abdominal discomfort in discomfort group (P = 0.002). There was no significant difference in IBS-SSS, extra-intestinal pain, IBS-QOL, and scores of HAMA and HAMD between the two groups.Conclusions For Chinese patients with IBS-D, abdominal pain and abdominal discomfort are two different symptoms, but they have similar clinical features.Trial registration ChiCTR, ChiCTR1900028082. Registered 11 December 2019 - Retrospectively registered, http://www.chictr.org.cn