Direct clinical evidence for spinal hyperalgesia in a patient with irritable bowel syndrome

OBJECTIVE: Our objective was to evaluate GI motor and sensory function and spinal cord testing in a patient with severe irritable bowel syndrome. METHODS: A patient is described who underwent an extensive assessment of GI motor and sensory function including transit studies, colonic and rectal b arostat studies, sensory and manometric studies of the small bowel, and col on and anorectal physiology testing. The patient also underwent testing wit h spinal cord stimulation and spinal drug delivery as part of a pain manage ment assessment. RESULTS: The viscerosomatic referral pain pattern resulting from rectal dis tention was consistent with spinal hyperalgesia. The patient underwent test ing for spinal cord stimulation and spinal drug delivery. CONCLUSION: This novel finding provides direct clinical evidence for the pr esence of spinal hyperalgesia in a patient with irritable bowel syndrome, c onsistent with the existing indirect clinical evidence and animal data.