IBS-Associated Chronic Pain: Formulation of Core Diagnostic Criteria

Public-private partnership initiative develops core diagnostic criteria for abdominal, pelvic, and urogenital pain associated with irritable bowel syndrome.

The Analgesic, Anesthetic, and Addiction Clinical Trial Translations, Innovations, Opportunities, and Networks (ACTTION) public-private partnership with the US Food and Drug Administration and the American Pain Society (APS)—the ACTTION-APS Pain Taxonomy (AAPT) initiative—has developed core diagnostic criteria for abdominal, pelvic, and urogenital pain associated with irritable bowel syndrome (IBS), which have been published in The Journal of Pain.

At a consensus meeting of a multidisciplinary group of clinicians and translational scientists, a working group applied an evidence-based framework to the diagnosis of chronic abdominal, pelvic, and urogenital pain in patients with IBS. Diagnostic systems developed by AAPT include the following 5 dimensions: core diagnostic criteria; common features; common medical and psychiatric comorbidities; neurobiological, psychosocial, and functional consequences; and putative neurobiological and psychosocial mechanisms, risk factors, and protective factors.

The diagnostic criteria for dimension 1 are based on the Rome IV Diagnostic Criteria for IBS, with minor stylistic alterations. Other recommendations are based on a systematic review and synthesis.

The authors noted, “The AAPT IBS criteria are part of an evidence-based classification system that provides a consistent vocabulary regarding diagnostic criteria, common features, comorbidities, consequences, and putative mechanisms of the disorder.”

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They added that future efforts “will subject these proposed AAPT criteria to systematic empirical evaluation of their feasibility, reliability, and validity.”

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Zhou Q, Wesselmann U, Walker L,et al. AAPT diagnostic criteria for chronic abdominal, pelvic, and urogenital pain: Irritable bowel syndrome [published online October 24, 2017]. J Pain. doi: 10.1016/j.jpain.2017.10.002