Abdominal pain localization is associated with non-diarrheic Rome III functional gastrointestinal disorders

Neurogastroenterol Motil. 2013 Aug;25(8):686-93. doi: 10.1111/nmo.12149. Epub 2013 May 27.


Background: Abdominal pain is common in patients with functional bowel disorders (FBDs). The aim of this study was to characterize the predominant sites of abdominal pain associated with FBD subtypes, as defined by the Rome III criteria.

Methods: A total of 584 consecutive patients attending FBD consultations in a tertiary center participated in the study. Stool form, abdominal pain location (nine abdominal segments), and pain intensity (10-point Likert scale) during the previous week were recorded. Logistic regression analysis was used to characterize the association of abdominal pain sites with specific FBD subtypes.

Key results: FBDs were associated with predominant pain sites. Irritable bowel syndrome (IBS) with constipation was associated with pain in the left flank and patients were less likely to report pain in the right hypochondrium. Patients with functional constipation reported pain in the right hypochondrium and were less likely to report pain in the left flank and left iliac site. IBS with alternating constipation and diarrhea was associated with pain in the right flank, and unsubtyped IBS with pain in the hypogastrium Patients with functional abdominal pain syndrome reported the lower right flank as predominant pain site. Patients with unspecified FBDs were least likely to report pain in the hypogastrium. Patients with functional diarrhea, IBS with diarrhea, or functional bloating did not report specific pain sites.

Conclusions & inferences: The results from this study provide the basis for developing new criteria allowing for the identification of homogeneous groups of patients with non-diarrheic FBDs based on characteristic sites of pain.

Keywords: Rome III; abdominal pain; constipation; diarrhea; functional bowel disorders; irritable bowel syndrome.

MeSH terms

  • Abdominal Pain / diagnosis*
  • Abdominal Pain / epidemiology*
  • Abdominal Pain / physiopathology
  • Adult
  • Diarrhea*
  • Female
  • Gastrointestinal Diseases / diagnosis*
  • Gastrointestinal Diseases / epidemiology*
  • Gastrointestinal Diseases / physiopathology
  • Humans
  • Male
  • Middle Aged
  • Pain Measurement / methods
  • Prospective Studies