Abstract
In conjunction with the Analgesic, Anesthetic, and Addiction Clinical Trial Translations,
Innovations, Opportunities, and Networks public-private partnership with the U.S.
Food and Drug Administration and the American Pain Society, the Analgesic, Anesthetic,
and Addiction Clinical Trial Translations, Innovations, Opportunities, and Networks-American
Pain Society Pain Taxonomy (AAPT) initiative strove to develop the characteristics
of a diagnostic system useful for clinical and research purposes across disciplines
and types of chronic pain conditions. After the establishment of these characteristics,
a working group of clinicians and clinical and basic scientists with expertise in
abdominal, pelvic, and urogenital pain began generating core diagnostic criteria and
defining the related extraintestinal somatic pain and other symptoms experienced by
patients. Systematic diagnostic criteria for several common abdominal, pelvic, and
urogenital pain conditions are in development. In this report, we present the proposed
AAPT criteria for irritable bowel syndrome (IBS), the most common chronic, noncancer
abdominal pain condition. A systematic review and synthesis was conducted to complement
the Rome IV Diagnostic Criteria for IBS. Future efforts will subject these proposed
AAPT criteria to systematic empirical evaluation of their feasibility, reliability,
and validity. 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. A similar approach
is being applied to other chronic and often debilitating abdominal, pelvic, and urogenital
pain conditions.
Perspective
The AAPT's goal is to develop an evidence-based taxonomy for chronic pain on the basis
of a consistently applied multidimensional framework, and encourage experts to apply
this taxonomy to specific chronic pain conditions. In this report, the taxonomy is
applied to IBS, a chronic abdominal pain condition.
Key words
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Article info
Publication history
Published online: October 25, 2017
Footnotes
Supported by the National Institute of Diabetes and Digestive and Kidney Diseases (DK099052) and the Department of Veterans Affairs (CX001477-01).
The views expressed in this article are those of the authors. No official endorsement by the U.S. Food and Drug Administration (FDA) should be inferred. Support was provided by the Analgesic, Anesthetic, and Addiction Clinical Trial Translations, Innovations, Opportunities, and Networks (ACTTION) public-private partnership with the FDA, which has received contracts, grants, and other revenue for its activities from the FDA, multiple pharmaceutical and device companies, philanthropy, and other sources. A complete list of current ACTTION sponsors is available at: http://www.acttion.org/partners.
Ursula Wesselmann serves as a special government employee of the FDA Anesthetic and Analgesic Drug Products Advisory Committee. She has served as a consultant for Ironwood Pharmaceuticals, Inc. Lonnie Zeltzer serves as a special government employee of the FDA Anesthetic and Analgesic Drug Products Advisory Committee. She also is on the Speaker's Bureau of Sanofi to talk with families with genetic diseases about pain management; she is also on a special committee on pain in sickle cell disease for the National Heart, Lung, and Blood Institute of the National Institutes of Health. The remaining authors have no conflicts of interest to declare.
Identification
Copyright
© Published by Elsevier Inc. on behalf of the American Pain Society
