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Visceral pain hypersensitivity in functional gastrointestinal disorders
1Neurogastroenterology Group, The Wingate Institute of Neurogastroenterology, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, Whitechapel, London E1 2AJ, UK.
British Medical Bulletin
|July 22, 2009
Summary
Visceral pain hypersensitivity (VPH) in functional gastrointestinal disorders (FGIDs) involves complex mechanisms from the nervous system to genetics. Personalized patient characterization is key for effective VPH treatment development.
Area of Science:
- Gastroenterology and Pain Research
- Neuroscience and Genetics
Background:
- Functional gastrointestinal disorders (FGIDs) are common, symptom-based conditions lacking clear structural abnormalities.
- Visceral pain hypersensitivity (VPH), heightened pain sensitivity to visceral stimuli, is a key feature in a subset of FGID patients.
Purpose of the Study:
- To review recent advances in the mechanisms underlying visceral pain hypersensitivity (VPH).
- To explore the pathophysiology of VPH in functional gastrointestinal disorders (FGIDs).
Main Methods:
- Literature review of recent scientific publications.
- Analysis of evidence for mechanisms involved in VPH pathophysiology.
Main Results:
- VPH arises from anomalies across the visceral nociceptive neuraxis, involving peripheral and central sensitization.
- Mechanisms include ion channels, neurotransmitter receptors, trophic factors, aberrant brain processing, and autonomic/HPA axis modulation.
- Treatment development for VPH remains challenging due to safety concerns.
Conclusions:
- Genome-wide association studies may illuminate the genetic basis of VPH.
- Effective VPH treatment requires individualized patient characterization based on phenotype, genetics, and physiology.
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