[Pathophysiology of abdominal pain]
1Universitätsklinik für Anästhesiologie und Schmerztherapie, Inselspital, Bern. michele.curatolo@insel.ch
Therapeutische Umschau. Revue Therapeutique
|July 29, 2011
Summary
Abdominal pain involves visceral nociceptor stimulation, often worsened by central sensitization and altered pain modulation. These central nervous system changes amplify pain and explain discrepancies between symptoms and objective findings.
Area of Science:
- Neuroscience
- Gastroenterology
- Pain Medicine
Context:
- Visceral pain arises from nociceptor stimulation, typically requiring prior sensitization by pathological conditions like inflammation or ischemia.
- Clinicians often observe that visceral pathology only partially explains patient pain complaints, sometimes in the absence of objective visceral lesions.
- Pain states are linked to significant alterations in the central processing of sensory input.
Purpose:
- To explore the role of central nervous system changes in the manifestation and perception of abdominal pain.
- To elucidate the mechanisms of central sensitization and altered endogenous pain modulation in visceral pain.
- To investigate the clinical implications of central pain processing alterations in patients with abdominal pain.
Summary:
- Activation of visceral nociceptors, often sensitized by pathology, can lead to abdominal pain.
- Central nervous system alterations, including central sensitization and impaired endogenous pain modulation, amplify pain perception and cause pain spread.
- These central changes help explain the disconnect between peripheral lesion signs and symptom severity, and are measurable in clinical practice.
Impact:
- Central hypersensitivity and altered pain modulation can be clinically measured, offering patients an explanatory model for their pain.
- Alterations in central pain processing may serve as negative prognostic factors in abdominal pain conditions.
- Understanding individual pathophysiology of central pain processing can guide the development of personalized therapeutic strategies for abdominal pain.
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