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Intraoperative Detection of Subtle Endometriosis: A Novel Paradigm for Detection and Treatment of Pelvic Pain Associated with the Loss of Peritoneal Integrity

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Stress and recurrent abdominal pain.

Gösta Alfvén¹, Eva Andersson^2,3,4

¹Clintec, Karolinska Institute, Stockholm, Sweden.

Acta Paediatrica (Oslo, Norway : 1992)

|August 11, 2023

Summary

Recurrent abdominal pain may stem from psychogenic factors, with stress activating the brain-gut axis. The startle reflex plays a key role in widespread pain experienced during stress.

Keywords:

abdominal pain chronic stress functional pain psychosomatic startle reflex

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Area of Science:

Gastroenterology
Psychology
Neuroscience

Background:

Functional Gastrointestinal Disorders (FGIDs) are common.
Recurrent abdominal pain of non-organic origin is a significant FGID.
Psychogenic factors are increasingly recognized in FGIDs.

Purpose of the Study:

To explore the aetiology of non-organic recurrent abdominal pain.
To examine the role of the psychogenic hypothesis and the Rome Criteria.
To investigate the influence of stress and the startle reflex on pain.

Main Methods:

Review of literature on functional gastrointestinal disorders.
Application of the Rome Criteria for diagnosis.
Analysis of the psychogenic hypothesis linking stress to pain.

Main Results:

Stress activates the brain-gut axis, contributing to local gut symptoms like abdominal pain.
Stress-induced pain is not limited to the abdomen but can manifest in other body areas.
The startle reflex appears to be a dominant factor in this generalized stress-induced pain pattern.

Conclusions:

Non-organic recurrent abdominal pain can be understood within a psychogenic framework.
The brain-gut axis and startle reflex are crucial in mediating stress-related pain.
Abdominal pain may be one component of a broader stress response causing multifocal pain.