Novel therapeutic targets for chronic visceral pain in gastrointestinal disorders

Chronic visceral pain imposes a major clinical challenge in gastroenterology and beyond, profoundly impacting patients' quality of life. However, limited understanding of its complex, multifaceted pathophysiology, encompassing both peripheral and central mechanisms, continues to impede the development of effective management strategies. This underscores the need for novel, targeted therapeutic approaches. Current treatment in gastroenterology often relies on conventional analgesics, including opioids, which are associated with adverse effects and limited long-term efficacy. As a result, alternative pharmacological options need to be explored. Neuromodulators, such as tricyclic antidepressants and gabapentinoids, have demonstrated therapeutic benefit, particularly in the context of central sensitization. Advances in the understanding of molecular mediators, including neurokinins, have prompted the development of receptor-targeted therapies. Nonetheless, clinical evidence remains limited and warrants further investigation. In parallel, non-pharmacological strategies, including neurostimulation and psychotherapy, are being explored. Collectively, these emerging approaches underscore the need for a mechanism-based, multimodal treatment paradigm.