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Trastornos de Dolor Gastrointestinal Mediados Centralmente
Shin Fukudo1, Qasim Aziz2, Douglas A Drossman3
1Tohoku University Graduate School of Medicine, Research Center for Accelerator and Radioisotope Science, Tohoku University, Sendai, Japanese Red Cross Ishinomaki Hospital, Ishinomaki, Japan.
Gastroenterology
|February 15, 2026
Resumen
Este estudio detalla tres trastornos centrales del dolor gastrointestinal: síndrome de dolor abdominal de mediación central, migraña abdominal e hiperalgesia gastrointestinal inducida por opioides. El manejo efectivo implica farmacoterapia, terapia conductual y una sólida relación médico-paciente.
Área de la Ciencia:
- Gastroenterología
- Neurociencia
- Medicina del Dolor
Sus antecedentes:
- Los trastornos del dolor gastrointestinal mediados centralmente son cada vez más reconocidos.
- Estas afecciones implican un procesamiento alterado de las señales de dolor visceral en el sistema nervioso central.
Objetivo del estudio:
- Identificar y describir tres trastornos del dolor gastrointestinal mediados centralmente.
- Esbozar su epidemiología, fisiopatología, evaluación clínica y opciones de tratamiento.
Principales métodos:
- Revisión de la literatura existente sobre el síndrome de dolor abdominal de mediación central, la migraña abdominal y el síndrome del intestino narcótico/hiperalgesia gastrointestinal inducida por opioides.
- Síntesis de información sobre fisiopatología, presentación clínica y estrategias terapéuticas.
Principales resultados:
- El síndrome de dolor abdominal de mediación central se presenta como dolor crónico, con o sin asociación a eventos fisiológicos, impulsado por la sensibilización central.
- La migraña abdominal se caracteriza por episodios recurrentes y estereotipados de dolor abdominal intenso en adultos.
- El síndrome del intestino narcótico/hiperalgesia gastrointestinal inducida por opioides implica un aumento paradójico del dolor con el uso de opioides.
Conclusiones:
- El manejo efectivo requiere un enfoque multimodal que incluya farmacoterapia, terapia conductual cerebro-intestino y neuromodulación.
- Una sólida relación médico-paciente es crucial para obtener resultados de tratamiento exitosos.
- La comprensión de la sensibilización central es clave para abordar estos complejos trastornos del dolor.
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