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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

Abstract:

We identify three centrally mediated disorders of gastrointestinal pain in the context of epidemiology, pathophysiology, clinical evaluation and treatment, including pharmacotherapy, brain-gut behavioral therapy and neuromodulation, with emphasis on the importance of a physician-patient relationship. Centrally mediated abdominal pain syndrome is characterized by chronic continuous abdominal pain. It has two main categories: Category A, where the pain occurs without association with physiological events, while in Category B, there is a variable association of pain with physiological events. It is thought to be predominantly a result of central sensitization with altered processing of visceral pain by spinal and brain networks rather than heightened peripheral afferent nerve excitability. Abdominal migraine is newly recognized in adults with paroxysmal, stereotypical episodes of intense abdominal pain. Narcotic bowel syndrome/opioid-induced gastrointestinal hyperalgesia is characterized by the paradoxical development of, or increases in, abdominal pain associated with continuous or increasing dosages of opioids.

Palabras clave:

Migraña abdominal Sensibilización central Síndrome de dolor abdominal de mediación central Síndrome del intestino narcótico/hiperalgesia gastrointestinal inducida por opioides

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