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Centrally Targeted Pharmacotherapy for Chronic Abdominal Pain: Understanding and Management

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Gastrointestinal Pharmacology

Part of the book series: Handbook of Experimental Pharmacology ((HEP,volume 239))

Abstract

Chronic abdominal pain has a widespread impact on the individual and the society. Identifying and explaining mechanisms of importance for the pain experience within a biopsychosocial context are central in order to select treatment that has a chance for symptom reduction. With current knowledge of brain–gut interactions, chronic abdominal pain, which mostly appears in functional gastrointestinal disorders, to a large extent involves pain mechanisms residing within the brain. As such, the use of centrally targeted pharmacotherapy as an effective treatment option is obvious in a selected number of patients. The antidepressants are most common, but also other classes of medications can be used, either alone or in combination. The latter option refers to when there is insufficient effect of one drug alone or side effects limiting dosage, and when combined in lower doses, certain drugs give rise to augmentation effects. This chapter outlines basic mechanisms of importance for the understanding of chronic abdominal pain and the pharmacologic treatment options.

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Authors and Affiliations

  1. Dept of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, SE-41345, Gothenburg, Sweden

    Hans Törnblom

  2. Drossman Center for the Education and Practice of Biopsychosocial Care, Professor Emeritus of Medicine and Psychiatry, UNC Center for Functional GI and Motility Disorders, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Douglas A. Drossman

  3. Drossman Gastroenterology PLLC, Chapel Hill, NC, USA

    Douglas A. Drossman

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Correspondence to Hans Törnblom .

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  1. Health Sciences Center, The University of Oklahoma, Oklahoma City, Oklahoma, USA

    Beverley Greenwood-Van Meerveld

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Törnblom, H., Drossman, D.A. (2016). Centrally Targeted Pharmacotherapy for Chronic Abdominal Pain: Understanding and Management. In: Greenwood-Van Meerveld, B. (eds) Gastrointestinal Pharmacology . Handbook of Experimental Pharmacology, vol 239. Springer, Cham. https://doi.org/10.1007/164_2016_106

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