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Etiology and Mechanisms of Chronic Abdominal Pain

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Abstract

Pain is a complex and multidimensional process which involves physical, emotional, and perceptual integration. It has the fundamental objective of survival and protecting against tissue damage. In normal conditions, this process is adaptive and has a protective role, which is usually self-limited. However, in pathological conditions neuroplastic changes lead to persistent increased perception and responsiveness to noxious stimuli, or response to normally non-noxious stimuli. Such changes can occur in primary afferent terminals (peripheral sensitization) but also in the spinal cord and in the brain (central sensitization) in both neurons and glia, thereby altering the processing of sensory information. Recent information suggests that intestinal microorganisms have the ability to alter intestinal sensation and perhaps may alter mood as well, as there is a bilateral communication between luminal gut inhabitants and the peripheral and central nervous systems. These processes are very important in the development and persistence of visceral pain in several locations, predominantly gastrointestinal chronic pain syndromes.

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Authors and Affiliations

  1. Pediatric GI, Massachusetts General Hospital, 175 Cambridge ST, Room 575, Boston, MA, 02114, USA

    Jaime Belkind-Gerson M.D., M.Sc.

  2. GI Unit, Massachusetts General Hospital, GRJ 719, 55 Fruit St, Boston, MA, 02114, USA

    Braden Kuo M.D., M.Sc.

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  1. Jaime Belkind-Gerson M.D., M.Sc.
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  2. Braden Kuo M.D., M.Sc.
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Editors and Affiliations

  1. Medical Director, Carolinas Pain Institute and Clinical Research Center, Professor of Anesthesiology, Wake Forest University, School of Medicine, Winston-Salem, North Carolina, USA

    Leonardo Kapural

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Belkind-Gerson, J., Kuo, B. (2015). Etiology and Mechanisms of Chronic Abdominal Pain. In: Kapural, L. (eds) Chronic Abdominal Pain. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-1992-5_1

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