Chronic Abdominal and Visceral Pain: Theory and Practice

by Pasricha; Pankaj Jay

• ISBN13: 9780849328978
• ISBN10: 0849328977
• Edition: 1st
• Format: Hardcover
• Copyright: 2006-11-02
• Publisher: CRC Press

Summary

Standing alone as the first definitive and comprehensive book on the subject, this guide describes the most recent studies on the brain-gut connection and psychosocial issues related to patients experiencing visceral pain. Bringing together leading experts from the top-tiers of the science, this source provides 33 engaging chapters and spans basic concepts in pharmacology, neurobiology, physiology, and psychology to provide a practical approach to the treatment of chronic pain.

Table of Contents

Preface	iii
Contributors	xiii
SECTION I: INTRODUCTION AND OVERVIEW OF VISCERAL AND ABDOMINAL PAIN
Distinctive Clinical and Biological Characteristics of Visceral Pain	1	(10)
T. J. Ness
Introduction	1	(1)
Clinical Visceral Pain	1	(1)
Clinical Superficial Pain	2	(1)
Psychophysical Studies of Visceral Sensation	3	(1)
Neuroanatomy of Visceral Pain	4	(1)
Differences in Spinal Pathways	5	(1)
Functional Imaging of Visceral Sensation	6	(1)
Effects of Stress on Visceral Pain	6	(1)
Silent Afferents in the Viscera	7	(1)
Are All Visceral Pains the Same?	7	(1)
References	8	(3)
Epidemiology and Socioeconomic Impact of Visceral and Abdominal Pain Syndromes	11	(6)
Smita L. S. Halder
G. Richard Locke III
Introduction	11	(1)
Abdominal Pain	11	(1)
Specific Visceral and Abdominal Pain Syndromes	12	(3)
Conclusions	15	(1)
References	15	(2)
SECTION II: THE NEUROBIOLOGY AND PSYCHOBIOLOGY OF CHRONIC VISCERAL PAIN
Overview of Pain and Sensitization	17	(16)
Michael S. Gold
What is Pain?	17	(1)
Pain Terminology	18	(9)
Summary and Conclusions	27	(1)
References	27	(6)
Neuroanatomy of Visceral Pain: Pathways and Processes	33	(12)
Elie D. Al-Chaer
William D. Willis
Peripheral Pathways	33	(1)
Central Pathways	34	(4)
Representation of Visceral Sensation in the Brain	38	(1)
References	39	(6)
The Neurobiology of Visceral Nociceptors	45	(22)
Stuart M. Brierley
L. Ashley Blackshaw
Introduction	45	(1)
Irritable Bowel Syndrome	45	(1)
Sensory Innervation of the Gastrointestinal Tract	46	(14)
Conclusions	60	(1)
References	60	(7)
Neurochemical and Molecular Basis of Peripheral Sensitization	67	(18)
Klaus Bielefeldt
Introduction	67	(1)
Ion Channels as Transducers	67	(8)
Synaptic Transmission	75	(1)
Nerve-Immune Interactions and Peripheral Sensitization	76	(1)
Peripheral Sensitization and Visceral Pain Syndromes	77	(1)
References	78	(7)
Spinal Mechanisms of Visceral Pain and Sensitization	85	(22)
Richard J. Traub
Introduction	85	(1)
Visceral Afferent Organization Contributing to Visceral Pain and Hyperalgesia	86	(2)
Referred Pain and Hyperalgesia: Convergence of the Somatic and Visceral Body	88	(3)
Measurement of Experimental Visceral Pain and Hyperalgesia	91	(4)
Pharmacology of Spinal Processing of Visceral Pain	95	(2)
Gonadal Hormone Modulation of Visceral Pain	97	(1)
Conclusions and a Hypothesis	97	(1)
References	98	(9)
Animal Models of Visceral Pain	107	(20)
David R. Robinson
G. F. Gebhart
Introduction	107	(2)
The Cardiopulmonary System	109	(2)
The Gastrointestinal Tract	111	(5)
The Genitourinary Tract	116	(5)
Closing Notes	121	(1)
References	121	(6)
Measuring Pain and Hyperalgesia in Persistent Pain Conditions with a Special Emphasis on Irritable Bowel Syndrome	127	(14)
Donald D. Price
Michael E. Robinson
G. Nicholas Verne
Introduction	127	(1)
General Considerations Concerning Pain Measurement	127	(1)
Psychophysical Characterization of Pathophysiological Pain	128	(4)
Testing Visceral and Cutaneous Hyperalgesia in Irritable Bowel Syndrome Patients	132	(5)
Conclusions and Future Implications	137	(1)
References	138	(3)
Mechanisms of Visceral Sensitization in Humans	141	(20)
Abhishek Sharma
Q. Aziz
Background	141	(1)
The Modulation of Pain Perception	141	(1)
Visceral Hypersensitivity	141	(8)
Variability in the Development of Sensitized States	149	(1)
Mechanisms of Visceral Sensitization in Functional Gastrointestinal Disorder	150	(4)
Summary	154	(1)
References	155	(6)
Visceral Pain: Lessons from Functional Brain Imaging	161	(16)
Emeran A. Mayer
Bruce Naliboff
Introduction	161	(1)
Review of Published Studies on Brain Responses to Visceral Stimuli	161	(10)
Conclusions and Future Directions	171	(1)
References	172	(5)
The Neural Basis of Referred Visceral Pain	177	(16)
Maria Adele Giamberardino
Fernando Cervero
Introduction	177	(1)
Referred Pain Phenomena in the Clinical Context	177	(3)
Referred Pain Phenomena in the Experimental Context	180	(3)
Neurophysiological Basis of Referred Pain	183	(6)
Conclusion	189	(1)
References	189	(4)
From Sensation to Perception: The Gut-Brain Connection	193	(12)
Fernando Azpiroz
General Overview	193	(1)
Evaluation of Visceral Sensitivity in Humans	194	(3)
Modulation of Visceral Perception	197	(1)
Dysfunction of the Sensory System: Functional Gut Disorders	198	(3)
References	201	(4)
Stress, Visceral Pain, and the Brain-Gut Connections	205	(16)
Yvette Tache
Mulugeta Million
Introduction	205	(1)
Stress-Induced Visceral Hyperalgesia	205	(3)
Stress-Induced Somatic and Visceral Hypoalgesia	208	(1)
CRF/CRF1 Receptors and the Biochemical Coding of Stress	209	(1)
Brain CRF/CRF1-Signaling Pathways in Stress-Related Visceral Hyperalgesia	210	(3)
Conclusions	213	(1)
References	213	(8)
The Biopsychosocial Continuum in Visceral Pain in Chronic Abdominal and Visceral Pain: Theory and Practice	221	(10)
Douglas A. Drossman
Introduction	221	(1)
The Biopsychosocial Continuum	222	(1)
Pathophysiology	223	(4)
Clinical Presentation Based on Severity of Pain and Implications for Treatment	227	(1)
Conclusion	228	(1)
References	229	(2)
Chronic Pain and Addiction	231	(14)
Howard Heit
Douglas Gourlay
Introduction	231	(1)
Binary Concept of Pain and Addiction	231	(1)
Pain and Opioid Addiction---A Continuum Approach	232	(1)
Basic Science of Addiction	233	(1)
Addiction	234	(1)
Physical Dependence	234	(1)
Tolerance	234	(2)
Basic Concepts in the Use of Opioids	236	(1)
Modified-Release Delivery Systems	237	(1)
Long-acting Drugs	238	(1)
Opioids for Analgesia or Opioid Stabilizing Effect?	238	(1)
Universal Precautions in Pain Medicine	239	(1)
Group I Primary Care Management	239	(1)
Group II Primary Care with Consultative Support	239	(1)
Group III Specialty Referral	240	(1)
Classification of Pain	240	(1)
Specific Pain Condition	241	(1)
Federal Regulations for Prescribing a Scheduled Controlled Substance	241	(1)
Conclusion	242	(1)
References	243	(2)
SECTION III: THERAPY FOR VISCERAL PAIN: SCIENTIFIC BASIS AND PRACTICE ASPECTS
Treating Visceral Pain Via Molecular Targets on Afferent Neurons: Current and Future	245	(26)
Peter Holzer
Visceral Pain Therapy: Current and Future	245	(1)
Sensory Neurons and GI Hypersensitivity	245	(1)
Criteria for the Design of Efficacious Sensory Neuron-Targeting Drugs	246	(1)
Three Classes of Sensory Neuron-Targeting Drugs	247	(1)
Sensory Neuron-Specific Receptors and Sensors	247	(6)
Ion Channels Regulating Sensory Nerve Excitability, Conduction, and Transmission	253	(1)
Receptors Relevant to Afferent Neuron Transmission	254	(4)
Conclusions	258	(1)
References	259	(12)
Management of the Patient with Chronic Abdominal Pain and Clinical Pharmacology of Nonopioid Drugs	271	(16)
Michael Camilleri
Introduction	271	(1)
Establishing a Roadmap	271	(11)
Conclusion	282	(1)
References	282	(5)
Pharmacology and Practice of Opioid Drugs for Visceral Pain	287	(14)
Jane C. Ballantyne
Introduction	287	(1)
Pharmacology	287	(4)
Acute Visceral Pain	291	(1)
Long-Term Opioid Treatment and its Liabilities	291	(3)
Psychosomatic Gastrointestinal and Genitourinary Disease	294	(1)
Specific Conditions	295	(1)
Conclusion	296	(1)
References	297	(4)
Clinical Approach to Visceral Cancer Pain	301	(10)
Sebastiano Mercadante
Mechanisms	301	(1)
Clinical Implications in Cancer Pain	301	(1)
Treatment	302	(4)
Techniques	306	(2)
Conclusion	308	(1)
References	308	(3)
Neuromodulation Techniques for Visceral Pain from Benign Disorders	311	(12)
Charles D. Brooker
Michael J. Cousins
Introduction	311	(1)
Intrathecal Drug Therapy	312	(3)
Electrical Stimulation Techniques	315	(3)
Neurolytic Techniques	318	(1)
References	319	(4)
Psychological Interventions for Patients with Chronic Abdominal and Pelvic Pain	323	(8)
Luis F. Buenaver
Robert Edwards
Jennifer A. Haythornthwaite
Introduction	323	(1)
Biofeedback	324	(1)
Hypnosis	324	(1)
Cognitive Behavior Therapy	325	(1)
Multidisciplinary Treatment	326	(1)
Future Directions	326	(1)
References	327	(4)
Complementary and Integrative Medicine Approaches to Visceral Pain	331	(10)
Victor S. Sierpina
Indumathi Kuncharapu
Introduction	331	(1)
Case Study	332	(1)
Biological Therapies	333	(2)
Mind-Body Therapies	335	(1)
Manual Therapies	335	(1)
Alternative Systems of Care	336	(1)
Bioenergetic Therapies	337	(1)
Summary	337	(1)
References	338	(3)
SECTION IV: CLINICAL SYNDROMES: PATHOPHYSIOLOGY, DIAGNOSIS AND MANAGEMENT
Irritable Bowel Syndrome and Functional Abdominal Pain Syndromes: Pathophysiology	341	(32)
Andrew W. DuPont
Pankaj Jay Pasricha
Introduction and Nature of the Problem	341	(1)
Is Pain Secondary to Motility Abnormalities in IBS?	342	(1)
Is Pain Secondary to Disturbances in Sensory Processing (Visceral Hypersensitivity)?	343	(2)
Visceral Hypersensitivity: Central or Peripheral?	345	(5)
Etiopathogenesis of Visceral Hypersensitivity	350	(3)
Conclusions	353	(1)
References	353	(4)
Irritable Bowel Syndrome and Functional Abdominal Pain Syndromes: Clinical Features and Management	357	(1)
Lin Chang
Lucinda Harris
Introduction	357	(1)
Irritable Bowel Syndrome	358	(9)
Functional Abdominal Pain Syndrome	367	(1)
Conclusion	367	(1)
References	368	(5)
Noncardiac Chest Pain: Pathophysiology	373	(26)
Premjit S. Chahal
Satish S. C. Rao
Introduction	373	(5)
Conclusion	378	(1)
References	378	(3)
Noncardiac Chest Pain: Clinical Features and Management	381	(1)
Ronnie Fass
Ram Dickman
Introduction	381	(1)
History and Clinical Presentation	381	(1)
Epidemiology	382	(1)
Diagnosis	383	(6)
Treatment	389	(5)
Summary	394	(1)
References	395	(4)
Pathophysiology of Functional Dyspepsia	399	(16)
Jan Tack
Definitions	399	(1)
Dyspepsia Symptom Pattern	399	(1)
Subgroups of Functional Dyspepsia Patients	399	(1)
Putative Pathophysiological Mechanisms	400	(1)
Pathogenesis of Functional Dyspepsia	401	(1)
References	402	(2)
Dyspepsia: Clinical Features and Management	404	(1)
Nimish Vakil
Definitions	404	(1)
Prevalence	405	(1)
Differential Diagnosis	405	(1)
Clinical Diagnosis	406	(1)
Alarm Features	406	(1)
Management Strategies	406	(5)
References	411	(4)
Pathophysiology and Management of Pain in Chronic Pancreatitis	415	(12)
John H. Winston
Pankaj Jay Pasricha
Background and Nature of The Problem	415	(1)
Pathogenesis of Pain in Chronic Pancreatitis	415	(8)
References	423	(4)
Abdominal Wall Pain	427	(10)
David S. Greenbaum
Economic Costs	427	(1)
Prevalence	428	(1)
Nonrecognition of CAWP	428	(1)
Etiologies	428	(2)
Clinical History	430	(1)
Physical Examination	430	(1)
Reliability of Diagnosis	431	(1)
Management	432	(1)
Conclusions	433	(1)
References	434	(3)
Unexplained Visceral-Pain in Children: Pathophysiology, Clinical Features, and Management	437	(16)
Robert J. Shulman
Danita Czyzewski
Margaret Heitkemper
Introduction	437	(1)
RAP - Functional Abdominal Pain and Irritable Bowel Syndrome	438	(9)
Functional Dyspepsia	447	(1)
Summary	448	(1)
References	448	(5)
Functional Biliary Type Pain Syndromes	453	(10)
Arnold Wald
Introduction	453	(1)
Definitions	453	(1)
Epidemiology	453	(1)
Gallbladder and Biliary Anatomy and Physiology	454	(1)
Functional (Acalculous) Biliary Type Pain	454	(4)
Postcholecystectomy Functional Biliary Type Pain	458	(2)
Conclusions	460	(1)
References	460	(3)
SECTION V: PELVIC PAIN SYNDROMES
Pelvic Pain Syndromes: Pathophysiology	463	(16)
Charles H. Hubscher
Harpreet K. Chadha
Ezidin G. Kaddumi
Introduction	463	(1)
Females	463	(9)
References	472	(7)
Pelvic Pain Syndromes: Clinical Features and Management	479	(16)
Jane Moore
Stephen Kennedy
Introduction	479	(1)
Definitions and Epidemiology	479	(7)
Treatment	486	(3)
Vulval Pain	489	(1)
Conclusion	490	(1)
References	490	(5)
Interstitial Cystitis and Related Painful Bladder Syndromes: Pathophysiology	495	(26)
Naoki Yoshimura
Lori A. Birder
Introduction	495	(1)
Disease Process	495	(17)
Conclusion	512	(1)
References	512	(9)
Index	521