Gastrointestinal pain.,Nature Reviews Disease Primers

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Gastrointestinal pain.
Nature Reviews Disease Primers ( IF 76.9 ) Pub Date : 2020-01-06 , DOI: 10.1038/s41572-019-0135-7
Asbjørn M Drewes _{1,

2} , Anne E Olesen _{1,

3} , Adam D Farmer ₄ , Eva Szigethy ₅ , Vinciane Rebours ₆ , Søren S Olesen _{1,

2}

Affiliation

Gastrointestinal (GI) pain - a form of visceral pain - is common in some disorders, such as irritable bowel syndrome, Crohn's disease and pancreatitis. However, identifying the cause of GI pain frequently represents a diagnostic challenge as the clinical presentation is often blurred by concomitant autonomic and somatic symptoms. In addition, GI pain can be nociceptive, neuropathic and associated with cancer, but in many cases multiple aetiologies coexist in an individual patient. Mechanisms of GI pain are complex and include both peripheral and central sensitization and the involvement of the autonomic nervous system, which has a role in generating the symptoms that frequently accompany pain. Treatment of GI pain depends on the precise type of pain and the primary disorder in the patient but can include, for example, pharmacological therapy, cognitive behavioural therapies, invasive surgical procedures, endoscopic procedures and lifestyle alterations. Owing to the major differences between organ involvement, disease mechanisms and individual factors, treatment always needs to be personalized and some data suggest that phenotyping and subsequent individual management of GI pain might be options in the future.

中文翻译：

肠胃痛。

胃肠道 (GI) 疼痛 - 一种内脏疼痛 - 在某些疾病中很常见，例如肠易激综合征、克罗恩病和胰腺炎。然而，识别胃肠道疼痛的原因通常是一个诊断挑战，因为临床表现常常因伴随的自主神经和躯体症状而变得模糊。此外，胃肠道疼痛可能是伤害性的、神经性的并与癌症有关，但在许多情况下，个体患者中存在多种病因。胃肠道疼痛的机制很复杂，包括外周和中枢敏化以及自主神经系统的参与，自主神经系统在产生经常伴随疼痛的症状方面发挥作用。胃肠道疼痛的治疗取决于疼痛的确切类型和患者的原发疾病，但可以包括例如药物治疗、认知行为疗法、侵入性外科手术、内窥镜手术和生活方式改变。由于器官受累、疾病机制和个体因素之间存在重大差异，治疗总是需要个性化，一些数据表明，表型分析和随后的胃肠道疼痛个体管理可能是未来的选择。

更新日期：2020-01-06

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