Most of us live blissfully unaware of the orchestrated function that our internal organs conduct. When this peace is interrupted, it is often by routine sensations of hunger and urge. However, for >20% of the global population, chronic visceral pain is an unpleasant and often excruciating reminder of the existence of our internal organs. In many cases, there is no obvious underlying pathological cause of the pain. Accordingly, chronic visceral pain is debilitating, reduces the quality of life of sufferers, and has large concomitant socioeconomic costs. In this review, we highlight key mechanisms underlying chronic abdominal and pelvic pain associated with functional and inflammatory disorders of the gastrointestinal and urinary tracts. This includes how the colon and bladder are innervated by specialized subclasses of spinal afferents, how these afferents become sensitized in highly dynamic signaling environments, and the subsequent development of neuroplasticity within visceral pain pathways. We also highlight key contributing factors, including alterations in commensal bacteria, altered mucosal permeability, epithelial interactions with afferent nerves, alterations in immune or stress responses, and cross talk between these two adjacent organs.

中文翻译：

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内脏痛。

我们大多数人过着幸福的生活，没有意识到我们内部器官所执行的协调功能。当这种和平被打断时，通常是饥饿和敦促的日常感觉。但是，对于全球超过20％的人口来说，慢性内脏痛令人不快，而且经常令人不禁想起我们内部器官的存在。在许多情况下，没有明显的潜在病理原因引起的疼痛。因此，慢性内脏痛使人衰弱，降低了患者的生活质量，并且伴随着巨大的社会经济成本。在这篇综述中，我们重点介绍了与胃肠道和泌尿道的功能性和炎症性疾病相关的慢性腹部和盆腔疼痛的关键机制。这包括如何通过特殊的脊髓传入子类来支配结肠和膀胱，这些传入感受如何在高度动态的信号环境中变得敏感，以及内脏疼痛途径内神经可塑性的后续发展。我们还重点介绍了关键的影响因素，包括共生细菌的改变，粘膜通透性的改变，与传入神经的上皮相互作用，免疫或压力反应的改变以及这两个相邻器官之间的串扰。