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Pain management in patients with inflammatory bowel disease: translational approaches from bench to bedside.
Srinath, Arvind; Young, Erin; Szigethy, Eva.
Afiliación
  • Srinath A; *Department of Pediatric Gastroenterology, Children's Hospital of UPMC, Pittsburgh, Pennsylvania; †Department of Anesthesiology, University of Pittsburgh, Pittsburgh, Pennsylvania; and ‡Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
Inflamm Bowel Dis ; 20(12): 2433-49, 2014 Dec.
Article en En | MEDLINE | ID: mdl-25208108
ABSTRACT
Abdominal pain is a common symptom in patients with inflammatory bowel disease (IBD) that negatively affects quality of life and can lead to increased health-seeking behavior. Although abdominal pain has been traditionally attributed to inflammation, there is growing literature demonstrating the existence of functional abdominal pain in patients with IBD, of which there are a variety of potential causes. Thus, when approaching a patient with IBD who has abdominal pain, in addition to IBD-related complications (e.g., inflammation/stricture), it is important to screen for related contributors, including peripheral factors (visceral hypersensitivity, bacterial overgrowth, and bowel dysmotility) and centrally mediated neurobiological and psychosocial underpinnings. These central factors include psychological symptoms/diagnoses, sleep disturbance, and stress. Opioid-induced hyperalgesia (e.g., narcotic bowel syndrome) is also growing in recognition as a potential central source of abdominal pain. This review draws from clinical studies and animal models of colitis and abdominal pain to consider how knowledge of these potential etiologies can be used to individualize treatment of abdominal pain in patients with IBD, including consideration of potential novel treatment modalities for the future. Accurate assessment of the source(s) of pain in patients with IBD can help guide appropriate diagnostic workup and use of disease-modifying therapy.
Asunto(s)

Texto completo: 1 Base de datos: MEDLINE Asunto principal: Enfermedades Inflamatorias del Intestino / Dolor Abdominal / Investigación Biomédica Traslacional / Analgésicos Opioides Tipo de estudio: Etiology_studies / Prognostic_studies Idioma: En Revista: Inflamm Bowel Dis Asunto de la revista: GASTROENTEROLOGIA Año: 2014 Tipo del documento: Article

Texto completo: 1 Base de datos: MEDLINE Asunto principal: Enfermedades Inflamatorias del Intestino / Dolor Abdominal / Investigación Biomédica Traslacional / Analgésicos Opioides Tipo de estudio: Etiology_studies / Prognostic_studies Idioma: En Revista: Inflamm Bowel Dis Asunto de la revista: GASTROENTEROLOGIA Año: 2014 Tipo del documento: Article