Farmer Adam D, Aziz Qasim
Department of Gastroenterology, Shrewsbury & Telford Hospitals NHS Trust, Princess Royal Hospital, Apley Castle, Telford, Shropshire, UK ; Neurogastroenterology Group, Blizard Institute of Cell & Molecular Science, Wingate Institute of Neurogastroenterology, Barts and the London School of Medicine & Dentistry, Queen Mary University of London, London, UK.
Neurogastroenterology Group, Blizard Institute of Cell & Molecular Science, Wingate Institute of Neurogastroenterology, Barts and the London School of Medicine & Dentistry, Queen Mary University of London, London, UK.
Br J Pain. 2013 Feb;7(1):39-47. doi: 10.1177/2049463713479229.
Visceral pain is a highly complex entity whose experience is variable in health and disease. It can occur in patients with organic disease and also in those without any readily identifiable structural or biochemical abnormality such as in the functional gastrointestinal disorders (FGID). Despite considerable progress in our understanding of the culpable underlying mechanisms significant knowledge gaps remain, representing a significant unmet need in gastroenterology. A key, but not universal, pathological feature is that patients with FGID often display heightened sensitivity to experimental gut stimulation, termed visceral hypersensitivity. A plethora of factors have been proposed to account for this epiphenomenon including peripheral sensitization, central sensitization, aberrant central processing, genetic, psychological and abnormalities within the stress responsive systems. Further research is needed, bringing together complementary research themes from a diverse array of academic disciplines ranging from gastroenterology to nociceptive physiology to functional neuro-imaging, to address this unmet need.
内脏痛是一个高度复杂的实体,其体验在健康和疾病状态下各不相同。它可发生于患有器质性疾病的患者,也可发生于那些没有任何易于识别的结构或生化异常的患者,如功能性胃肠病(FGID)患者。尽管我们对潜在致病机制的理解取得了相当大的进展,但仍存在重大的知识空白,这代表着胃肠病学中一个尚未满足的重大需求。一个关键但并非普遍存在的病理特征是,FGID患者通常对实验性肠道刺激表现出更高的敏感性,即内脏高敏感性。人们提出了许多因素来解释这一现象,包括外周敏化、中枢敏化、异常的中枢处理、遗传、心理以及应激反应系统内的异常。需要进一步开展研究,整合从胃肠病学到伤害感受生理学再到功能性神经成像等一系列不同学科的互补性研究主题,以满足这一未被满足的需求。
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