Gupta Mayank, Patil Anand S, Staats Peter, Schatman Michael E, Kalia Hemant, Sayed Dawood, Soin Amol, Baranidharan Ganesan, Kapural Leonardo, Chitneni Ahish, Verrills Paul, Diwan Sudhir, Abd-Elsayed Alaa A, Deer Timothy R
Kansas Pain Management and Neuroscience Research Center, Overland Park, KS, USA.
St. Luke's Rehabilitation Medical Center, Spokane, WA, USA.
J Pain Res. 2025 Jul 8;18:3451-3462. doi: 10.2147/JPR.S524853. eCollection 2025.
Chronic Abdominal Discomfort Syndrome (CADS) is a recently proposed term that is a subclassification of Chronic Abdominal Pain, characterized by symptoms affecting clinical, diagnostic, and functional domains. Patients with CADS often have a history of abdominal surgery and experience chronic gastrointestinal symptoms such as nausea, bloating, vomiting, and dyspepsia. This review explores the underlying pathophysiology of CADS, emphasizing the role of the sympathetic and parasympathetic nervous systems in pain transmission. Various pharmacological treatments are discussed, including acid suppressants, antispasmodics, and analgesics, highlighting their effectiveness and limitations. Non-pharmacological approaches such as intrathecal pumps, nerve blocks, peripheral nerve stimulation, and spinal cord stimulation are also examined, providing insights into interventional pain management strategies. The review underscores the necessity of an individualized treatment algorithm due to the complexity of CADS and the multiple pain generators involved. Ultimately, this paper advocates for a structured approach to CADS treatment, incorporating both emerging and established therapeutic options.
慢性腹部不适综合征(CADS)是最近提出的一个术语,它是慢性腹痛的一个子分类,其特征是症状影响临床、诊断和功能领域。CADS患者通常有腹部手术史,并经历慢性胃肠道症状,如恶心、腹胀、呕吐和消化不良。本综述探讨了CADS的潜在病理生理学,强调了交感神经系统和副交感神经系统在疼痛传递中的作用。讨论了各种药物治疗方法,包括抑酸剂、解痉药和镇痛药,突出了它们的有效性和局限性。还研究了非药物方法,如鞘内泵、神经阻滞、外周神经刺激和脊髓刺激,为介入性疼痛管理策略提供了见解。由于CADS的复杂性和涉及的多个疼痛产生源,本综述强调了个性化治疗方案的必要性。最终,本文主张采用结构化方法治疗CADS,将新兴和已确立的治疗选择结合起来。