Visceral perception in functional gastro-intestinal disorders: disease marker or epiphenomenon?
The pathophysiology of functional gastro-intestinal disorders remains unclear. A relatively new approach to these disorders has been the study of visceral sensory perception. A decreased pain threshold to intraluminal balloon distension has been demonstrated in patients with irritable bowel syndrome, functional dyspepsia, and non-cardiac chest pain. This altered visceral sensitivity does not appear to extend to somatic sensation; patients have generally had normal sensory thresholds to various stimuli applied to the skin. It is uncertain whether altered gut sensation represents a primary event in the pathogenesis of disease or simply a disease marker. In this review, we examine the evidence of altered visceral sensation and discuss the implications for patient management and drug therapy.
Hu
W H
WH
Department of Medicine, University of Sydney, Nepean Hospital, Penrith, NSW, Australia.
Talley
N J
NJ
D002637:Chest Pain / Q000503:physiopathology*; D003109:Colonic Diseases, Functional / Q000188:drug therapy / Q000503:physiopathology*; D004415:Dyspepsia / Q000188:drug therapy / Q000503:physiopathology*; D005767:Gastrointestinal Diseases / Q000188:drug therapy / Q000503:physiopathology*; D006801:Humans; D017288:Pain Threshold / Q000502:physiology; D017833:Visceral Afferents / Q000503:physiopathology