Basic and clinical aspects of visceral sensation: transmission in the CNS.
Pain and discomfort are the leading cause for consultative visits to gastroenterologists. Acute pain should be considered a symptom of an underlying disease, thereby serving a physiologically important function. However, many patients experience chronic pain in the absence of potentially harmful stimuli or disorders, turning pain into the primary problem rather than a symptom. Vagal and spinal afferents both contribute to the sensory component of the gut-brain axis. Current evidence suggests that they convey different elements of the complex sensory experience. Spinal afferents play a key role in the discriminatory dimension, while vagal input primarily affects the strong emotional and autonomic reactions to noxious visceral stimuli. Drugs, surgical and non-pharmacological treatments can target these pathways and provide therapeutic options for patients with chronic visceral pain syndromes.
Bielefeldt
K
K
Department of Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA. bielefeldtk@dom.pitt.edu
Christianson
J A
JA
Davis
B M
BM
D000344:Afferent Pathways / Q000033:anatomy & histology / Q000502:physiology*; D000818:Animals; D002490:Central Nervous System / Q000033:anatomy & histology / Q000502:physiology*; D006801:Humans; D012677:Sensation / Q000502:physiology*; D014781:Viscera / Q000294:innervation*; D017833:Visceral Afferents / Q000033:anatomy & histology / Q000502:physiology*