Recent advances in chronic visceral pain.
OBJECTIVE
Chronic visceral pain is one of the most common causes of morbidity in the general population. Despite a gargantuan effort from academia and the pharmaceutical industry, an integrated understanding of the pathophysiological mechanisms of chronic visceral pain, particularly with respect to functional gastrointestinal disorders, remains incomplete.


RESULTS
Advances in our understanding of the structure and function of the microanatomy of nociception has led to the identification of a number of ion channels, neurotransmitter receptors and trophic factors that may be intimately involved in chronic visceral pain. These advances have been paralleled with those in the fields of genetics, neurophysiology and functional neuroimaging. These advances have allowed the objective assessment of central processing of visceral sensation and furthermore the factors that may modulate this process in health and disease.


CONCLUSIONS
These findings have important implications for the future direction of research. The real challenge for the future progress is to further characterize patients with chronic visceral pain in terms of their clinical phenotype, genotyping and nociceptive physiology on an individual basis towards the development of more efficacious therapeutic strategies.
Farmer
Adam D
AD
The Wingate Institute of Neurogastroenterology, Barts and the London School of Medicine and Dentistry, Whitechapel, London, UK.
Aziz
Qasim
Q
D015746:Abdominal Pain / Q000503:physiopathology*; D000344:Afferent Pathways / Q000503:physiopathology; D001341:Autonomic Nervous System / Q000503:physiopathology; D002908:Chronic Disease; D005767:Gastrointestinal Diseases / Q000503:physiopathology*; D006801:Humans; D009619:Nociceptors / Q000503:physiopathology*; D010147:Pain Measurement; D017833:Visceral Afferents / Q000503:physiopathology