Visceral Hypersensitivity

摘要

Physicians have long appreciated that visceral inflammation or insult is associated with an increase in tenderness to palpation and an enlargement of the area of referred sensation. For example, the flank muscle becomes sensitive to palpation when a kidney stone is passed, and tenderness and pain are common throughout the abdomen in acute appendicitis. The correlation between the amount of visceral pathology and the intensity of visceral pain is poor, and circumstances of significant pathology, such as ulcerative colitis or gastric ulceration, are not reliably associated with significant pain. Conversely, several gastrointestinal disorders characterized by the absence of tissue damage or apparent pathology are commonly associated with altered sensations from the gastrointestinal tract. These functional gastrointestinal disorders (FGIDs), including functional or non-ulcer dyspepsia, noncardiac chest pain, and irritable bowel syndrome (IBS), show increased responses to balloon distension of the organ and increased areas of referred sensation.