Introduction
Functional abdominal pain syndrome is also known as centrally mediated abdominal pain syndrome. It is a less common disorder characterized by abdominal pain, which is chronic and frequently recurring. It has no relation to any other medical condition or any changes in the bowel pattern. It is a functional gastrointestinal disorder due to the altered sensitivity of nerve impulses in the gut and the brain. No laboratory findings or abnormalities are seen in the X-rays of patients suffering from abdominal pain syndrome. The pain caused can be severe and becomes the main focus of the individual as it is so consuming.
What Causes Abdominal Pain Syndrome?
It is important to understand the cause of abdominal pain syndrome or centrally mediated abdominal pain syndrome to understand the phenomenon of pain in the body. Several areas of the brain are involved in the occurrence of abdominal pain. One of these areas controls the location and intensity of pain, and the other is concerned with emotions and memories. This is why pain can be associated with emotions or life experiences.
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Emotions and Traumatic Causes: It is stated that the nerve impulses for abdominal pain and emotions are closely associated, so any emotional trauma or disturbance, such as any close one's death or other similar grief, can trigger abdominal pain, which can be chronic.
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Repeated Infections or Injuries: When the abdomen is affected by an infection frequently or undergoes several surgeries, the nerve receptors become more sensitive, and the pain incidences in the future get worse and more frequent.
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Visceral Hypersensitivity: Abdominal pain experienced even after normal activity is known as visceral hypersensitivity. These activities include walking, moving, or bending for work.
The brain can subside the pain signals produced by the abdomen. Still, this ability is reduced in centrally-mediated abdominal pain syndrome cases, and even a small amount of disturbances in the intestine or gastrointestinal tract can lead to severe pain. This is known as an altered 'brain-gut axis' in which an individual's brain cannot control the nerve activities of the gut and causes severe pain in the abdomen.
How to Treat Abdominal Pain Syndrome?
The treatment aims to control the symptoms of the pain rather than eliminate it, which is not possible anyway. Controlling the symptoms will help improve the individual's daily routine and functions.
The steps which can be followed to control the symptoms are:
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One of the easiest ways to start this is by keeping a record of pain onset and identifying the trigger factors, which can be emotional or situational. This information helps the patient and the doctor plan strategies for symptom control.
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If the person has suffered the pain previously, the fear of pain worsens the abdominal pain next time as it is emotionally affecting the individual. A patient needs to control his fear of pain which may help him to keep a hold of the symptoms. The family and close ones need to support the person in overcoming the pain.
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The brain can not only control the senses of pain but also block it if required. When the nerve impulses of pain from the abdomen reach the brain, they pass through a barrier or gate where the nerves from the brain coming down also cross. These nerve impulses from the brain can control the entry of nerve impulses from the abdomen. If these nerve impulses want, they can stop the pain impulses from the abdomen from crossing as well as if they want, they can let them pass and lead to severe intensity of pain.
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As the brain greatly impacts the abdominal pain in abdominal pain syndrome, psychological treatments such as relaxation, hypnosis, or cognitive behavioral therapy can help control the symptoms.
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Antidepressants stimulate the brain to send signals and initiate the closing of pain-control gates in the abdomen. They also help to relieve the pain. These medicines take a long time to work, and thus it is advised to consume them until the doctor suggests. The drugs have few side effects, which subside gradually after a few days of treatment. Some of the antidepressants used are selective serotonin-norepinephrine reuptake inhibitors (SNRIs) and tricyclic antidepressants (TCAs).
How Does Abdominal Pain Syndrome Affect Children?
It is reported that almost 10 to 15% of school-aged children suffer from functional abdominal pain in life. It can accompany other symptoms such as irritable bowel syndrome, diarrhea, or constipation. The child may also suffer from other issues such as headache, fatigue or sleep discomfort, anxiety or depression, nausea, or joint pain. The condition is not life-threatening, but it can affect the school and other activities of the child. The diagnosis of abdominal pain syndrome is difficult in children and requires complete systemic evaluation to look for the trigger factor of the pain. Generally, children affected with abdominal pain syndrome do not require investigations. Still, tests and imaging such as blood tests, ultrasound, and endoscopy can be carried out in cases involving other symptoms. The treatment of abdominal syndrome in children includes pain control, dietary changes, which include a balanced diet and avoiding junk and greasy food, and cognitive-behavioral treatments in cases of anxiety, depression, or trauma.
Conclusion
Abdominal pain syndrome is a chronic condition with no particular cure existing. Abdominal pain is associated with the psychological functioning of the brain and can get worse with every period. It also affects children of middle age. The syndrome's treatment includes pain control with medications and psychological therapies.
