Chronic functional abdominal pain
Encyclopedia
Chronic functional abdominal pain (CFAP) is the ongoing presence of abdominal pain
for which there is no known medical explanation. It is quite similar to, but less common than, irritable bowel syndrome
(IBS), and many of the same treatments for IBS can also be of benefit to those with CFAP. The fundamental difference between IBS and CFAP is that in CFAP, unlike in IBS, there is no change in bowel habits such as constipation
or diarrhea
. Bowel dysfunction is a necessary diagnostic criterion of IBS.
CFAP is characterized by chronic pain
, with no physical explanation or findings (no structural, infectious, or mechanical causes can be found). It is theorized that CFAP is a disorder of the nervous system
where normal nociceptive
nerve impulses are amplified "like a stereo system turned up too loud" resulting in pain
. Alternately it is hypothesized that there exists in the intestine a protozoan (namely blastocystis) which is interacting with the sympathetic nervous system and causing the pain. Newer semi-synthetic antibiotics such as rifaximin have been used in treatment. This visceral hypersensitivity may be a stand-alone cause of CFAP, or CFAP may result from the same type of brain-gut nervous system disorder that underlies IBS. As with IBS, low doses of antidepressants have been found useful in controlling the pain of CFAP.
Non-pharmaceutical approaches to CFAP also overlap with treatments for Irritable Bowel Syndrome. This includes enteric coated peppermint oil capsules, which act as anti-spasmodics to relax the gut and also have pain-killing properties due to the methyl salicylate that naturally occurs in peppermint. Gut-directed hypnotherapy
or self-hypnosis can also mitigate the hyperreactive nervous system of CFAP, and help alleviate abdominal pain.
Abdominal pain
Abdominal pain can be one of the symptoms associated with transient disorders or serious disease. Making a definitive diagnosis of the cause of abdominal pain can be difficult, because many diseases can result in this symptom. Abdominal pain is a common problem...
for which there is no known medical explanation. It is quite similar to, but less common than, irritable bowel syndrome
Irritable bowel syndrome
Irritable bowel syndrome is a diagnosis of exclusion. It is a functional bowel disorder characterized by chronic abdominal pain, discomfort, bloating, and alteration of bowel habits in the absence of any detectable organic cause. In some cases, the symptoms are relieved by bowel movements...
(IBS), and many of the same treatments for IBS can also be of benefit to those with CFAP. The fundamental difference between IBS and CFAP is that in CFAP, unlike in IBS, there is no change in bowel habits such as constipation
Constipation
Constipation refers to bowel movements that are infrequent or hard to pass. Constipation is a common cause of painful defecation...
or diarrhea
Diarrhea
Diarrhea , also spelled diarrhoea, is the condition of having three or more loose or liquid bowel movements per day. It is a common cause of death in developing countries and the second most common cause of infant deaths worldwide. The loss of fluids through diarrhea can cause dehydration and...
. Bowel dysfunction is a necessary diagnostic criterion of IBS.
CFAP is characterized by chronic pain
Chronic pain
Chronic pain has several different meanings in medicine. Traditionally, the distinction between acute and chronic pain has relied upon an arbitrary interval of time from onset; the two most commonly used markers being 3 months and 6 months since the initiation of pain, though some theorists and...
, with no physical explanation or findings (no structural, infectious, or mechanical causes can be found). It is theorized that CFAP is a disorder of the nervous system
Nervous system
The nervous system is an organ system containing a network of specialized cells called neurons that coordinate the actions of an animal and transmit signals between different parts of its body. In most animals the nervous system consists of two parts, central and peripheral. The central nervous...
where normal nociceptive
Nociception
Nociception is defined as "the neural processes of encoding and processing noxious stimuli." It is the afferent activity produced in the peripheral and central nervous system by stimuli that have the potential to damage tissue...
nerve impulses are amplified "like a stereo system turned up too loud" resulting in pain
Pain
Pain is an unpleasant sensation often caused by intense or damaging stimuli such as stubbing a toe, burning a finger, putting iodine on a cut, and bumping the "funny bone."...
. Alternately it is hypothesized that there exists in the intestine a protozoan (namely blastocystis) which is interacting with the sympathetic nervous system and causing the pain. Newer semi-synthetic antibiotics such as rifaximin have been used in treatment. This visceral hypersensitivity may be a stand-alone cause of CFAP, or CFAP may result from the same type of brain-gut nervous system disorder that underlies IBS. As with IBS, low doses of antidepressants have been found useful in controlling the pain of CFAP.
Non-pharmaceutical approaches to CFAP also overlap with treatments for Irritable Bowel Syndrome. This includes enteric coated peppermint oil capsules, which act as anti-spasmodics to relax the gut and also have pain-killing properties due to the methyl salicylate that naturally occurs in peppermint. Gut-directed hypnotherapy
Hypnotherapy
Hypnotherapy is a therapy that is undertaken with a subject in hypnosis.The word "hypnosis" is an abbreviation of James Braid's term "neuro-hypnotism", meaning "sleep of the nervous system"....
or self-hypnosis can also mitigate the hyperreactive nervous system of CFAP, and help alleviate abdominal pain.
External links
- Functional bowel disorders and functional abdominal pain - Article on diagnosis
- Chronic Functional Abdominal Pain - International Foundation for Functional Gastrointestinal Disorders, Inc.