Basic and clinical aspects of gastrointestinal pain |
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Authors: | Charles H. Knowles Qasim Aziz |
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Affiliation: | 1. Neurogastroenterology Group, Centres for Academic Surgery, Barts and the London NHS Trust and the Homerton, University NHS Foundation Trust, 3rd Floor Alexandra Wing, Royal London Hospital, London E1 1BB, UK;2. Gastroenterology, Wingate Institute of Neurogastroenterology, Barts and the London, Queen Mary’s School of Medicine and Dentistry, Whitechapel, London, UK |
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Abstract: | The gastrointestinal (GI) tract is a system of organs within multicellular animals which facilitates the ingestion, digestion, and absorption of food with subsequent defecation of waste. A complex arrangement of nerves and ancillary cells contributes to the sensorimotor apparatus required to subserve such essential functions that are with the exception of the extreme upper and lower ends of the GI tract normally subconscious. However, it also has the potential to provide conscious awareness of injury. Although this function can be protective, when dysregulated, particularly on a chronic basis, the same system can lead to considerable morbidity. The anatomical and molecular basis of gastrointestinal nociception, conditions associated with chronic unexplained visceral pain, and developments in treatment are presented in this review. |
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Keywords: | ACC, anterior cingulated cortex ASIC, acid-sensing ion channel ATP, adenosine triphosphate ANS, autonomic nervous system CGRP, calcitonin gene-related peptide CCK, cholecystokinin CRH, corticotrophin-releasing hormone CS, central sensitisation ENS, enteric nervous system 5HT, 5-hydroxy-trypamine FGID, functional gastrointestinal disorders GI, gastrointestinal GINMD, gastrointestinal neuromuscular disease GCPR, G-protein-coupled receptor HAP, hypothalamo&ndash pituitary axis IB4, isolectin-B4 IGLE, intraganglionic laminar ending NGF, nerve growth factor LC, locus cereleus NDMA, N-methyl-d-aspartate NK, neurokinin PAG, peri-aquaductal grey PG, prostaglandin PAR, protease-activated receptor SP, substance-P SNS, sacral nerve stimulation SST, somatostain TTX, tetrodotoxin TRP, transient receptor potential VH, visceral hypersensitivity VGSC, voltage-gated sodium channel |
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