Cited by 304Inflammatory Bowel DiseasePain Mechanisms and TreatmentsGastrointestinal motility and disorders

Pain and inflammatory bowel disease.

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Bielefeldt, Klaus, Davis, Brian, Binion, David G.·2009·Inflammatory Bowel Diseases

Abstract

Abdominal pain is a common symptom of inflammatory bowel disease (IBD: Crohn's disease, ulcerative colitis). Pain may arise from different mechanisms, which can include partial blockage and gut distention as well as severe intestinal inflammation. A majority of patients suffering from acute flares of IBD will experience pain, which will typically improve as disease activity decreases. However, a significant percentage of IBD patients continue experiencing symptoms of pain despite resolving inflammation and achieving what appears to be clinical remission. Current evidence suggests that sensory pathways sensitize during inflammation, leading to persistent changes in afferent neurons and central nervous system pain processing. Such persistent pain is not only a simple result of sensory input. Pain processing and even the activation of sensory pathways is modulated by arousal, emotion, and cognitive factors. Considering the high prevalence of iatrogenic as well as essential neuropsychiatric comorbidities including anxiety and depression in IBD patients, these central modulating factors may significantly contribute to the clinical manifestation of chronic pain. The improved understanding of peripheral and central pain mechanisms is leading to new treatment strategies that view pain as a biopsychosocial problem. Thus, improving the underlying inflammation, decreasing the excitability of sensitized afferent pathways, and altering emotional and/or cognitive functions may be required to more effectively address the difficult and disabling disease manifestations.

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Authors
Bielefeldt, K., Davis, B., & Binion, D. G.
Affiliations
University of Pittsburgh (US)
Venue
Inflammatory Bowel Diseases
Published
2009-05
Volume
15
Issue
5
Pages
778-788
ISSN
1078-0998 (ISSN-L)
OpenAlex
W2006195533
Cited by
304
References
126
Citations by year
2026: 12 · 2025: 25 · 2024: 25 · 2023: 24 · 2022: 30 · 2021: 34 · 2020: 33 · 2019: 28 · 2018: 18 · 2017: 16 · 2016: 10 · 2015: 6 · 2014: 11 · 2013: 13 · 2012: 6
FWCI
0.57
Type
journal article
Language
en
Open access
Locations
  • Inflammatory Bowel Diseases (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institute of Neurological Disorders and Stroke (R01NS050758)
Topics
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Inflammatory Bowel Disease
  • Health Sciences › Medicine › Physiology › Pain Mechanisms and Treatments
  • Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
Keywords
inflammatory bowel disease, abdominal pain
MeSH terms
Humans, Pain, Inflammatory Bowel Diseases

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