Focus on current and future management possibilities in inflammatory bowel disease-related chronic pain

Abstract

IntroductionVisceral pain is a symptom reported by over 70% of inflammatory bowel disease (IBD) sufferers. So far, a single, specific cause of this debilitating state has not been established. Chronic pain is one of the most important factors decreasing the quality of life in IBD course. Concurrently, management of pain is the most challenging issue encountered by clinicians in IBD treatment.Areas coveredThis review focuses on pathophysiology of inflammatory bowel disease-caused visceral pain and explores currently available approaches to its management. We also covered recent pharmacological developments in the field.ConclusionsPain-related disability has major effects on quality of life and on functional and social outcomes in IBD patients. Currently, there is no one standardized method of managing chronic visceral pain in IBD. Therefore, future development, focusing primarily on alleviating the pain, but also on reducing inflammation, is essential.

Pomegranate Mesocarp against Colitis-Induced Visceral Pain in Rats: Effects of a Decoction and Its Fractions

“…Abdominal hypersensitivity related to these pathologies is currently treated by different, often unsatisfactory, approaches. In IBD patients, pain is managed by nonsteroidal anti-inflammatory drugs, opioids, antispasmodics, anticonvulsants, tricyclic antidepressants, or by a generic intensification of disease therapy (aminosalicylates, corticosteroids, immunomodulators, biologic agents, antibiotics, and probiotics [43].…”

Marine Toxins and Nociception: Potential Therapeutic Use in the Treatment of Visceral Pain Associated with Gastrointestinal Disorders

“…Accordingly, pro-inflammatory cytokines may influence enteric sensory innervations, thus altering visceral sensory perception and pain threshold with consequent pain generation [44]. Interestingly, pain is also one of the presenting symptoms in up to 70% of patients experiencing IBD [3]. IBD is a group of chronic inflammatory conditions comprising Crohn’s disease (CD) and ulcerative colitis (UC), with increasing incidence worldwide, which mainly affect the gastrointestinal tract [3,7].…”

“…Interestingly, pain is also one of the presenting symptoms in up to 70% of patients experiencing IBD [3]. IBD is a group of chronic inflammatory conditions comprising Crohn’s disease (CD) and ulcerative colitis (UC), with increasing incidence worldwide, which mainly affect the gastrointestinal tract [3,7]. Disease activity varies during the course of disease, as both the extent of inflammation and symptoms change over time [3].…”

“…Chronic visceral pain represents one of the main symptoms of functional gastrointestinal disorders, which lack a recognizable pathological cause, comprising irritable bowel syndrome (IBS) [2]. In addition, inflammatory bowel disease (IBD) may be also associated with long-lasting pain perception despite resolution of the underlying inflammatory state [3]. Visceral sensitivity is commonly not restricted to the affected organ, but is associated with both an expansion of the body area from which visceral pain is typically referred and an increased tenderness to cutaneous/subcutaneous examination of the referral area [2,4].…”

“…Indeed, treatment of chronic abdominal visceral pain is a fundamental issue, owing to the increasing incidence of functional and inflammatory gut disorders worldwide [2,7]. Available drugs are analgesics, also used for somatic pain treatment, such as opioids and nonsteroidal anti-inflammatory drugs (NSAIDs), benzodiazepines, antidepressants, or antispasmodics [2,3]. However, these drugs exert several effects on the body other than nociception, and may worsen symptoms associated with the disease.…”