Abdominal Pain

At some time of the other, everyone has belly pain. Abdominal pain can be easily diagnosed and treated, but chronic abdominal pain is often difficult to control. Chronic functional abdominal pain (CFAP) is a functional gastrointestinal disorder, and there are no lab tests or x-rays that explain this pain.

 

What are the symptoms of chronic functional abdominal pain?

 

People with functional abdominal pain often have pain associated with constipation and/or diarrhea, as well as changes in bowel habits. The pain is often intermittent, and described as stabbing, aching, dull, or sharp.

 

What causes chronic abdominal pain?

 

With CFAP, the pain often becomes the main focus of a person’s life. It occurs due to altered sensitivity to nerve impulses in the brain and gut, and is not associated with altered gut/intestine motility. With this condition, nerve impulses travel from the abdomen to the spinal cord, and then go to the brain. One of these areas of the brain is also associated with emotions and memories. Because of this interconnection, the perception of pain is often affected by life experiences and emotions.

 

How does chronic abdominal pain affect quality of life?

 

This condition impacts quality of life, and has a major impact on the workforce/economy. In the U.S., people with chronic functional abdominal pain miss an average of 12 days of work each year, compared to 4 missed days by people without abdominal symptoms. The symptoms of CFAP often appear without a cause, and they also occur following traumatic life events, such as divorce, loss of a loved one, and a history of sexual abuse.

 

What are the treatment strategies for chronic abdominal pain?

 

With chronic abdominal pain, treatment is aimed at helping the patient improve daily function and control symptoms. The options include:

 

● Celiac plexus block – The celiac plexus is a group of autonomic nerves of the abdomen. These nerves mediate some visceral functions. A celiac plexus block involves instilling alcohol or phenol onto these nerves to stop nerve signal transmission.

 

● Splanchnic nerve block – Used for abdominal pain caused by compression, irritation, or entrapment of nerve bundles within certain abdominal organs, the splanchnic nerve block involves use of an anesthetic onto this nerve bundle. The block is used for chronic abdominal pain, Chron’s disease, and chronic pancreatitis.

 

● Hypogastric plexus block – The hypogastric plexus is a cluster of sympathetic nerves involved in the function of various pelvic organs (testes, penis, vagina, bladder, and uterus). This block is used to alleviate the pain of the lower abdomen region. An anesthetic and/or neurolytic agent is instilled onto these nerves to relieve pain.

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