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Role of Neural Control in Gastrointestinal Motility and Visceral Pain

  • Emeran A. Mayer
  • Helen Raybould
Part of the Topics in Gastroenterology book series (TGEN)

Abstract

Neural control mechanisms play a critical role in pain perception and modulation of gastrointestinal motility. However, little is known about the role of the nervous system in mediating symptoms in irritable bowel syndrome (IBS). Subsets of patients with the diagnosis of IBS have symptoms either of altered bowel habit (diarrhea and/or constipation) or of altered visceral sensation (pain, “gaseous distension”), or changes in bowel habits and visceral sensation can occur together. Current selection criteria (self-selection of health-seeking patient subset, diagnosis by exclusion, lack of distinct pathophysiological marker) result in a highly heterogeneous group of patients who share the following: (1) a high degree of psychoneuroticism; (2) symptoms are not local but affect the entire GI tract to various degrees; (3) GI symptoms are embedded in a matrix of symptoms of chronic pain and/or psychosocial distress. 1–3 Thus, careful questioning of IBS patients reveals pain in multiple sites, including headaches, back pain, muscle pain, and heartburn.4–10 In addition, non-GI symptoms such as weakness, fatigue, palpitations, dizziness, perspiration, sweaty palms, brisk reflexes, dysuria, and dysmenorrhea are common in IBS.1 Recent studies indicate that there is a disturbance in colonic electrolyte transport in certain patients with IBS. These common features suggest a more generalized systemic dysregulation that may be mediated in part by the autonomic nervous system.

Keywords

Irritable Bowel Syndrome Enteric Nervous System Myenteric Plexus Irritable Bowel Syndrome Patient Visceral Pain 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Plenum Publishing Corporation 1989

Authors and Affiliations

  • Emeran A. Mayer
    • 1
  • Helen Raybould
    • 2
    • 3
  1. 1.Division of GastroenterologyHarbor-UCLA Medical CenterTorranceUSA
  2. 2.Center for Ulcer Research and EducationVeterans Administration Medical CenterLos AngelesUSA
  3. 3.Department of MedicineUniversity of California-Los AngelesLos AngelesUSA

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