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Centrally Mediated Abdominal Pain Syndrome

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Essential Medical Disorders of the Stomach and Small Intestine

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Abstract

Centrally mediated abdominal pain syndrome (CAPS) was previously termed functional abdominal pain syndrome. The condition can be distinguished from other functional gastrointestinal disorders as it is characterised by continuous or nearly continuous abdominal pain, which is chronic in nature and relatively independent from gastrointestinal physiological events. Moreover, CAPS limits some aspect of daily functioning, such as the ability to work, perform household activities or attend social events. The pain is caused primarily by amplified central perception of normal visceral input, rather than enhanced peripheral afferent excitability. The management of CAPS is based on a strong patient-physician relationship and the use of centrally acting pharmacological therapy often in conjunction with concomitant behavioural therapy.

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References

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Essential Reading

  • Drossman DA, Tack J, Ford AC, Szigethy E, Törnblom H, Van Oudenhove L. Neuromodulators for functional gastrointestinal disorders (disorders of gut-brain interaction): a Rome foundation working team report. Gastroenterology. 2018;154(4):1140–1171.e1141. This article provides an advanced and comprehensive review of the use of neuromodulators in clinical practice.

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    Article  Google Scholar 

  • Sobin WH, Heinrich TW, Drossman DA. Central neuromodulators for treating functional GI disorders: a primer. Am J Gastroenterol. 2017;112(5):693–702. This article is a primer to help gastroenterologists understand how best to use central neuromodulators to optimise patient care.

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Author information

Authors and Affiliations

  1. Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden

    Imran Aziz, Hans Törnblom & Magnus Simrén

  2. Center for Functional Gastrointestinal and Motility Disorders, University of North Carolina, Chapel Hill, NC, USA

    Magnus Simrén

Authors
  1. Imran Aziz
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  2. Hans Törnblom
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  3. Magnus Simrén
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Corresponding author

Correspondence to Imran Aziz .

Editor information

Editors and Affiliations

  1. Mayo Clinic, Jacksonville, FL, USA

    Brian E. Lacy

  2. Mayo Clinic, Scottsdale, AZ, USA

    John K. DiBaise

  3. Cedars-Sinai Medical Center, Los Angeles, CA, USA

    Mark Pimentel

  4. Leeds Teaching Hospitals NHS Trust, Leeds Gastroenterology Institute, Leeds, UK

    Alexander C. Ford

Self-Test

Self-Test

  • Question 1. Which of the following statements regarding CAPS is true?

    1. A.

      CAPS is characterised by chronic constant or near-constant abdominal pain that is commonly associated with altered bowel habit.

    2. B.

      CAPS is associated with chronic constant or near-constant abdominal pain with relative independence from gastrointestinal physiological events.

    3. C.

      CAPS is always exacerbated by eating.

  • Question 2. Which of the following receptor sites do tricyclic antidepressants (TCA) work on?

    1. A.

      Norepinephrine, serotonin, and histamine but not acetylcholine

    2. B.

      Norepinephrine, serotonin, and acetylcholine but not histamine

    3. C.

      Norepinephrine, serotonin, acetylcholine, and histamine

  • Question 3. Which of the following neuromodulators would not be considered as first-line therapy for CAPS?

    1. A.

      Selective serotonin reuptake inhibitors (SSRI)

    2. B.

      Serotonin norepinephrine reuptake inhibitors (SNRI)

    3. C.

      Tricyclic antidepressants (TCA)

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Aziz, I., Törnblom, H., Simrén, M. (2019). Centrally Mediated Abdominal Pain Syndrome. In: Lacy, B., DiBaise, J., Pimentel, M., Ford, A. (eds) Essential Medical Disorders of the Stomach and Small Intestine. Springer, Cham. https://doi.org/10.1007/978-3-030-01117-8_13

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  • DOI: https://doi.org/10.1007/978-3-030-01117-8_13

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-01116-1

  • Online ISBN: 978-3-030-01117-8

  • eBook Packages: MedicineMedicine (R0)

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