Dysfunctional endogenous pain modulation in patients with functional dyspepsia

Neurogastroenterology and Motility : the Official Journal of the European Gastrointestinal Motility Society
C H Wilder-SmithR K Wong

Abstract

Endogenous pain modulation (EPM) is central to the processing of sensory information. Visceral and somatic EPM are abnormal in irritable bowel syndrome, but have not been studied in functional dyspepsia (FD). Visceral EPM was assessed in 34 FD patients and 42 healthy controls. Gastric pain was induced with oral capsaicin and EPM was studied by adding heterotopic thermal foot stimulation or distraction by STROOP test. Somatic EPM was assessed using foot heat stimulation with heterotopic hand electrical stimulation. Endogenous pain modulation by distraction reduced mean gastric pain by 11.9 on the 0-100 visual analog scale (95% CI: 3.8-20.1) in controls (p = 0.006) and by 2.0 (-6.18 to 10.44) in FD (p = 0.6), with greater EPM in controls than in FD (difference -13.3 [-26.1 to -0.5]; p = 0.04). Endogenous pain modulation by heterotopic foot stimulation reduced gastric pain by 6.5 (-0.7 to 13.6) in controls (p = 0.07) and by 7.1 (-2.29 to 16.47) in FD (p = 0.1), with no significant difference in EPM between controls and FD (-2.0 [-14.5 to 10.5]; p = 0.75). In patients with prominent FD pain, greater pain correlated with decreased visceral EPM by distraction (r = 0.51, p = 0.04). Somatic EPM by heterotopic stimulation significantly ...Continue Reading

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Citations

Dec 3, 2014·European Journal of Pharmacology·Višnja DrinovacZdravko Lacković
Nov 5, 2015·The New England Journal of Medicine·Nicholas J Talley, Alexander C Ford
May 27, 2017·Neurogastroenterology and Motility : the Official Journal of the European Gastrointestinal Motility Society·J Hammer, M Führer
Feb 3, 2018·Neurogastroenterology and Motility : the Official Journal of the European Gastrointestinal Motility Society·T Pribic, F Azpiroz
Sep 13, 2018·Alimentary Pharmacology & Therapeutics·Ahmed AlbusodaAdam D Farmer
Jan 22, 2019·Expert Review of Clinical Pharmacology·Louise KuhlmannAsbjørn M Drewes
Dec 7, 2018·Journal of Neurogastroenterology and Motility·Rapat PittayanonVarocha Mahachai
Jul 4, 2019·The Clinical Journal of Pain·Louise KuhlmannAsbjørn M Drewes
Jul 26, 2019·European Journal of Pain : EJP·Morten HoeghThomas Graven-Nielsen
Sep 22, 2020·Clinical and Translational Gastroenterology·Clive H Wilder-SmithSøren S Olesen
Apr 13, 2021·Neurogastroenterology and Motility : the Official Journal of the European Gastrointestinal Motility Society·Clive Wilder-SmithEric Chun Yong Chan

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