Visceral hyperalgesia revisited

Most forms of visceral pain, from a mild indigestion to the agony of a renal colic, produce two additional sensory alterations-increased tenderness in remote and superficial areas of the body (referred hyperalgesia) and enhanced pain sensitivity of the same or nearby viscera (visceral hyperalgesia). 1 Giamberardino MA Visceral hyperalgesia. in: Devor M Rowbotham M Wiesenfeld-Hallin Z Proceedings of the 9th World Congress on Pain. IASP Press, Seattle2000: 523-550 Google Scholar The fact that these two sensory alterations occur in otherwise healthy tissues strongly suggests that they originate in the central nervous system (CNS) rather than in the periphery. Over the past 20–30 years evidence has accumulated from many studies in laboratory animals and in human beings to support the central organisation of the mechanisms of visceral and referred hyperalgesia. In today's Lancet, Sanchoy Sarkar and colleagues revisit the topic and add to the evidence by illustrating a central component of the visceral hyperalgesia associated with non-cardiac chest pain that they attribute to oesophageal irritation. Contribution of central sensitisation to the development of noncardiac chest painThe finding of secondary viscerovisceral and viscerosomatic pain hypersensitivity suggests that central sensitisation may contribute to visceral pain disorders. The prolonged visceral pain hypersensitivity in patients with noncardiac chest pain suggests a central enhancement of sensory transfer. New therapeutic opportunities are therefore possible. Full-Text PDF