Chronic functional abdominal pain

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Chronic functional abdominal pain (CFAP) is the ongoing presence of abdominal pain for which there is no known medical explanation. It is quite similar to, but less common than, Irritable Bowel Syndrome (IBS), and many of the same treatments for IBS can also be of benefit to those with CFAP. The fundamental difference between IBS and CFAP is that in CFAP, unlike in IBS, there is no change in bowel habits such as constipation or diarrhea. Bowel dysfunction is a necessary diagnostic criteria of IBS.

CFAP is characterized by chronic pain, with no physical explanation or findings (no structural, infectious, or mechanical causes can be found). It is theorized that CFAP is a disorder of the nervous system where normal nociceptive nerve impulses are amplified "like a stereo system turned up too loud" resulting in pain. Alternately it is hypothesized that there exists in the intestine a protozoan (namely blastocystis) which is interacting with the sympathetic nervous system and causing the pain. Newer semi-synthetic antibiotics such as Rifaximin have been used in treatment. This visceral hypersensitivity may be a stand-alone cause of CFAP, or CFAP may result from the same type of brain-gut nervous system disorder that underlies IBS. As with IBS, low doses of antidepressants have been found useful in controlling the pain of CFAP^{[citation needed]}.

Non-pharmaceutical approaches to CFAP also overlap with treatments for Irritable Bowel Syndrome. This includes enteric coated peppermint oil capsules, which act as anti-spasmodics to relax the gut and also have pain-killing properties due to the methyl salicylate that naturally occurs in peppermint. Gut-directed hypnotherapy or self-hypnosis can also mitigate the hyperreactive nervous system of CFAP, and help alleviate abdominal pain.

[edit] External links

Functional bowel disorders and functional abdominal pain - Article on diagnosis
Chronic Functional Abdominal Pain - International Foundation for Functional Gastrointestinal Disorders, Inc.

v • d • e Pain and nociception

Head and neck	Jaw and mouth pain (Odynophagia , temporal arteritis) • Ear pain (otalgia, otitis media, otitis externa) • Eye pain (glaucoma) • Head pain (headache, migraine, tension headache, cluster headache, cerebral aneurysm, sinusitis, meningitis) • Neck pain (atypical myocardial infarction)

Thorax	Back pain (upper back pain, lower back pain, spinal disc herniation, degenerative disc disease, coccydynia) • Breast pain (perimenstrual, breast cancer) • Chest pain (myocardial infarction, gastroesophageal reflux disease, pancreatitis, hiatus hernia, aortic dissection, asymptomatic pulmonary embolism, Tietze's syndrome) • Shoulder pain (right side - cholecystitis)

Abdominal pain	Left and right upper quadrant (peptic ulcer disease, gastroenteritis, hepatitis, pancreatitis, cholecystitis, atypical myocardial infarction, abdominal aortic aneurysm, asymptomatic gastric cancer) • Left and right lower quadrant (appendicitis, ulcerative colitis, Crohn's disease, ectopic pregnancy, endometriosis, pelvic inflammatory disease, diverticulitis, urolithiasis, pyelonephritis, colorectal cancer)

Limbs	Arms (myocardial infarction, left arm) • Legs (deep vein thrombosis, peripheral artery occlusive disease, claudication, spinal disc herniation, sciatica)

Joints	Small joints (osteoarthritis, rheumatoid arthritis, systemic lupus erythematosis, gout, pseudogout • Large joints (septic arthritis, hemarthrosis, osteonecrosis) • Back joints (ankylosing spondylitis, inflammatory bowel disease) • Other (psoriatic arthritis, Reiter's syndrome)

Musculoskeletal	Delayed onset muscle soreness, Myalgia, Physical trauma

Other/unspecified pain	Allodynia, breakthrough pain, chronic pain, congenital insensitivity to pain, congenital insensitivity to pain with anhidrosis, hyperalgesia, hyperpathia, neuralgia, pain asymbolia, pain disorder, paroxysmal extreme pain disorder, phantom pain, referred pain

Related concepts	Anterolateral system, gate control theory of pain, pain management (anesthesia, cordotomy), pain scale, pain threshold, posteromarginal nucleus, substance P, OPQRST