Visceral Pain

Abstract

Visceral pain is qualitatively distinct from other pain types; it is poorly localized, difficult to quantify, and accompanied by marked autonomic changes. Acute visceral pain may be an indication of a medical emergency requiring urgent surgical or clinical intervention. However, chronic visceral pain, which contributes significantly to lifelong morbidity, occurs most frequently in the absence of any distinct pathology making it difficult to treat. This article reviews our current understanding of how visceral pain is detected in the periphery, and processed within the spinal cord and central nervous system. It focuses on recent work that has identified pro-nociceptive changes in the bowel of patients with chronic visceral pain and discuss how these findings could lead to the development of novel viscero-specific analgesics. Finally, the article considers how the microbiota can act locally to shape the detection of pain in the periphery and centrally to modulate our perception of visceral pain.