Chronic visceral pain from persistent inflammation

Definition

Chronic visceral pain from persistent inflammation is chronic pain due to longlasting inflammation of internal organs of the head/neck region and of the thoracic, abdominal or pelvic cavities. [6,7]. It can be due to infectious or noninfectious agents, or endogenous release of algogenic substances. Demonstrative examples include: Behchets disease, Wegners Granulomatosis, pericarditis, chronic bronchitis, bronchiectasis, chronic pleurisy, ulcer of esophagus, esophagitis, gastritis, duodenitis, ulcerative colitis, Crohn’s disease, chronic pancreatitis, recurrent diverticulitis; recurrent cystitis and urethritis, chronic pelvic inflammatory disease, endometriosis,, chronic prostatitis [1-7]. The pain is perceived in the somatic tissues of the body wall (skin, subcutis, muscle) in areas that receive the same sensory innervation as the internal organ at the origin of the symptom (referred visceral pain). In these areas, secondary hyperalgesia (increased sensitivity to painful stimuli in areas other than the primary site of the nociceptive input) often occurs [6,7]. Diagnostic Criteria: Conditions A to D are fulfilled: A. Chronic pain (persistent or recurrent for longer than 3 months) is present and characterized by both of the following: A.1 The distinct anatomical location is compatible with typical referral pain patterns from specific internal organs. A.2 The history is suggestive of relevant inflammatory disease of one or more internal organs. B. At least one confirmatory test demonstrates an anatomical location compatible with a specific referred pain pattern. C. At least one confirmatory test demonstrates the relevant inflammatory disease. D. The pain is not better accounted for by another diagnosis of chronic pain.

Inclusions

• Chronic visceral pain from persistent inflammation in the head or neck region
• Chronic visceral pain from persistent inflammation in the thoracic region
• Chronic visceral pain from persistent inflammation in the abdominal region
• Chronic visceral pain from persistent inflammation in the pelvic region

Index Terms