the pain system in oesophageal disorders mechanisms, clinical characteristics, and treatment食管疾病的疼痛系统机制、临床特点和治疗.pdfVIP

Hindawi Publishing Corporation Gastroenterology Research and Practice Volume 2011, Article ID 910420, 14 pages doi:10.1155/2011/910420 Review Article The Pain System in Oesophageal Disorders: Mechanisms, Clinical Characteristics, and Treatment Christian Lottrup,1 Søren Schou Olesen,1 and Asbjørn Mohr Drewes1, 2 1 Mech-Sense, Department of Gastroenterology and Hepatology, Aalborg Hospital, Aarhus University Hospital, 9000 Aalborg, Denmark 2 Center for Sensory-Motor Interaction (SMI), Department of Health Science and Technology, Aalborg University, 9220 Aalborg East, Denmark Correspondence should be addressed to Asbjørn Mohr Drewes, drewes@hst.aau.dk Received 11 March 2011; Accepted 23 May 2011 Academic Editor: Robert Odze Copyright © 2011 Christian Lottrup et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Pain is common in gastroenterology. This review aims at giving an overview of pain mechanisms, clinical features, and treatment options in oesophageal disorders. The oesophagus has sensory receptors specific for different stimuli. Painful stimuli are encoded by nociceptors and communicated via afferent nerves to the central nervous system. The pain stimulus is further processed and modulated in specific pain centres in the brain, which may undergo plastic alterations. Hence, tissue inflammation and long- term exposure to pain can cause sensitisation and hypersensitivity. Oesophageal sensitivity can be evaluated ,for example, with the oesophageal multimodal probe. Treatment should target the cause of the patient’s symptoms. In gastro-oesophageal reflux diseases, proton pump inhibitors