Fig. 23.1 Common causes and location of chronic abdominal pain Table 23.1 Characteristics of abdominal pain Epigastric pain Referred pain from pancreas, stomach and hepatobiliary tree Umbilical pain Small bowel…
Component Visceral Somatic Nerve fiber Ad, C Ab [allodynia], Ad, C End organ silent nociceptors Yes (~80 %) Yes (~20 %) DH laminar synapse I, V, X I-to-V and X…
Etiology Typical diagnostic tests Treatment Organic Gallstones US, HIDA scan Cholecystectomy Cholangitis RUQ US, ERCP ERCP Appendicitis CT scan Appendectomy Peptic ulcer disease Upper endoscopy, H. pylori testing Proton pump…
Alcoholic pancreatitis Hereditary pancreatitis Autoimmune pancreatitis Metabolic pancreatitis (hypercalcemia, hyperlipidemia) Tropical pancreatitis Idiopathic Increased daily alcohol intake has been linked to a higher risk for chronic pancreatitis. There is, however,…
Fig. 25.1 The functional anatomy of the hypothalamic–pituitary–adrenal axis. Reprinted with permission, Cleveland Clinic Center for Medical Art & Photography © 2013. All Rights Reserved Stress has been well documented…
Fig. 24.1 Ascending sensory spinal cord pathways. (a) Spinothalamic tract. (b) Dorsal midline visceral nociceptive pathway. The black box indicates the location for cordotomy procedure and the yellow box indicates…
Recurrent abdominal pain or discomfortb at least 3 days/month in the last 3 months associated with two or more of the following: 1. Improvement with defecation 2. Onset associated with a change…
Drug Range of doses Morphine 1.0–20 mg/day Hydromorphone 0.5–25 mg/day Sufentanil 10–100 μg/day Bupivacaine 6–20 mg/day Clonidine 250–2,000 μg/day Thus, compounding by a trained pharmacist will be needed. The goal…
61. Yin J, Chen JD. Mechanisms and potential applications of intestinal electrical stimulation. Dig Dis Sci. 2010;55(5):1208–20.PubMed 62. Chen JD, Lin HC. Electrical pacing accelerates intestinal transit slowed by fat-induced…
Fig. 13.1 Celiac plexus parasagittal anatomy Distal to the splenic flexure of the large intestine, the visceral-nociceptive fibers of the remaining colon (and of pelvic viscera) travel in part through…
