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Centrally targeted pharmacotherapy for chronic abdominal pain: Understanding and management

Chapter in book
Authors Hans Törnblom
D. A. Drossman
Published in Gastrointestinal Pharmacology. Handbook of Experimental Pharmacology, vol 239. Greenwood, Van Meerveld B. (eds)
Pages 417-440
ISBN 978-3-319-56360-2
ISSN 0171-2004
Publisher Springer
Publication year 2016
Published at Institute of Medicine, Department of Internal Medicine and Clinical Nutrition
Pages 417-440
Language en
Keywords Abdominal pain, Antidepressants, Brain-gut axis, Functional gastrointestinal disorders, Treatment
Subject categories Clinical pharmacology, Pharmacology


Chronic abdominal pain has a widespread impact on the individual and the society. Identifying and explainingmechanisms of importance for the pain experiencewithin a biopsychosocial context are central in order to select treatment that has a chance for symptom reduction. With current knowledge of brain-gut interactions, chronic abdominal pain, which mostly appears in functional gastrointestinal disorders, to a large extent involves pain mechanisms residing within the brain. As such, the use of centrally targeted pharmacotherapy as an effective treatment option is obvious in a selected number of patients. The antidepressants are most common, but also other classes of medications can be used, either alone or in combination. The latter option refers to when there is insufficient effect of one drug alone or side effects limiting dosage, and when combined in lower doses, certain drugs give rise to augmentation effects. This chapter outlines basic mechanisms of importance for the understanding of chronic abdominal pain and the pharmacologic treatment options. © Springer International Publishing AG 2016.

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