Chronic Functional Abdominal Pain
What is chronic functional abdominal pain (CFAP)?
CFAP is a type of pain that is chronic or frequent and known to be caused by a change in the nervous system related to stress. Scientists have confirmed a direct connection between our brain and gut nerves to explain this very real pain. No infection or disease can be found.
What causes CFAP?
It is thought that CFAP is a disorder of the nervous system in which nerve impulses are increased “like a stereo system turned up too loud” and result in pain.
There are a few parts of the brain involved in sensing abdominal pain. One of these parts is concerned with the amount of pain and where it is located. The other is concerned with memories and feelings. Because of this, our nerves and the way we sense pain can be affected by feelings and stress.
While symptoms of CFAP can appear without a cause, they can also happen after a stressful event like the death of a loved one, a divorce, or abuse. After the first event, during times of added stress, symptoms can worsen. Injury such as surgery can cause nerves in the abdomen to become very sensitive. Even normal abdominal activity may be felt as painful. This is sometimes called hypersensitivity of the abdominal organs.
What is the treatment?
The goal of treatment for CFAP is to help you gain control over and improve your symptoms to allow the most pain relief. Although medicine may be prescribed to help with some of the symptoms, the most important treatment is to use non-medicine techniques to relax and distract yourself from the pain.
How does that work?
The brain not only affects how you sense pain, but is also able to block pain. When nerve impulses travel up from the abdomen to the spinal cord some of them go through a kind of “gate” that is controlled by nerve impulses coming down from the brain. These impulses coming down from the brain can block pain signals to the brain by closing the gate. They can also increase signals to the brain by opening the gate. You can use techniques to close the gate to pain signals.
How can I try to retrain my brain to decrease my feelings of pain?
There is no proven way to do this, but there are some things you may want to try. The first step is to understand the nature of your symptoms. Using a journal to keep track of your bowel movements, pain symptoms, and feelings during the day can help you to assess your patterns and triggers. Be sure to bring your journal to clinic when you see your doctor.
Ask yourself what you do in your daily life to relax. It is helpful to have a few ways that you enjoy to relax and/or distract yourself. Some people like to exercise, others like to read or watch TV, and still others like to do mind body techniques like yoga, meditation, tai chi, or receive regular massages.
Some people feel better talking to people about their feelings. If you are in this group ask family and friends to listen to you, or join a support group to talk about your feelings related to CFAP. Others would rather write them down in a journal. If you are in this group, setting aside a private time each day to write can be helpful.
Medicines may be used to treat the pain or other problems like constipation, diarrhea, or anxiety. For constant or severe pain, your doctor may order medicines that work in ways to affect nerve messages of pain. This may include some types of anti-depression medicine, muscle relaxants, or anti-seizure medicine. It may take a few weeks before you notice a change. Opioid medicines (narcotics) are rarely helpful for CFAP and can be harmful. Over time, opioids can worse symptoms of CFAP.
Each medicine is different and can cause side effects. Often, side effects will go away after a few days, so try to stay on it until you feel it is working. Take time to understand what the side effects are and when to report them to your doctor.
Is follow-up care needed?
It is helpful to see a doctor who has an interest and is an expert in CFAP. Treatment is most helpful when you and your doctor work as a team. Your doctor will teach you about CFAP and what your treatment options are. You know yourself and your symptoms best, and how they respond to the treatments. The result is a plan that allows you to have the most pain relief.
Drossman, Douglas A. MD. Chronic functional abdominal pain. This article is on the internet www.aboutibs.org/Publications/CFAP.html
American Pain Foundation www.painfoundation.org
The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.
Last Updated: 08/10/2011
Copyright © 08/10/2011 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#6694
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