Do you sometimes experience strange pain or discomfort in your stomach, chest, or anywhere else inside your body? Does this pain continue to bother you even though you can't find a clear reason for it, and even when doctors say it's nothing serious? If so, today we're going to talk about something that could be very important to you. This is called visceral hypersensitivity, or `(Visceral Hypersensitivity)`.
What is Visceral Hypersensitivity?
Simply put, ``Visceral Hypersensitivity`` is when you feel pain or discomfort in the soft internal organs inside your body, such as the chest, stomach, and lower abdomen , more easily than the average person. To be precise, your threshold for feeling pain in these organs is lower than the average person.
Imagine, doctors can measure this pain threshold with some tests. In those tests, a small amount of pressure is applied to the organs. Most people do not feel any discomfort from this. However, for someone with ``Visceral Hypersensitivity'', even that small amount of pressure can be felt as a lot of pain. Not only that, but you may also feel discomfort from sensations that are not felt by others and are caused by the normal functioning of the organs.
How does this affect the body?
When we talk about our internal organs, we mean many things, such as the heart, lungs, bladder, genitals, and the intestines in our digestive system . When you have ``Visceral Hypersensitivity`` (VH), you may feel discomfort even when one or more of these organs are functioning normally. Often, people with this condition also fall into the category of ``Functional Disorders`` , especially those related to the digestive system.
Dysfunction is when something like air, fluid, or food moves through an organ, causing pain and discomfort. There is usually no obvious cause, such as an injury or infection. Doctors believe that a condition called ``Visceral Hypersensitivity'' may also be involved in this dysfunction.
Are this and `(IBS)` two different things?
No, this is not the same as IBS (Irritable Bowel Syndrome). But there is a strong connection between the two. People with IBS are often tested for Visceral Hypersensitivity. It has been found that about 40% of people with IBS have Visceral Hypersensitivity. Doctors believe that Visceral Hypersensitivity can be caused by long-term IBS symptoms and can also make IBS symptoms worse. It is also associated with other functional disorders, but most research has been done on its association with IBS.
How common is this condition?
Visceral Hypersensitivity is actually a relatively newly identified condition. So we don't know exactly how common it is yet. But the dysfunction is very common. IBS alone affects at least 20% of the population. And considering that 40% of people with IBS also have Visceral Hypersensitivity, we can estimate that this condition affects at least 10% of the population.
Who is more likely to develop this?
Visceral Hypersensitivity is usually seen with other functional disorders. However, not everyone who has a functional disorder has Visceral Hypersensitivity. It is also closely linked to mood disorders related to stress . There is also evidence that it runs in families, meaning it may have a genetic influence . Surprisingly, the condition is twice as common in women as in men .
You may be more likely to develop this condition if you have:
- Irritable Bowel Syndrome (IBS)
- Functional Dyspepsia
- Noncardiac Chest Pain
- Anismus (anus muscle problem)
- Interstitial Cystitis
- Fibromyalgia
- Painful menstruation (Dysmenorrhea)
- Mental problems such as anxiety disorders
- Depression
- Having functional pain conditions in someone in the family.
- If you had severe stomach pain (Colic) as a baby.
- Having a female reproductive system.
How does this pain feel?
When we talk about it, the word "visceral" means something that comes from inside, something deep, something instinctive. It's like saying "a visceral reaction." And it also has to do with our gut, like a "gut feeling." That's what this visceral pain is like.
It tends to be diffuse , meaning it's hard to pinpoint exactly where it hurts, even if the pain is severe. Most often, it affects your intestines. Symptoms like stomach pain, nausea, and indigestion can occur, even if the pain is primarily located elsewhere.
Also, this pain may feel strongly tied to your mental and emotional state . Pain in internal organs can cause stress, and stress can also make this pain worse.
What are the symptoms of this?
People with Visceral Hypersensitivity usually experience persistent discomfort in the chest, stomach, or lower abdomen. Chronic pain is pain that lasts for more than three months . This pain may come and go, or it may be triggered by certain bodily functions, such as when the bladder fills or when swallowing. The organs that may be affected include:
- Esophagus
- Heart
- Lungs
- Stomach
- Pancreas
- Small Intestine
- Large Intestine
- Bladder
- Urethra
- Uterus
- Rectum
Internal pain can be diffuse, difficult to pinpoint, and sometimes radiates to other areas. This makes it a bit more difficult to diagnose. One unique feature of this type of pain is that it can trigger strong responses from your body's autonomic nervous system . For example:
- Paleness of the skin (Pallor)
- Sweating
- Whole-body motor responses
- Changes in body temperature
- Changes in blood pressure
- Changes in heart rate
People with Visceral Hypersensitivity may also have other symptoms of Functional Gastrointestinal Disorders. The symptoms of these disorders are similar to those of inflammatory diseases such as GERD (Gastroesophageal Reflux Disease), Peptic Ulcer Disease, and Inflammatory Bowel Disease. The only difference is that in functional disorders, doctors cannot find an organic cause, such as an ulcer, acid reflux, or chronic inflammation.
Common symptoms of functional bowel disease are:
- Heartburn
- Chest Pain
- Indigestion
- Bloated Stomach
- Abdominal Pain
- Nausea & Vomiting
- Diarrhea
- Constipation
There are also a number of less common symptoms that doctors see in people with IBS that they think may be related to Visceral Hypersensitivity. For example:
- Feeling pain even when the stomach is lightly touched.
- A burning sensation in various parts of the body.
- Hypersensitivity to cold.
- Pain spreading to the limbs.
These symptoms show that it is not just a matter of physical stimuli, but also of the nervous system .
Why does this happen?
Researchers are still trying to understand exactly how Visceral Hypersensitivity occurs. They speculate that exposure to severe or repeated physical, mental, or emotional stress can cause the nervous system, which responds to pain, to become hypersensitive. Researchers have identified several factors that may contribute to this pain response. Some of them include:
- Genes: Some people may be genetically predisposed to having hypersensitivity reactions, which makes them more sensitive to pain.
- Early life trauma: Childhood is a critical time for the development of brain circuits that control stress and pain. Trauma during this time, especially if there is a genetic predisposition, can alter the way these circuits develop. This can include mental/emotional trauma, or a serious illness, infection, or injury during childhood.
- Psychological disorders: Some of the same mechanisms that predispose to pain states can also predispose to psychological disorders, such as anxiety and depression. Also, because people with mental disorders constantly activate their pain and stress circuits, they are more likely to be hypersensitive.
- Social stress factors: There are many stressors in adult life. However, most people can cope with them if they have adequate social support and physical resilience. However, some adults are more vulnerable to the factors mentioned above. When these are not adequately addressed, some develop chronic pain conditions.
- Leaky Gut Syndrome: Like some organic causes, chronic stress can also cause long-term, low-level inflammation in the gut. This can damage the protective lining of the gut. One theory is that this allows inflammatory substances to cross the intestinal barrier and stimulate the central nervous system.
- Bad Gut Microbiome: The balance of bacteria living in your gut can affect your visceral pain sensitivity. Gut bacteria inform the central nervous system about the state of your gut. Although the cause is not clear, overgrowth of the wrong type of bacteria, or the destruction of good bacteria by antibiotics, has been linked to Visceral Hypersensitivity.
When your nervous system is already primed for a hyper-reactive pain response, visceral pain can start in the organ itself, or it can start in the brain as an abnormal physiological response to stress. Doctors have found that ``Visceral Hypersensitivity'' often occurs after a specific event. For example, an injury, infection, or severe stress may cause severe pain and inflammation in one of your organs. However, even after the emergency has passed, your nerves continue to interpret normal sensations as pain and send those pain signals to the brain.
These nerves send pain signals to the part of your brain that registers pain. That part, in turn, sends signals to the areas of your brain that process the emotional aspects of pain. An emotional response is your body’s way of teaching you to avoid something that has hurt you. However, this neural pathway also works the other way. That is, stress and emotions can also increase the perception of physical pain or discomfort in your internal organs . When you have Visceral Hypersensitivity, physical pain and emotional stress continue to reinforce each other. Your brain responds to both with stress hormones. This makes your symptoms worse.
How does this relate to functional bowel disorders like IBS?
Your digestive system has its own nervous system. It's called the enteric nervous system. It's spread throughout your digestive tract. It's sometimes called the "second brain" or the "brain in the gut." The nerve endings of this enteric nervous system are located in every layer of your digestive tract. These nerve endings are stimulated by many things, including digestive contents, bacteria and bacterial products, stretching and distension, inflammation, and chemical stress signals.
These nerves not only alert your brain to discomfort, but they also signal your body to respond in various ways to what it perceives as a threat: slowing down the digestive process, speeding up the process, and flushing out toxins. If these nerves are constantly overstimulated, they can cause these responses to occur over and over again. That's what causes symptoms. Or, you might experience a condition called ``Visceral Hypersensitivity'', where you perceive even normal digestion as painful.
How do doctors detect this?
Although various tests are used in clinical studies to diagnose `(Visceral Hypersensitivity)`, these tests are not usually performed on patients who come for medical treatment. `(Visceral Hypersensitivity)` is often diagnosed in the same way as other functional diseases: by observing your symptoms and ruling out other structural causes (diseases) . After asking you for a complete medical history and performing a complete examination, routine tests are ordered. If those tests do not find anything significant, you may be diagnosed with `(Visceral Hypersensitivity)`.
What is the treatment for this?
Researchers are still looking for new ways to target Visceral Hypersensitivity. Current treatments typically involve a combination of medications and mind/body therapies . Because this condition involves both your physical organs and your brain, a two-pronged approach is the most practical and likely to have the best long-term success.
Medicines
Medications for Visceral Hypersensitivity aim to calm your nervous system. Regular painkillers don't work for this type of pain . Stronger painkillers like narcotics and opioids aren't recommended because their side effects can make the condition worse. Instead, doctors usually prescribe the same medications they use for mental illnesses like anxiety and depression, but in much lower doses .
This does not mean that doctors assume you have a mental illness. Some people with Visceral Hypersensitivity have a mental illness, but some do not. If your mental symptoms are lowering your pain threshold, these medications can help raise that threshold. However, they also numb the pain signals coming from your nerves. Treating the pain itself can help reduce stress hormones and prepare your body and brain to receive the most benefit from mind/body treatments.
Types of antidepressants include:
- Tricyclic antidepressants
- Selective Serotonin Reuptake Inhibitors (SSRIs)
- Selective Noradrenaline and Serotonin Inhibitors (SNRIs)
Other medications that can help with nerve pain:
- Histamine H1 receptor antagonists
- Anti-seizure medications
Mind/body therapies
Medications can treat your symptoms, but they don't treat the underlying condition. That's what mind/body therapies try to do. Taking advantage of neuroplasticity - the ability of your nervous system and brain to learn new patterns - these treatments try to stop nerve pain from starting in the first place. Recommended treatments include:
- Cognitive Behavioral Therapy (CBT): This is a long-term, systematic way to retrain your nervous system's response to sensations "from the top down" - that is, at the level of the mind.
- Hypnotherapy: The power of suggestion in a hypnotic state can help calm the nervous pain response.
- Biofeedback: This treatment uses equipment to measure your physical responses to pain and directs your attention to those responses. You can then work to change them.
Complementary medicine
Although these recommendations have not been fully tested, they are promising in helping to treat Visceral Hypersensitivity.
- Probiotics: Given that an imbalanced gut microbial population (Visceral Hypersensitivity) may be a cause, probiotics and prebiotics may help with symptoms.
- Acupuncture: Acupuncture has been shown to be effective in treating chronic pain in some people.
- Psychotherapy: If necessary, psychotherapy for related anxiety and depression can help reduce mental/emotional stress and influence your pain perception.
Can this be cured completely?
We don't know. There are encouraging reports that some people have improved significantly with certain treatments. However, this often depends on many things , such as the underlying cause of their symptoms and how many other factors are contributing to their hypersensitivity. The good news is that research is ongoing, and many promising ways to target ``Visceral Hypersensitivity'' are being explored.
Can this be relieved by eating and drinking?
Dietary changes are often recommended to help with IBS symptoms. If your internal sensitivity is in your digestive system, dietary changes may help reduce the discomfort associated with poor digestion.
Digestion is not a necessary part of Visceral Hypersensitivity. However, if you have food intolerances, they can cause chronic, low-level inflammation, damage your gut’s protective barrier, and overgrowth of bad gut bacteria that feed on carbohydrates you can’t digest. All of these effects have been suggested as contributing factors to Visceral Hypersensitivity. If so, these dietary patterns may help:
- Elimination Diet: This is a temporary diet that helps you identify which foods are causing you problems. This involves eliminating foods that are usually causing problems and then gradually adding them back in based on your symptoms.
- Low FODMAP Diet: This is a specific elimination diet. It targets the types of carbohydrates that often cause digestive problems. If you have bacterial overgrowth, a low FODMAP diet can help reduce them by not giving them the carbohydrates they need.
- Probiotic Foods: If your problems are caused by a bad gut microbiome, probiotics may help. One of the best ways to get probiotics daily is by eating probiotic foods. Examples include yogurt, yogurt, cottage cheese, sauerkraut (a type of fermented cabbage), and miso soup (a type of Japanese soup).
Finally, things to remember
Visceral Hypersensitivity is a complex issue. It requires a holistic approach to treatment. Doctors are increasingly recognizing the importance of the gut-brain connection . Researchers are trying to better understand how our brains, organs, and nervous systems communicate with each other, and how this can go wrong.
One thing is for sure: Internal pain is not "all in your head." However, it does involve the brain, to some extent. So it's a little more complicated than treating a mechanical problem. But it does give you some power. By harnessing the power of your brain, you can work to change your own neural pathways to reduce pain. So there's hope!
` Visceral Hypersensitivity, IBS, Functional Bowel Disease, Abdominal Pain, Stress, Nervous System, Treatment
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