Copyright ©2006 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Apr 28, 2006; 12(16): 2477-2486
Published online Apr 28, 2006. doi: 10.3748/wjg.v12.i16.2477
Multimodal pain stimulation of the gastrointestinal tract
Asbjørn Mohr Drewes, Hans Gregersen
Asbjørn Mohr Drewes, Center for Biomechanics and Pain, Department of Gastroenterology, Aalborg Hospital & Center for Sensory-Motor Interactions (SMI), Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
Hans Gregersen, Center for Biomechanics and Pain, Department of Gastroenterology, Aalborg Hospital
Author contributions: All authors contributed equally to the work.
Supported by “Det Obelske Familiefond” & “Spar Nord Fonden”
Correspondence to: Professor Asbjørn Mohr Drewes, MD, PhD, DMSc, Center for Visceral Biomechanics and Pain, Department of Medical Gastroenterology, Aalborg University Hospital, DK-9000 Aalborg, Denmark. drewes@smi.auc.dk
Telephone: +45-99322505 Fax: +45-99322503
Received: December 18, 2005
Revised: January 18, 2006
Accepted: January 22, 2006
Published online: April 28, 2006

Understanding and characterization of pain and other sensory symptoms are among the most important issues in the diagnosis and assessment of patient with gastrointestinal disorders. Methods to evoke and assess experimental pain have recently developed into a new area with the possibility for multimodal stimulation (e.g., electrical, mechanical, thermal and chemical stimulation) of different nerves and pain pathways in the human gut. Such methods mimic to a high degree the pain experienced in the clinic. Multimodal pain methods have increased our basic understanding of different peripheral receptors in the gut in health and disease. Together with advanced muscle analysis, the methods have increased our understanding of receptors sensitive to mechanical, chemical and temperature stimuli in diseases, such as systemic sclerosis and diabetes. The methods can also be used to unravel central pain mechanisms, such as those involved in allodynia, hyperalgesia and referred pain. Abnormalities in central pain mechanisms are often seen in patients with chronic gut pain and hence methods relying on multimodal pain stimulation may help to understand the symptoms in these patients. Sex differences have been observed in several diseases of the gut, and differences in central pain processing between males and females have been hypothesized using multimodal pain stimulations. Finally, multimodal methods have recently been used to gain more insight into the effect of drugs against pain in the GI tract. Hence, the multimodal methods undoubtedly represents a major step forward in the future characterization and treatment of patients with various diseases of the gut.

Keywords: Pain, Gut, Experimental, Allodynia, Hyperalgesia, Neurophysiology