Biopsychosocial assessment criteria for functional chronic visceral pain: a pilot review of concept and practice

Pain Med. 2011 Apr;12(4):552-64. doi: 10.1111/j.1526-4637.2010.01025.x. Epub 2010 Dec 10.

Abstract

Functional chronic visceral pain (FCVP) is one of the most common causes of morbidity in the general population. Pain perceived within the abdomen may occur due to a range of different mechanisms according to the organ and their afferent pathways. Advances in our understanding of the complexities of FCVP could lead to the exploitation of contemporary research in order to develop and utilize our understanding of neurobiological and psychobiological visceral mechanisms in a clinical setting. This progression, together with increasing amounts of epidemiological and gender based information concerning specific abdominal pain syndromes can allow us to develop assessment tools that go beyond disease only analysis and move toward a more comprehensive assessment model so that patients may have access to expert or multidisciplinary management sooner, rather than later. Based on current evidence, one must consider the main contributors to pain, whether it is nociceptive, neuropathic or psychosocial or as is common with FCVP, a combination of all three.

Aim: This comprehensive assessment model should encompass not only systematic evaluation for reliable communication, but should also progress toward idiographic diagnosis relating to the uniqueness of the patient. This model should be practical in a multidisciplinary setting, taking into account the multi-faceted nature of this presentation.

Publication types

  • Review

MeSH terms

  • Abdominal Pain / epidemiology
  • Abdominal Pain / etiology
  • Abdominal Pain / physiopathology*
  • Abdominal Pain / psychology*
  • Chronic Disease
  • Diagnosis, Differential
  • Humans
  • Models, Theoretical
  • Pain Measurement
  • Pain, Referred / physiopathology
  • Pilot Projects
  • Syndrome
  • Viscera / innervation*
  • Viscera / physiopathology*