Visceral pain has been defined as a
pain resulting from activation of pain receptors localized in mucous membrane, serous membrane, and smooth muscles of hollow organs. The great majority of these organs are innervated by parasympathetic and sympathetic outflows. Afferent nerve fibres are involved in conduction of both acute and persistent
pain and
hyperalgesia.
Visceral pain differs significantly from other types of
pain in the way it originates and in clinical presentation. It can be misleading as a symptom, producing several problems in the diagnostic process. Sometimes, severe
visceral pain is observed in the course of non-lifethreatening
functional gastrointestinal disorders, while slight abdominal discomfort may be a first symptom of malignant tumours. For many years, the treatment of
visceral pain has been considered as not satisfactory enough and covered a wide variety of pharmacological substances. For example, the complex
therapy of
pain and other manifestations associated with
irritable bowel syndrome include psychotherapy/behavioural
therapy, bulk-forming agents, probiotics, laxatives,
antidiarrheals,
antibacterial agents,
antispasmodics, and
antidepressants. The current knowledge about the pathogenesis of
visceral pain gives a rationale for the development of new, more efficacious drugs with a positive benefit/risk ratio. Unfortunately, experience gained so far with the use of some agents affecting serotoninergic transmission in the gastrointestinal tract have shown a serious danger associated with their administration for patients with
irritable bowel syndrome.