centrally-mediated abdominal pain syndrome (CAPS)

Pathology

• central sensitization with disinhibition of pain signals

History

• history & physical examination diagnostic tools of choice

Physical examination

• history & physical examination diagnostic tools of choice

Clinical manifestations

• abdominal pain
  • unrelated to food intake &/or defecation
  • nearly constant or frequently recurring
  • not localized
• musculoskeletal pain may be noted
• psychosocial issues & impairment in activities of daily living

Laboratory

• fecal immunochemical testing
• ESR, serum CRP

Management

• focus on setting appropriate goals & expectations
• combination of pharmaceutical & psychotherapy may be needed
  • psycotherapy
    • cognitive behavioral therapy
    • psychodynamic-interpersonal therapy
    • mindfulness-based therapy
    • hypnotherapy
  • pharmaceuticals
    • tricyclic antidepressant
    • SSRI or SNRI

More general terms

• central pain syndrome