Gastrointestinal Wellbeing

The concept of unspecific gastrointestinal well-being has been proposed, but supporting experimental evidence in still scarce. Uncontrolled observations suggest that specific pleasant sensations may originate from the gastrointestinal tract. Such sensations are primarily related with the intake of meals and the evacuation of feces, in particular, gratifying sensations, such as satiation and complete rectal evacuation, and conceivably also preparatory sensations, such as appetite or call for stools. Other physiological events, such as eructation and farting, and nonspecific sensation, such as "easy digestion,'' may also contribute to gastrointestinal well-being. In contrast to perception of symptoms (ill-being), very little is known about gastrointestinal "well-being" and perception of pleasant sensations originating in the gut. The conceptual and methodological developments derived from pathophysiological studies could be applied to investigate this area that may become very important in the future.

Abdominal pain is one of the sensations that may arise from abdominal viscera, but it is relatively infrequent as compared to other abdominal symptoms, such as pressure, fullness, bloating, borborygmi among others. In fact, there is some debate as to whether pain is a distinctive sensation or just an intensity qualifier of perception. This chapter will primarily deal with abdominal symptoms in general, not strictly with abdominal pain, and will review the mechanisms of visceral sensation both in physiological conditions and in the pathophysiology of abdominal symptoms, particularly in patients without no detectable cause, i.e., patients with functional gut disorders. Furthermore, this chapter will basically refer to the digestive system, but the general schema and the concepts discussed also apply, at least in part, to other abdominal systems.

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