Section Iii Therapy For Visceral Pain Scientific Basis And Practice Aspects

17. Treating Visceral Pain Via Molecular Targets on Afferent Neurons: Current and Future 245

Peter Holzer

Visceral Pain Therapy: Current and Future 245 Sensory Neurons and GI Hypersensitivity 245

Criteria for the Design of Efficacious Sensory Neuron-Targeting Drugs 246 Three Classes of Sensory Neuron-Targeting Drugs 247 Sensory Neuron-Specific Receptors and Sensors 247 Ion Channels Regulating Sensory Nerve Excitability,

Conduction, and Transmission 253 Receptors Relevant to Afferent Neuron Transmission 254 Conclusions 258 References 259

1S. Management of the Patient with Chronic Abdominal Pain and Clinical Pharmacology of Nonopioid Drugs 271 Michael Camilleri

Introduction . . . . 271 Establishing a Roadmap . . . . 271 Conclusion . . . . 282 References . . . . 282

19. Pharmacology and Practice of Opioid Drugs for Visceral Pain 287 Jane C. Ballantyne

Introduction 287 Pharmacology 287 Acute Visceral Pain 291

Long-Term Opioid Treatment and its Liabilities 291 Psychosomatic Gastrointestinal and Genitourinary Disease 294 Specific Conditions 295 Conclusion 296 References 297

20. Clinical Approach to Visceral Cancer Pain 301 Sebastiano Mercadante Mechanisms 301

Clinical Implications in Cancer Pain 301

Treatment 302

Techniques 306

Conclusion 308

References 308

21. Neuromodulation Techniques for Visceral Pain from Benign Disorders 311 Charles D. Brooker and Michael J. Cousins Introduction 311 Intrathecal Drug Therapy 312 Electrical Stimulation Techniques 315 Neurolytic Techniques 318 References 319

22. Psychological Interventions for Patients with Chronic Abdominal and Pelvic Pain 323 Luis F. Buenaver, Robert Edwards, and Jennifer A. Haythornthwaite Introduction 323 Biofeedback 324 Hypnosis 324 Cognitive Behavior Therapy . . . . 325 Multidisciplinary Treatment 326 Future Directions 326 References 327

23. Complementary and Integrative Medicine Approaches to Visceral Pain 331 Victor S. Sierpina and Indumathi Kuncharapu Introduction 331 Case Study 332 Biological Therapies 333 Mind-Body Therapies 335 Manual Therapies 335 Alternative Systems of Care 336 Bioenergetic Therapies 337 Summary 337 References 338

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