Neurophysiology of abdominal pain: a review of peripheral, spinal, central mechanisms and emerging research trends

J Basic Clin Physiol Pharmacol. 2026 Jun 3. doi: 10.1515/jbcpp-2026-0034. Online ahead of print.

ABSTRACT

Experience of visceral pain occurs when there is discomfort originating from internal organs of the body, often resulting from injury, infection, inflammation, ischemia, tumors, or neuropathy. In clinical practice, visceral pain is recognized as one of the most prevalent and incapacitating types of pain. It encompasses a diverse range of conditions impacting organs within thoracic, pelvic, and abdominal regions. Specifically, visceral pain of abdominal origin often presents as diffuse and poorly defined sensations of varying intensities. This characteristic arises from relatively sparse sensory innervation of visceral organs and divergent nature of visceral inputs. In addition, visceral noxious stimuli differ significantly from somatic pain triggers. Perception of visceral noxious stimuli from abdominal organs starts with transduction of signals at peripheral processes of sensory neurons, and transmission of these impulses to cortical centers, processing pain. Pathways concerned with nociceptive signaling from abdomen include intricate meshwork of neurons interconnecting different functional loci within nervous system. This review brings together current concepts on how abdominal pain is processed at several interconnected levels. Understanding of physiological pathways involved in abdominal pain processing supplemented with history, physical examinations, necessary biochemical, histopathological and radiological investigations constitute the cornerstone for abdominal pain management in clinical settings.

PMID:42227242 | DOI:10.1515/jbcpp-2026-0034