The Influence of Early Life Experience on Visceral Pain.

Isabella M Fuentes,Julie A Christianson

doi:10.3389/fnsys.2018.00002

Isabella M Fuentes, Julie A Christianson

Open Access

https://doi.org/10.3389/fnsys.2018.00002

Copy DOI

Abstract

Pain is the most reported and troublesome symptom of nearly all functional disorders affecting the genitourinary and gastrointestinal organs. Patients with irritable bowel syndrome (IBS), interstitial cystitis/painful bladder syndrome (IC/PBS), vulvodynia, and/or chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS; collectively termed chronic pelvic pain syndromes) report pain severe enough to impact quality of life and often suffer from symptoms of or are diagnosed with more than one of these syndromes. This increased comorbidity between chronic pelvic pain syndromes, and with pain disorders of disparate body regions, as well as with mood disorders, can be influenced by disruptions in the hypothalamic-pituitary-adrenal (HPA) axis, which regulates the response to stress and influences the perception of pain. Experiencing trauma, neglect, or abuse in early life can permanently affect the functioning of the HPA axis. As such, a significant proportion of patients suffering from comorbid chronic pelvic pain syndromes report a history of early life stress or trauma. Here we will report on how these early life experiences influence chronic pelvic pain in patients. We will also discuss various rodent models that have been developed to study this phenomenon to understand the mechanisms underlying HPA axis dysfunction, as well as potential underlying mechanisms connecting these syndromes to one another.

Highlights

The International Association for the Study of Pain (IASP) defines ‘‘pain’’ as an ‘‘unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage’’ (Loeser et al, 1994)
Findings from the Multi-Disciplinary Approach to the Study of Chronic Pelvic Pain (MAPP) Research Network reported that both male and female patients suffering from urologic chronic pelvic pain syndromes (UCPPS; chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) in males and interstitial cystitis/painful bladder syndrome (IC/PBS) in females) exhibit greater psychological distress, poorer coping, higher levels of current and lifetime stress, and more widespread pain symptoms that contribute to poorer self-reported quality of life than sex- and education-matched healthy controls
Anderson et al (2008, 2009) have reported that men with CP/CPPS, compared to healthy controls, have a greater slope of waking cortisol response (Anderson et al, 2008) and delayed adrenocorticotropic hormone (ACTH) release correlating with significant psychological disturbances in response to an acute stress (Anderson et al, 2009), suggesting altered HPA axis function

Summary

Introduction

The International Association for the Study of Pain (IASP) defines ‘‘pain’’ as an ‘‘unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage’’ (Loeser et al, 1994). Exposure to early life stress or trauma is a significant risk factor for developing HPA abnormalities and associated chronic pain syndromes (Anand, 1998).

Results

Conclusion