Diabetic Patients : An Ignored Cause Of Abdominal Pain

Visceral Pain: Pain from visceral tissue is poorly localized and diffuse. This means the pain is not felt at the area of damage. It is normally experienced superficially to the skin and not at the site of injury. One reason for this is because some organs can be innervated by multiple segments of the spinal cord. Another reason is due to very few nerve receptors located on visceral structures.6 For example, pathology within the gallbladder may demonstrate pain signs in the right subscapular region. 4 A clinical example would be a soccer player colliding into another player, taking the blow directly into his/her left torso. A few hours after the game he/she complains of pain in their left shoulder which is consistent with referred pain from trauma to the spleen. This is known as Kehr’s sign.

Visceral pain is pain caused by visceral nociceptors which are present in deeper structures such as organs and internal cavities. Nociceptors in these areas are more scarce and highly sensitive to distension, ischemia and inflammation but insensitive to other stimuli such as cuts or burns. Thus, the pain produced in these areas is usually that of aching or cramping and will last for a greater period than that of somatic pain.

Neuropathy. Nearly 70% of diabetics have some form of diabetic neuropathy. Symptoms of nerve damage include pain, tingling, or numbness in the legs, feet, arms, and hands. Nerve damage also occurs in other areas of the body, such as the heart, the digestive track, and in sexual organs. Neuropathies usually occur in

Abdominal pain is commonly experienced by individuals along the age continuum and presents with symptoms that may be vague in nature. A thorough assessment of the patient including, a history of their symptoms and a physical exam are imperative for a timely diagnosis. The condition may range from acute to chronic depending on the cause. Abdominal pain ranks second to chest pain as the most common need for presentation to the emergency department in individuals ranging from ages 15 and older (Purysko et al., 2011). The presentation

Pain is an adaptive mechanism which helps us learn to avoid dangers, it used to be believed that pain was an emotional state caused by intense stimuli and for 300 years people operated on Descartes single wire theory, that pain is a disturbance passed along nerve fibres to the brain, however, recent research into pain has come up with a more complex theory of nociception and pain. Nociception is a sensory process that provides the signals that trigger pain, whereas pain is the feeling of something unpleasant or an unbearable sensation arising from a part of the body. it is possible to have pain without nociception and nociception without pain, for example, back pain with no tissue damage is pain with no nociception and finding

While there are a variety of medical conditions which go hand in hand with peripheral neuropathy, diabetes is the most common. When nerves which transmit pain and other signals to the brain are damaged due to regularly high blood sugar levels, diabetic neuropathy can occur.

There are two types of pain; Acute or Fast pain, this is a protective event that enables the organism to localise pain rapidly and accurately and withdraw from a stimulus to reduce further damage . The second type of pain is Chronic, this is commonly triggered by an injury or disease, but may be perpetuated by factors other than the cause of pain. The injury may exceed the body’s capability for healing. One will be diagnosed with chronic pain if the ‘pain’ continues 3 months after normal healing time for the injury at hand. Pain occurs due to four processes, Transduction, Transmission, Modulation and finally Perception. For pain to be felt all four processes must occur in synchronisation. Pain can affect people differently, this could be due to their; Gender, Sex or age. Studies have found that rates of most

List et al., in a case-control study (35) (level of evidence 3) found that 83% of a sample of 46 patients had pain onset

Pain can be classified based on its type. It can be acute, cancer or chronic of by pathophysiology that can either be visceral or somatic. Neuropathic pain is the pain ensuing from injury to the tissues hence causing nerve dysfunction. Neuropathic pain is therefore described as a shooting, throbbing, or cold sensation. Cancer pain can also be defined as the pain that arises from both neuropathic and nociceptive pain. It is therefore important to identify the mechanisms as well as different forms of pain considering that selective treatment helps improve the outcomes of pain control.

Eligible patients are at ≥ 18 years to ≤ 75 years who diagnosis of painful diabetic peripheral neuropathy in both lower extremities. Patients who suffer from lower extremity pain for at least 6 months and had been given a primary diagnosis of PDPN. Patient eligibility required a score of ≥4cm on VAS at screening and a score of ≥3 on MNSI.

SECI Oncology 2016 DOI: 10.18056/seci2016.4 Page 2 of 8 Some of the main complications of untreated postoperative pain are cardiocirculatory complications like tachycardia,

Neuropathic pain is a broad category of non-odontogenic orofacial pain that should be in the differential diagnosis. Trigeminal neuralgia is often described as sharp, shooting, and stabbing pain.6 There is usually a trigger point which responds to light tactile, but not painful, stimuli. Pain is not provoked by thermal stimulus and local anesthetic block of the trigeminal nerve is effective in arresting the pain. Other neuralgias include glossopharyngeal and post-herpetic neuralgia.

Pain management is a critical component of surgical care. Untreated or inadequately treated pain pre and post operatively intensifies the effect of trauma on nearly every system of the human body including respiratory, cardiac, hemodynamic stability, renal, gastrointestinal and neurological function. Poorly treated pain significantly increases the risk of complication, patient suffering, morbidity and mortality. Neurological sequelae can result from the bodily response to repeated painful stimuli which can result in chronic pain syndrome (CPS). CPS is a complex and poorly understood condition that can provide a major challenge to health-care professionals in terms of management. Thus, it stands to reason that surgical pain should be aggressively

The most vital functions of the nervous system is to provide information about the occurrence or threat of injury. One of the ways this is done is in form of pain. However, sometimes, established pain can go beyond its protective role, thus becoming a disease in itself than just being a symptom. This condition is called chronic pain. The injury or the precipitating event can be physical (like in case of phantom limb pain or post-surgical pain), infection (as with post-herpetic neuralgia), systemic disease (like with diabetic neuropathy), drug (chemotherapy induced peripheral neuropathy) or can sometimes be unknown (trigeminal neuralgia, migraine, cluster headache, etc.) Even today, the pathological processes involved in genesis, establishment and continuation of such diseases are poorly understood. Eventually, such painful conditions usually remain refractory to available treatments.

Importance of afferent fibres from heart in management of angina and afferent fibres in pancreatic pain.