Scoping review: Potential effects of vagus nerve stimulation on visceral pain in adult patients with irritable bowel syndrome
Translated title
Scoping Review: Effekter af Vagus Nerve Stimulation på viscerale smerter ved colon irritabile
Author
Schättiger, Katrin
Term
4. Term
Publication year
2019
Submitted on
2019-05-16
Pages
57
Abstract
Visceral smerte—smerte fra indre organer—er et centralt symptom ved irritabel tyktarm (IBS). Den er sat i forbindelse med ændringer i det autonome nervesystem (ANS), som automatisk styrer funktioner som hjerterytme og fordøjelse og bidrager til smertehæmning. Vagusnervestimulation (VNS), der bruger milde elektriske impulser til at stimulere en stor nerve i ANS, er foreslået som en mulig behandling af IBS-relateret smerte. Denne scoping-gennemgang havde to mål: (1) at opsummere viden om ANS’ rolle i IBS og (2) systematisk at identificere litteratur om VNS’ effekter på IBS og IBS-relateret smerte. Gennemgangen fulgte PRISMA- og PRISMA-ScR-retningslinjerne for gennemsigtig rapportering. Vi identificerede syv relevante studier. Seks undersøgte VNS og somatisk smerte (smerte fra hud, muskler eller led); tre rapporterede smertedæmpende effekter, og to rapporterede pronociceptive effekter (øget smertefølsomhed). Ét studie undersøgte VNS i en model for visceral smerte og fandt, at VNS signifikant reducerede reaktiv hyperalgesi i spiserøret (øget følsomhed i spiserøret). Der blev ikke fundet studier, der direkte undersøgte VNS ved IBS eller IBS-relateret smerte. Samlet set tyder den tilgængelige evidens på, at VNS kan modulere både somatisk og visceral smerte, med smertehæmmende effekter i nogle sammenhænge. Evidens specifikt for IBS mangler dog. Disse resultater peger på et videnhul og understøtter behovet for fremtidige studier, der afprøver VNS’ potentiale ved IBS og IBS-relateret smerte.
Visceral pain—pain from internal organs—is a key symptom in irritable bowel syndrome (IBS). It has been linked to changes in the autonomic nervous system (ANS), which automatically regulates functions like heart rate and digestion and helps dampen pain (anti-nociception). Vagus nerve stimulation (VNS), which uses mild electrical pulses to stimulate a major ANS nerve, has been proposed as a treatment for IBS-related pain. This scoping review had two aims: (1) summarize current knowledge on the ANS in IBS and (2) systematically identify literature on the effects of VNS in IBS and IBS-related pain. The review followed PRISMA and PRISMA-ScR guidelines for transparent reporting. We identified seven relevant studies. Six examined VNS and somatic pain (pain from skin, muscles, or joints); three reported pain-reducing effects and two reported pro-nociceptive effects (increased pain sensitivity). One study investigated VNS in a visceral pain model and found that VNS significantly reduced reactive esophageal hyperalgesia (heightened sensitivity in the esophagus). No studies directly assessed VNS in people with IBS or in IBS-related pain. Overall, the available evidence suggests that VNS can modulate both somatic and visceral pain, with anti-nociceptive effects in some settings. However, evidence specific to IBS is lacking. These findings highlight a research gap and support future studies to test the potential of VNS for IBS and IBS-related pain.
[This abstract was generated with the help of AI]
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