On the role of visceral hypersensitivity in a multimodal concept of pain in functional gastroesophageal disorders

Chronic epigastric or chest pain that presumably derives from the esophagus represents a core symptom of functional gastroduodenal or esophageal disorders. In the present review, we would like to discuss the concept of visceral hypersensitivity, which is currently hypothesized to mediate these pain syndromes. Animal and human studies will be reviewed that reported major insights into the neurobiological mechanisms underlying sensitization processes in the sensory nervous system and pain modulation in the brain. Finally, the impact of cognition and the emotional state will be discussed to present a concept of a multimodal alteration of the gut-brain axis that may underlie these functional gastrointestinal disorders.