What is CAPS?
Centrally mediated abdominal pain syndrome (CAPS), formerly known as Functional abdominal pain syndrome (FAPS), is a condition of abdominal (belly) pain that is long-term or keeps coming back. The pain is not linked with changes in bowel pattern – constipation and/or diarrhea. It occurs because of abnormal functioning of nerve impulses in the abdomen and brain. The nerves become overly sensitive.
How do I know if I have CAPS?
A doctor will diagnose CAPS based on a careful history, physical exam, and the pattern of symptoms. There are no abnormal x-rays or laboratory findings to explain the pain.
What causes CAPS?
Symptoms of CAPS can appear without apparent cause. They can occur after infections or events that stimulate the bowel. They can also occur after traumas like the death of a loved one or a divorce. During times of added stress, symptoms can worsen. Repeated injury in the abdomen can cause nerves to become overly sensitive. Even normal abdominal activity then may be felt as being painful.
How do emotions have an effect on pain?
Different areas in the brain are involved in the sensation of abdominal pain. One area perceives where the pain is located and how much it hurts. Another area is concerned with memories or emotions. These areas are connected. So the perception of pain can be affected by emotions or life experiences.
How is CAPS treated?
The brain can alter the pain experience for better or worse. Based on what we currently know about CAPS, the aim of treatment is to help you gain control over your symptoms and improve daily function. It usually is not possible to totally eliminate symptoms.
The brain not only affects how you sense pain, it is also able to block pain. For this reason, treatments like relaxation, imagery, hypnosis, and cognitive-behavioral therapy can provide relief. They teach how to send signals that help block pain.
Medicines may also be used to treat CAPS. For continuous or severe abdominal pain, your doctor might prescribe an antidepressant. These medications don’t only treat depression. They also act as pain relievers, at doses lower than for depression, for treatment of CAPS and many other painful conditions.
These drugs can help stimulate the brain to increase the signals that block pain messages from the abdomen to the brain. It may take several weeks before you notice a difference.
Opioids are not indicated. They can even be harmful and need to be avoided in treating chronic abdominal pain. Over long periods of time, narcotics may produce more pain causing a condition called “Opioid Induced Constipation.”
It is important that you work with a doctor who shows an understanding of the symptoms of CAPS. It is a disorder where treatment requires you and your doctor to work together.
You need to express your views about your treatment goals, work with your doctor to develop the treatment plan, and work toward putting the plan into action.
If you follow the treatment plan closely, you and your doctor will be better able to track your results. This will allow you to achieve the best possible relief of abdominal pain.
Source: Adapted from IFFGD publication #264