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 centrally mediated abdominal pain syndrome?
A healthcare provider will diagnose this syndrome based on a careful history, a 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 centrally mediated pain syndrome 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 also cause nerves to become overly sensitive. Sometimes even normal abdominal activity 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 human brain has the ability to both sense and block pain. Hence, therapeutic interventions such as relaxation techniques, guided imagery, hypnotherapy, and cognitive-behavioral therapy (CBT) can be effective in alleviating pain by facilitating the transmission of signals that help to mitigate pain sensations. These interventions teach individuals how to modulate their own pain perception and provide relief from discomfort.
Centrally mediated abdominal pain syndrome can be a challenging condition to manage. However, medicines are available that can help alleviate the symptoms. Specifically, your healthcare provider may suggest an antidepressant for continuous or severe abdominal pain. It’s important to keep in mind that these medications are not solely for the treatment of depression. In fact, they can act as pain relievers at lower doses than those typically used for depression or for the treatment of other painful conditions.
These drugs help to stimulate the brain in such a way that it increases the signals that block pain messages from the abdomen to the brain. Of course, it’s important to be patient as it may take several weeks before you start to notice any difference in your symptoms. However, with the right medication and treatment plan in place, it is possible to manage centrally mediated abdominal pain syndrome and improve your overall quality of life.
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.”
Learn more about Opioid Induced Constipation (OIC)
It is important that you work with a healthcare provider who shows an understanding of the symptoms of Centrally mediated pain syndrome. It is a disorder where treatment requires you and your healthcare provider to work together.
You need to express your views about your treatment goals, work with your healthcare provider to develop the treatment plan, and work toward putting the plan into action.
If you follow the treatment plan closely, you and your healthcare provider 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