The nervous system sends sensory signals from the gut to the brain. Changes in the nervous system can change the signals being sent from the gut causing pain. One type of pain is visceral hyperalgesia, which is increased sensitivity to pain in the internal organs, like the stomach, pancreas or intestines. Another type of pain is central neuropathic pain, which is pain initiated or caused by a dysfunction in the central nervous system.

Recurrent functional ileus, sometimes referred to as intestinal pseudo-obstruction, occurs when the intestinal motility suddenly slows down and the cause is not a blockage mechanical obstruction in the intestines. The medical team will assess for mechanical obstruction. Functional ileus presents with acute severe distention of the abdomen along with pain. It can sometimes be triggered by an acute illness, like a bladder infection or pneumonia. Changes in the nervous system may also be a reason these episodes occur, without an acute illness as a trigger. These changes alter how the nervous system regulates motility of the intestines. The medical team can help manage an episode of functional ileus and determine how recurrent episodes might be managed each time.

No test can indicate that the nervous system is the cause of GI pain, but information from your child’s history can suggest when this is the case. GI pain may be suspected when pain occurs with normal or mild distention in the intestines. Examples include pain noted with a bowel movement followed by improvement after, when distention in the colon has decreased. This is because changes in the nervous system can lower the amount of distention that causes a pain signal, even if the distention is mild. Medications for neuropathic pain can decrease these abnormal pain signals. They can also decrease the frequency and severity of pain events, though milder breakthrough pain can still occur as no treatment can fix or cure what causes this type of pain.