Chronic Abdominal Discomfort Syndrome (CADS): Defining and Discussing a Novel Diagnosis

Abstract

In this article, we propose a new diagnostic paradigm known as Chronic Abdominal Discomfort Syndrome (CADS). Patient’s presentation centers around chronic abdominal pain not explained by acute pathology with or without accompanying dyspepsia, bloating, nausea and vomiting among other symptoms. The pathophysiology is noted to be neurogenic, possibly stemming from visceral sympathetic nerves or abdominal wall afferent nerves. Diagnosis is supported by signs or symptoms traversing clinical, diagnostic and functional criteria. Included is a tool which can assist clinicians in diagnosing patients with CADS per those domains. We hope to facilitate primary care physicians’ and gastroenterologists’ utilization of our criteria to provide guidance for selecting which patients may benefit from further interventions or evaluation by a pain physician. The pain physician may then offer interventions to provide the patient with relief.

Keywords:

• CADS
• chronic abdominal pain
• neurogenic abdominal pain
• chronic abdominal discomfort

Disclosure

Mayank Gupta and Anand S Patil are co-first authors for this study. Dr Michael Schatman is a research consultant for Modoscript and advisory committee for Syneos Health, outside the submitted work. Dr Timothy Deer reports personal fees for consultant and/or research from Abbott, Vertos, SpineThera, Saluda Medical, Cornerloc, SPR Therapeutic, Boston Scientific, PainTeq, Spinal Simplicity, Biotronik, and MainStay, outside the submitted work; In addition, Dr Timothy Deer has a patent pending to Abbott. Dr Dawood Sayed reports personal fees from and/or stock options for Painteq, Abbott, Neuralace, MainStay, Vertos, Saluda, SPR, and Surgentec, outside the submitted work. Dr Amol Soin reports ownership of Soin Neuroscience, JanOne, Neuros Medical, Soin Bioscience, and Avanos, during the conduct of the study. Dr Ganesan Baranidharan reports grants, personal fees from and advisory board for Abbott; grants and/or personal fees from Nevro Corp, MainStay Medical, Boston Scientific, Stryker, Saluda Medical, and Artha Medical, outside the submitted work. Dr Peter Staats reports personal fees from electroCore, outside the submitted work; in addition, Dr Peter Staats has a patent abdominal pain and vagus licensed to electroCore. Dr Paul Verrills reports consultant to Saluda, Presidio. The authors report no other conflicts of interest in this work.