ABSTRACT
Pain experience early in life can, theoretically, shape the developing nervous system at a time when heightened plasticity characterizes early postnatal development. Chronic abdominal pain is frequently seen during infancy and is often associated with functional constipation. Functional constipation occurs in otherwise well infants at the time of weaning from breast milk to infant formula. Stools become rm with the transition to formula. If a child experiences pain in the anal sphincter while passing a large hard bowel movement, the child becomes conditioned to avoid defecation [6]. e propagating colonic contractions push against an obstructed anal sphincter with pressures of 80 mm Hg and more, well above the threshold for colorectal pain [7]. Colonic painful distension in neonatal rats mimics the naturally occurring pressure build-up in the descending colon and rectum of human infants and provides a reproducible and controllable nociceptive visceral procedure. Most studies have looked at the adult sequelae of child stress and abuse and have focused on emotional and psychological problems, defects in interpersonal relationships, sexual maladjustment and social function [8-10]. Few studies have suggested an association between a history of physical abuse and functional gastrointestinal disorders [11], particularly irritable bowel syndrome (IBS) [12-14]. On the other hand, a number of studies have suggested that sometimes well-intended but painful medical procedures on neonates, without or with inadequate anesthesia, can have negative long-term implications and can engender unwanted consequences [15,16]. In a cohort matched case-control study, using siblings as controls, noxious stimulation caused by gastric suction at birth was associated with an increased prevalence of functional intestinal disorders in later life, possibly linked to the development of long-term visceral hypersensitivity and cognitive hypervigilance [17].
