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Chronic Abdominal Pain (CAPS) Treatment

Pain that's there most days, barely moves with eating or bowel movements, and has outlasted every scan and scope. Centrally mediated abdominal pain syndrome is the most misunderstood DGBI — and it has a treatment pathway.

What CAPS is

In centrally mediated abdominal pain syndrome, the pain-processing circuits of the central nervous system become sensitized — amplifying and even generating pain signals independent of what's happening in the gut. That's why the pain is constant rather than meal- or bowel-related, and why gut-targeted treatments and repeat investigations keep coming up empty. The pain is genuinely felt in the abdomen; its generator is central.

Why more scopes won't help

Once central sensitization is established, additional negative investigations don't change treatment and often deepen the cycle of worry and pain amplification. The evidence-based move is to stop searching the gut and start treating the nervous system's pain processing.

How treatment works

CAPS responds to neuromodulatory approaches: psychological therapies (CBT, ACT, hypnotherapy) that retrain central pain processing and reduce the threat-response amplifying every signal, often alongside neuromodulator medications managed with your physician. This combination is the guideline-supported standard for centrally mediated pain.

Your pathway

We confirm the diagnosis against Rome IV criteria, ensure red flags have been appropriately excluded, then begin a structured course of brain-targeted therapy with validated pain and function tracking — virtually, anywhere in Manitoba.

Start your assessment

Virtual care across Manitoba · Self-referrals welcome · Response within 2 business days

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Frequently asked questions

Are you saying the pain is psychological?
No. The pain is real and neurologically generated — central sensitization is a physiological process. Psychological therapies are used because they are among the most effective tools for retraining central pain circuits.
Can CAPS get better?
Yes. Central sensitization is plastic — the same nervous system that learned amplified pain can unlearn it with structured treatment.
Do I need more tests first?
If your workup has appropriately excluded structural disease, more testing usually delays recovery. We review your investigations as part of assessment and coordinate with your physician on any true gaps.
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