North Central OK Ostomy 2009-05 The nerve(s) of those stomas

From North Central Oklahoma Ostomy Outlook May 2009:

The nerve(s) of those stomas!

posted by user “Mike ET” on the UOAA Discussion Board, May 11, 2009

The question or comment about stomas lacking sensory nerves, or the more broadly stated claim that stomas have no nerves, is a myth that dies very hard. Allow me to borrow from one of my presentations that partly addresses this issue:

“…most of the information carried by gastrointestinal primary afferent neurons is not consciously perceived. This is nicely demonstrated by tests on fistula patients who report no sensation when the healthy stomach is probed or in patients that have had the intestinal lining cut to take a biopsy.” quoted from: Am J Physiol Gastrointest Liver Physiol 277:922-928, 1999. John B. Furness, Wolfgang A. A. Kunze and Nadine Clerc. page G924.

Additionally, we have: “There are more than 100 million nerve cells in the human small intestine, a number roughly equal to the number of nerve cells in the spinal cord. Add in the nerve cells of the esophagus, stomach, and large intestine and you find that we have more nerve cells in our bowel than in our spine. We have more nerve cells in our gut than in the entire remainder of our peripheral nervous system.” quoted from: The Second Brain by Michael Gershon, M.D. page Xiii.

Alas, stomas do have nerves!
So, now let us put to rest the misstatement about the bowel and nerves, and bother to reeducate those who have misspoken early on.
There are nerves; but the sensory nerves of the bowel between the esophagus and the rectum, for certain types of painful stimuli, such as cutting or cautery, are either very low in number and caliber or the brain is not readily able to perceive the pain.
Of course, one can still be a pain in the a**; however, this is a topic for other times and places.

Editor’s note: For some earlier articles we’ve published on this topic, see Does Your Stoma Hurt? by Victor Alterescu, which appeared in our January 1999 newsletter; and a reply by Mike ET (same author as the present article above) titled Stomas and Pain Response, that we printed in our February 1999 issue.

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This page last revised 2009-10-05

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