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Chronic Gut Pain That No One Can Explain? It May Be Visceral Hypersensitivity.

You've had the tests. Nothing shows up. Yet the abdominal pain, bloating, and urgency are real and relentless. Dr. Karmina Choi is one of the few colorectal specialists in the region who diagnoses and treats visceral hypersensitivity — with a gentle, natural-first approach before considering medication.

DIGESTIVE & GI CONDITION

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Common questions

Expert Colorectal Care | Fort Lee, NJ

~40%

of IBS patients have visceral hypersensitivity as the root cause

Natural

first-line treatments that are effective and well-tolerated

Often

misdiagnosed or dismissed after normal test results

What is visceral hypersensitivity?

Visceral hypersensitivity (VH) means your gut's pain threshold is significantly lower than normal. Sensations that would be imperceptible to most people — gas moving through the colon, normal digestive pressure, mild bloating — register as genuine pain or intense discomfort in people with VH.

This is not a psychological problem. It reflects real changes in how pain signals travel between the gut and the brain — a process researchers call central sensitization of the gut-brain axis. It commonly underlies conditions like irritable bowel syndrome (IBS), functional abdominal pain, and unexplained rectal pain, and it can persist even after inflammation or infection has fully resolved.

The most under-recognized condition in colorectal care. Because standard tests — colonoscopy, bloodwork, imaging — often return normal results, patients with visceral hypersensitivity are frequently told "nothing is wrong." Dr. Choi understands that normal tests don't mean no problem. The pain is real, and there are effective, natural treatments to explore first.

Symptoms that may point to visceral hypersensitivity

Chronic abdominal pain

Persistent or recurring pain in the belly, often without a clear structural cause on imaging.

Painful bloating and gas

Normal amounts of gas cause disproportionate cramping or pressure.

Bowel urgency

A sudden, overwhelming need to use the restroom — often with little warning.

Alternating constipation and diarrhea

Unpredictable bowel habits that resist simple dietary fixes.

Rectal pain or pressure

Discomfort in the rectal area that worsens with bowel movements or prolonged sitting.

Symptoms that return after illness

Pain that persists or begins after a GI infection, surgery, or inflammatory episode.

Worsening with stress

Symptoms that flare during periods of anxiety, emotional stress, or poor sleep.

Normal test results

Colonoscopy, CT scan, and bloodwork come back clean — but the pain continues.

How Dr. Choi diagnoses visceral hypersensitivity?

There is no single test that confirms visceral hypersensitivity. Diagnosis requires a specialist who knows what to look for — and who takes the time to listen. Dr. Choi follows a thorough, structured diagnostic process:

1. Comprehensive history. A detailed review of your symptoms, their timing, triggers, and how they affect daily life.

2. Exclusion of structural causes. Bloodwork, stool studies, and targeted imaging rule out IBD, infection, celiac disease, and structural abnormalities.

3. Clinical pattern recognition. Using established Rome criteria for functional GI disorders, Dr. Choi identifies the characteristic symptom patterns of visceral hypersensitivity.

4. Anorectal evaluation when appropriate. A careful in-office exam assesses sphincter function, pelvic floor coordination, and rectal sensitivity — providing objective data that guides treatment.

A personalized, natural-first treatment approach

Dietary modification

A low-FODMAP diet — which reduces fermentable carbohydrates that overstimulate a sensitive gut — improves symptoms in up to 80% of patients. Dr. Choi also helps identify personal trigger foods such as caffeine, alcohol, spicy foods, and high-fat meals, and guides practical, sustainable changes you can maintain long term.

Bowel regulation and soluble fiber

Establishing consistent bowel habits and optimizing soluble fiber intake — through foods and natural bulking agents such as psyllium husk — reduces mechanical stimulation of an already-sensitive gut, breaking cycles of urgency and pain.

Neuromodulators — when further support is required

For patients whose symptoms remain significantly disruptive after exhausting natural and dietary approaches, low-dose neuromodulators (such as tricyclic antidepressants or SNRIs) may be recommended. These are used at sub-antidepressant doses specifically to quiet overactive gut-brain pain signals — not as psychiatric medications. Dr. Choi discusses this option transparently and only when genuinely warranted.

Herbal and natural supplements — soothing the gut gently

Dr. Choi incorporates evidence-informed natural supplements as a preferred first step before pharmaceutical options. Peppermint oil (enteric-coated) has strong clinical support for reducing gut spasm and pain. Iberogast, a well-studied herbal blend, helps regulate gut motility and ease discomfort. Probiotics are used to restore microbiome balance, which can perpetuate sensitivity when disrupted. Magnesium and ginger may further support gut comfort and regularity. All supplements are selected and guided carefully to ensure safety and effectiveness for your situation.

Traditional mind-body and supportive therapies

Before considering behavioral health referrals, Dr. Choi encourages traditional approaches to stress and nervous system regulation — including mindfulness and relaxation techniques, gentle yoga and movement practices, acupuncture, and structured sleep hygiene. These approaches calm the overactive gut-brain connection through natural, time-honored means and complement the dietary and supplement plan.

Antispasmodics and symptom-specific agents

When cramping or gut motility remains problematic despite natural measures, targeted antispasmodic medications can provide relief. For diarrhea-predominant symptoms, specific agents such as rifaximin or bile acid sequestrants may be considered. These are introduced only when natural approaches alone are insufficient.

Dr. Choi believes in starting with the gentlest, most natural interventions — prioritizing diet, herbal supplements, probiotics, and traditional supportive therapies before considering prescription medications. Every plan is tailored to your symptoms, preferences, and lifestyle.

First line

Natural supplements

Traditional therapy

If needed

First line

If needed

Why choose Dr. Karmina Choi?

Evidence-informed care

Every recommendation — natural or otherwise — is grounded in current clinical research.

She listens

Dr. Choi takes a thorough history and respects your preferences for how you want to be treated.

Convenient location

Fort Lee, NJ — accessible from Bergen County, Manhattan, and surrounding areas.

Natural-first philosophy

Diet, supplements, and lifestyle changes come first. Medication is a last resort, not the default.

Personalized plans

No one-size-fits-all protocols. Your treatment reflects your unique symptoms, values, and lifestyle.

Female physician option

A comfortable, sensitive environment — especially important for patients with pelvic and anorectal pain.

Common Questions

Is viseral hypersensitivity a real medical condition?

Yes. It is a well-documented condition recognized by gastroenterology and colorectal medicine. The gut-brain axis — the two-way communication network between your digestive tract and your nervous system — can become dysregulated, causing your gut to register pain from stimuli that wouldn't bother most people. The pain is neurologically real.

I've had a normal colonoscopy. Can I still have this?

Absolutely. Visceral hypersensitivity is not visible on a colonoscopy, CT scan, or standard bloodwork. A normal scope rules out structural problems — which is important — but it does not rule out a sensitized gut. Many patients with VH have had multiple negative workups before receiving the correct diagnosis.

Will I be put on antidepressants or psychiatric medications?

Not as a first step. Dr. Choi's approach starts with dietary changes, natural supplements, and traditional supportive therapies. Prescription medications are only considered when these approaches have been given a fair trial and symptoms remain significantly disruptive. Your preferences are respected throughout the process.

Can this condition be cured?

For many patients, symptoms improve dramatically — and sometimes resolve — with the right combination of treatments. The goal is to significantly raise your pain threshold, identify and avoid triggers, and restore quality of life. This is a manageable condition with a thoughtful, sustained approach.

Related conditions

Pelvic floor dysfunction

Constipation

Your pain deserves a real answer — not another normal result.

If you've been told nothing is wrong but continue to suffer, it's time for a specialist evaluation. Dr. Choi can help you find clarity and a natural path forward.

Book a Consultation

Call (551) 321-1388

1625 Anderson Avenue, Suite 203, Fort Lee, New Jersey 07024

This page is for informational purposes only and does not constitute medical advice. Individual results vary. Please consult Dr. Choi for a personalized evaluation and treatment plan.

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Fort Lee, New Jersey 07024

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