Pain in chronic pancreatitis and pancreatic cancer.
Chronic, debilitating abdominal pain is arguably the most important component of chronic pancreatitis, leading to significant morbidity and disability. Attempting to treat this pain, which is too often unsuccessful, is a frustrating experience for physician and patient. Multiple studies to improve understanding of the pathophysiology that causes pain in some patients but not in others have been performed since the most recent reviews on this topic. In addition, new treatment modalities have been developed and evaluated in this population. This review discusses new advances in neuroscience and the study of visceral pain mechanisms, as well as genetic factors that may play a role. Updates of established therapies, as well as new techniques used in addressing pain from chronic pancreatitis, are reviewed. Lastly, outcome measures, which have been highly variable in this field over the years, are addressed.
Fasanella
Kenneth E
KE
Department of Medicine, Division of Gastroenterology, Hepatology and Nutrition, University of Pittsburgh Medical Center, Mezzanine level 2, C-wing, 200 Lothrop Street, Pittsburgh, PA 15213, USA. fasanellake@upmc.edu
Davis
Brian
B
Lyons
John
J
Chen
Zongfu
Z
Lee
Kenneth K
KK
Slivka
Adam
A
Whitcomb
David C
DC
D015746:Abdominal Pain / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000379:methods; D003937:Diagnosis, Differential; D006801:Humans; D008096:Lithotripsy; D009407:Nerve Block / Q000379:methods; D010180:Pancreatectomy / Q000379:methods; D010190:Pancreatic Neoplasms / Q000150:complications*; D050500:Pancreatitis, Chronic / Q000150:complications*; D016896:Treatment Outcome