Pain management in chronic pancreatitis.
Abdominal pain is a major clinical problem in patients with chronic pancreatitis. The cause of pain is usually multifactorial with a complex interplay of factors contributing to a varying degree to the pain in an individual patient and, therefore, a rigid standardized approach for pain control tends to lead to suboptimal results. Pain management usually proceeds in a stepwise approach beginning with general lifestyle recommendations. Low fat diet, alcohol and smoking cessation are encouraged. Analgesics alone are needed in almost all patients. Maneuvers aimed at suppression of pancreatic secretion are routinely tried. Patients with ongoing symptoms may be candidates for more invasive options such as endoscopic therapy, and resective or drainage surgery. The role of pain modifying agents (antidepressants, gabapentin, peregabalin), celiac plexus block, antioxidants, octreotide and total pancreatectomy with islet cell auto transplantation remains to be determined.
Gachago
Cathia
C
University of Florida, Department of Gastroenterology, Hepatology and Nutrition, 1600 SW Archer Rd, Room 602, Gainesville, Florida 32610, United States.
Draganov
Peter V
PV
D015746:Abdominal Pain / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D003131:Combined Modality Therapy; D006801:Humans; D010147:Pain Measurement; D050500:Pancreatitis, Chronic / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D016896:Treatment Outcome