title: Pancreatic pain.
abstract: OBJECTIVE
  Pain is the most common symptom of chronic pancreatitis, with a profound socioeconomic impact. Historical management paradigms failed, as they did not adequately address the fundamental underlying mechanisms. The present article describes the neurobiology of pain and sensitization in this condition, in an effort to explain prior failings and provide future directions for managing pain in chronic pancreatitis.
  
  
  RESULTS
  A number of recent advances have been made in understanding the neurobiology of pain for this condition. This has been coupled with clinical advances in assessing sensitization to pain in these patients, which has been shown to predict response to medical and surgical therapy.
  
  
  CONCLUSIONS
  Pain in chronic pancreatitis is complex. Addressing the mechanical and morphological findings in chronic pancreatitis without addressing the underlying neurobiological mechanisms is destined to fail. New advances in our understanding of the neurobiology of pain in chronic pancreatitis helps to explain prior failings and provides future direction for managing pain in patients afflicted by this disease.
authors.affiliation: Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA.
authors.forename: Robert A
authors.initials: RA
authors.lastname: Moran
authors.forename: Theodore
authors.initials: T
authors.lastname: James
authors.forename: Pankaj Jay
authors.initials: PJ
authors.lastname: Pasricha
mesh_terms: D000700:Analgesics / Q000627:therapeutic use*; D015220:Calcium Channels / Q000187:drug effects*; D018450:Disease Progression; D006801:Humans; D058990:Molecular Targeted Therapy / Q000639:trends; D009419:Nerve Tissue Proteins / Q000187:drug effects*; D059226:Nociceptive Pain / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology / Q000523:psychology*; D010147:Pain Measurement; D050500:Pancreatitis, Chronic / Q000150:complications / Q000503:physiopathology / Q000523:psychology*; D011788:Quality of Life / Q000523:psychology; D000074025:TRPA1 Cation Channel; D050916:TRPV Cation Channels / Q000187:drug effects*; D050051:Transient Receptor Potential Channels / Q000187:drug effects*
chemical_list: D000700:Analgesics; D015220:Calcium Channels; D009419:Nerve Tissue Proteins; D000074025:TRPA1 Cation Channel; C473350:TRPA1 protein, human; D050916:TRPV Cation Channels; C494482:TRPV1 protein, human; D050051:Transient Receptor Potential Channels