Pain management in chronic pancreatitis

Abstract

Pain in chronic pancreatitis (CP) is difficult to manage. Many patients suffer from inadequate pain relief, completely incapacitating them in their daily activities. Historically, despite their well-known adverse effects, opioids have been the pillar of treatment regimens in painful CP. The management is now gradually evolving with a better understanding of the underlying pathophysiology of CP-related pain. Clinicians should follow a holistic approach to the management of CP-associated pain, which must involve lifestyle changes that are coupled with analgesic medications and other pain-relieving interventions. Furthermore, there is no easy cure for vanquishing CP-associated pain. Each patient must be evaluated on a case-by-case basis by a multidisciplinary team to decide which treatment option is best suited for that individual.

Keywords: Pancreatitis; Abdominal pain; Palliative care; Analgesics; Life style; Psychology

Core Tip: Management of pain associated with chronic pancreatitis (CP) is difficult because of the intricate pathophysiology of this pain and the lack of universal guidelines. Recent evidence suggests an altered central response to the chronic inflammatory changes in the pancreas, which may rewrite the approach to control pain in CP. Currently, several treatment modalities are available to clinicians. However, optimal patient care must be taken into account comprehensively with inputs from multiple disciplines.