Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2013 Feb;7(1):8-22.
doi: 10.1177/2049463713479230.

The pain of chronic pancreatitis: a persistent clinical challenge

Michael R Goulden  1
Affiliations

The pain of chronic pancreatitis: a persistent clinical challenge

Michael R Goulden. Br J Pain. 2013 Feb.

Abstract

The pain of chronic pancreatitis represents a major challenge to those working in the field, including pain specialists, gastroenterologists and surgeons. This article describes the different aetiologies of chronic pancreatitis and lists the models for the pathogenesis of pain, including novel ideas such as the role of the immune system in the modulation of pain. The patient profile in chronic pancreatitis is discussed along with the social impact of the disease in relation to alcohol misuse. The range of treatment strategies including medical, endoscopic and surgical approaches are evaluated. Common analgesic regimes and their limitations are reviewed. The pain of chronic pancreatitis remains refractory to effective treatment in many cases and further study and understanding of the underlying pathophysiology are required.

Keywords: Pancreatitis; chronic; neuropathic; opioid; pain.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Pancreatic duct dilatation and calcification.
Figure 2.
Figure 2.
TIGAR-O Risk factor classification system. Reproduced from Stevens T, Conwell DL and Zuccaro G. Pathogenesis of chronic pancreatitis: an evidence-based review of past theories and recent developments pathogenesis of chronic pancreatitis. Am J Gastroenterol 2004; 99: 2256–2270 with permission from Nature Publishing Group.
Figure 3.
Figure 3.
Large stone in the head of the pancreas.
Figure 4.
Figure 4.
Inflammatory mass at head of pancreas.
See this image and copyright information in PMC

References

    1. Bornman PC, Beckingham IJ. ABC of diseases of liver, pancreas, and biliary system. Chronic pancreatitis. BMJ 2001; 322(7287): 660–663. - PMC - PubMed
    1. Sarner M, Cotton PB. Classification of pancreatitis. Gut 1984; 25: 756–759. - PMC - PubMed
    1. Sarles H. Pancreatitis Symposium, Marseille, April 25 and 26, 1963 Basel: Karger, 1965.
    1. Sarles H. Proposal adopted unanimously by the participants of the Symposium, Marseilles 1963. Bibl Gastroenterol 1965; 7: 7–8.
    1. Singer MV, Gyr K, Sarles H. Revised classification of pancreatitis: report of the Second International Symposium on the Classification of Pancreatitis in Marseille, France, March 28–30, 1984. Gastroenterology 1985; 89: 683–685. - PubMed