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Pharmacological management of pain in chronic pancreatitis
- Source :
- Digestive and Liver Disease, 38, 7, pp. 518-26, Digestive and Liver Disease, 38, 518-26
- Publication Year :
- 2006
-
Abstract
- Contains fulltext : 49730.pdf (Publisher’s version ) (Closed access) Pain is the major presenting symptom of chronic pancreatitis. Patients with chronic pancreatitis experience substantial impairments in health-related quality of life. Pain may be considered as the most important factor affecting the quality of life. The pathogenesis of pancreatic pain is poorly understood. The cause of pain in chronic pancreatitis is probably multifactorial. This article discusses the various hypotheses that have been suggested to underlie pain. Special attention is paid to the concept of autonomous central sensitisation and hyperalgesia as a cause of pain. Strict abstinence from alcohol is the first step of chronic pancreatic pain management. As a second step, it is important to exclude treatable complications of chronic pancreatitis, such as pseudocysts. Symptomatic treatment with analgesics is often unavoidable in patients with chronic pancreatitis. Acetaminophen, non-steroidal anti-inflammatory drugs and eventually opioids are suitable. Several trials have been performed with pancreatic enzymes, but a meta-analysis demonstrated no significant benefit in terms of pain relief. The treatment of chronic pancreatic pain requires a multidisciplinary approach that tailors the various therapeutic options to meet the need of the individual patient.
- Subjects :
- medicine.medical_specialty
media_common.quotation_subject
Membrane transport and intracellular motility [NCMLS 5]
Pain
Pathogenesis
Quality of life
Pancreatitis, Chronic
medicine
Perception and Action [DCN 1]
Neurosensory disorders [UMCN 3.3]
Animals
Humans
Molecular gastro-enterology and hepatology [IGMD 2]
Intensive care medicine
media_common
Hepatology
business.industry
Gastroenterology
Chronic pain
Effective primary care and public health [NCEBP 7]
Abstinence
medicine.disease
Acetaminophen
Diet
Quality of Care [EBP 4]
Pathogenesis and modulation of inflammation [N4i 1]
Oxidative Stress
Pancreatic pain
Genetic defects of metabolism [UMCN 5.1]
Anesthesia
Hyperalgesia
Quality of Life
Pancreatitis
Microbial pathogenesis and host defense [UMCN 4.1]
medicine.symptom
business
medicine.drug
Subjects
Details
- ISSN :
- 15908658
- Volume :
- 38
- Database :
- OpenAIRE
- Journal :
- Digestive and Liver Disease
- Accession number :
- edsair.doi.dedup.....f321688988de1a821d4081d586a062e7