Painful chronic pancreatitis - New approaches for evaluation and management

Dhiraj Yadav, Tonya M. Palermo, Anna E. Phillips, Melena D. Bellin, Darwin L. Conwell

Research output: Contribution to journalReview articlepeer-review

2 Scopus citations

Abstract

Purpose of reviewManagement of abdominal pain in patients with chronic pancreatitis is often suboptimal. We review recent data on the epidemiology and new approaches for managing pain in chronic pancreatitis.Recent findingsChronic pancreatitis duration does not appear to affect the pain experience. Pain pattern in chronic pancreatitis patients frequently changes and is not related to traditional patient and disease-related factors. Psychologic comorbidities, i.e. anxiety and depression, are frequent in patients with chronic pancreatitis, and are associated with more severe pain and pain interference. Adjunctive treatments, such as cognitive behavioral therapy, may positively influence pain management in chronic pancreatitis. Total pancreatectomy with islet autotransplantation (TPIAT) is an increasingly adopted treatment option in painful chronic pancreatitis. Ongoing multicenter studies will help define optimal candidates, predictors of successful pain remission and diabetes outcomes after TPIAT. Pancreatic quantitative sensory testing, a promising technique to interrogate nociception and sensory response, holds promise to identify patients with central sensitization. Initial studies show feasibility to stratify patients into defined pain profiles, and future studies will explore if these can help in prognostication of pain therapy.SummarySeveral lines of investigations currently under evaluation are likely to have a positive impact on the management of pain in chronic pancreatitis.

Original languageEnglish
Pages (from-to)504-511
Number of pages8
JournalCurrent Opinion in Gastroenterology
Volume37
Issue number5
DOIs
StatePublished - Sep 1 2021

Bibliographical note

Publisher Copyright:
© 2021 Lippincott Williams and Wilkins. All rights reserved.

Keywords

  • TPIAT
  • chronic pancreatitis
  • cognitive behavioral therapy
  • pain
  • psychosocial factors
  • quantitative sensory testing

ASJC Scopus subject areas

  • Gastroenterology

Fingerprint

Dive into the research topics of 'Painful chronic pancreatitis - New approaches for evaluation and management'. Together they form a unique fingerprint.

Cite this