November 12, 2014
Notes: Popa, D
J Med Life. 2013 Dec 15;6(4):486-90. Epub 2013 Dec 25.
Author Address: “Carol Davila” University of Medicine and Pharmacy Department of Surgery, University Emergency Hospital Bucharest, Romania.
Reference Type: Journal Article
Record Number: 4750Author: Poulsen, J. L., Olesen, S. S., Malver, L. P., Frokjaer, J. B. and Drewes, A. M.
Title: Pain and chronic pancreatitis: a complex interplay of multiple mechanisms
Journal: World J Gastroenterol
Date: Nov 14
Short Title: Pain and chronic pancreatitis: a complex interplay of multiple mechanisms
Alternate Journal: World journal of gastroenterology : WJG
ISSN: 2219-2840 (Electronic)
Accession Number: 24259959
Keywords: Abdominal Pain/*etiology/physiopathology/psychology/therapy
Abstract: Despite multiple theories on the pathogenesis of pain in chronic pancreatitis, no uniform and consistently successful treatment strategy exists and abdominal pain still remains the dominating symptom for most patients and a major challenge for clinicians. Traditional theories focussed on a mechanical cause of pain related to anatomical changes and evidence of increased ductal and interstitial pressures. These observations form the basis for surgical and endoscopic drainage procedures, but the outcome is variable and often unsatisfactory. This underscores the fact that other factors must contribute to pathogenesis of pain, and has shifted the focus towards a more complex neurobiological understanding of pain generation. Amongst other explanations for pain, experimental and human studies have provided evidence that pain perception at the peripheral level and central pain processing of the nociceptive information is altered in patients with chronic pancreatitis, and resembles that seen in neuropathic and chronic pain disorders. However, pain due to e.g., complications to the disease and adverse effects to treatment must not be overlooked as an additional source of pain. This review outlines the current theories on pain generation in chronic pancreatitis which is crucial in order to understand the complexity and limitations of current therapeutic approaches. Furthermore, it may also serve as an inspiration for further research and development of methods that can evaluate the relative contribution and interplay of different pain mechanisms in the individual patients, before they are subjected to more or less empirical treatment.