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Chronic Pancreatitis With or Without Acute Exacerbations: Novel Options for Pain Control

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Chronic Abdominal Pain

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Abstract

Chronic pancreatitis (CP) is a benign inflammatory disease of the pancreas. The mechanism of pain is incompletely understood although the knowledge of this disease starts with the study of Sarles et al. in 1965. Irreversible morphological changes take place with progressive loss of the exocrine and later endocrine function of the gland due to fibrosis.

Alcohol has a leading etiopathogenetic role in chronic pancreatitis but genetic factors also play a key role in the onset of the disease. Besides, other causes of CP have been described like hereditary, tropical, autoimmune, obstructive, toxic infective, or idiopathic. The incidence of CP ranges between 5 and 12 cases/100,000 geographical differences are observed. The incidence of CP cases diagnosed during life is increasing [5]. The mortality within 10 years is about 30 %.

This disease develops insidiously with pain often being the first and most prominent clinical sign. It is important to establish a treatment plan that takes the cause and the symptoms into consideration. This often starts with lifestyle adjustments and medication. But if this is insufficient and pain is becoming continuous, more invasive techniques should be taken into account whether this is surgical, endoscopic, or (interventional) pain therapy.

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  1. Ziekenhuis Oost-Limburg, Anesthesiology and Multidisciplinary Pain Center, Bessemersstraat 478, Lanaken, 3620, Belgium

    Martine Puylaert M.D., F.I.P.P.

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Correspondence to Martine Puylaert M.D., F.I.P.P. .

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  1. Medical Director, Carolinas Pain Institute and Clinical Research Center, Professor of Anesthesiology, Wake Forest University, School of Medicine, Winston-Salem, North Carolina, USA

    Leonardo Kapural

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Puylaert, M. (2015). Chronic Pancreatitis With or Without Acute Exacerbations: Novel Options for Pain Control. In: Kapural, L. (eds) Chronic Abdominal Pain. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-1992-5_9

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