Pain Treatment

  • C. E. Forsmark
Conference paper

Abstract

Abdominal pain is a common complication of chronic pancreatitis, occurring in 75%–85% of all patients [1]. Pain is particularly common in patients with alcohol-induced and idiopathic chronic pancreatitis. Abdominal pain is the predominant symptom of chronic pancreatitis and the one that most affects the patients life. Many patients first present with an acute onset of abdominal pain in the setting of an episode of acute pancreatitis. Although this is occurring in the presence of an already irreversibly damaged pancreas, the clinical presentation and complications are indistinguishable from other forms of acute pancreatitis. Patients may experience many of these acute flares but typically eventually develop chronic or continuous pain. Episodes of pain may last from days to weeks. Another group of patients note the gradual onset of relatively continuous pain without acute flares. A small subset of patients will develop diabetes mel-litus or steatorrhoea without pain. The typical epigastric pain radiating to the back is common, but any type of abdominal pain may occur. The pain may be intermittent, continuous, or continuous with superimposed flares but is typically severe enough for analgesics and usually prompts the patient to seek medical attention. Pain is often worsened by eating or by the supine position. Pain may be reduced by cessation of alcohol, and many patients experience a “burn-out” of pain over the course of years as the disease progresses [2]. There is no therapy which effectively treats pain in all patients, making management frustrating to both physician and patient. There are certainly many potential mechanisms for abdominal pain in these patients and the absence of a unifying pathway for pain explains the absence of a single effective therapy. The selection of a particular therapy depends on the etiology of pancreatitis, the pancreatic duct morphology, and the presence of associated complications.

Keywords

Placebo Aspirin Pancreatitis Serine Flare 

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Copyright information

© Springer-Verlag Berlin Heidelberg 1994

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  • C. E. Forsmark

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