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Treatment of Chronic Pancreatitis Pain

Overview and Medical Management

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Pancreatitis and Its Complications

Part of the book series: Clinical Gastroenterology ((CG))

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Abstract

Patients with chronic pancreatitis (CP) come to medical attention because of abdominal pain or symptoms of maldigestion or diabetes. Abdominal pain is clearly the most common and most significant of symptoms and is the most difficult to treat and generally interferes with quality of life. The abdominal pain is quite variable in location, severity, and frequency. Patients with acute pancreatitis (AP) experience mid-epigastric pain that radiates to the back. The pain of CP often does not follow this classical pattern. Indeed, many variations of abdominal pain may be caused by CP. The pain can be constant or intermittent, and there may be frequent pain-free intervals. Eating may exacerbate the pain, leading to fear of eating and weight loss. The spectrum of abdominal pain ranges from mild to severe, often with narcotic dependence as a consequence.

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References

  1. Toskes PP, Greenberger NJ. Approach to the patient with pancreatic disease. In: Braunwald E, Fauci AS, Kasper DL, et al.,eds. Harrison’s Principles of Internal Medicine, ed. 15. McGraw Hill, New York, 2001: 1788–1792.

    Google Scholar 

  2. Greenberger NJ, Toskes PP. Acute and chronic pancreatitis. In: Braunwald E, Fauci AS, Kasper DL, et al., eds. Harrison’s Principles of Internal Medicine, ed. 15.McGraw Hill, New York, 2001: 1792–1804.

    Google Scholar 

  3. Toskes PP. Update on diagnosis and management of chronic pancreatitis. Curr Gastroenterol Rep 1999; 1: 145–153.

    Article  PubMed  CAS  Google Scholar 

  4. Draganov R, Toskes PP. Chronic pancratitis. Curr Opin Gastroenterol 2002; 18: 558–562.

    Article  PubMed  CAS  Google Scholar 

  5. Chowdhury R, Forsmark CE, Toskes PP, et al. The evaluation of unexplained pain of presumed pancreatic origin. Gastroenterology 2001; A-760(Abstract): 120.

    Google Scholar 

  6. Chowdhury R, Forsmark C, Toskes PP, et al. Prevalence of gastroparesis in patients with small duct chronic pancreatitis. Pancreas 2003; 26: 235–238.

    Article  PubMed  Google Scholar 

  7. Slaff J, Jacobson D, Tillman CR, et al. Protease-specific suppression of pancreatic exocrine secretion. Gastroenterology 1984; 87: 44–52.

    PubMed  CAS  Google Scholar 

  8. Warshaw AL, Banks PA, Fernandez-Del Castillo CAG. Atechnical review: treatment of pain in chronic pancreatitis. Gastroenterology 1998; 115: 765–776.

    Article  PubMed  CAS  Google Scholar 

  9. Toskes PP, Forsmark CE, DeMeo Mt, et al. A multi-center controlled trial of octreotide for the pain of chronic pancreatitis. Pancreas 1993; 8(abstract): 774.

    Google Scholar 

  10. De las Heras Castano G, Garcia de la Paz A, Fernandez MD, Fernandez Forcelledo JL. Use of antioxidants to treat pain in chronic pancreatitis. Rev Esp Enferm Dig 2000; 92: 375–385.

    PubMed  Google Scholar 

  11. Uden S, Bilton D, Guyan PM, et al. Rational for antioxidant therapy in pancreatitis and cystic fibrosis. Adv Exp Med Biol 1990; 264: 555–572.

    PubMed  CAS  Google Scholar 

  12. Toskes PP, Currington C, Cintron M, et al. Oral administration of the CCKantagonist MK329. substantiates feedback control of pancreatic secretion in chronic pancreatitis patients. Gastroenterology 1990; 98(abstract): 237.

    Google Scholar 

  13. Shiratori K, Takeuchi T, Satake K, Matsuno S. Clinical evaluation of oral administration of a cholecystokinin-a receptor antagonist (loxiglumide) to patients with acute, painful attacks of chronic pancreatitis: a multicenter dose-response study in Japan. Pancreas 2002; 25: E1–E5.

    Article  PubMed  Google Scholar 

  14. Mitchell RMS, Byrne MF, Baillie J. Pancreatitis. Lancet 2003; 361: 1447–1455.

    Article  PubMed  CAS  Google Scholar 

  15. Gress F, Schmitt C, Sherman S, et al. Endoscopic ultrasound guided celiac plexus block for managing abdominal pain associated with chronic pancreatitis: a prospective single center experience. Am J Gastroenterol 2001; 96: 409–416.

    Article  PubMed  CAS  Google Scholar 

  16. Buscher HC, Jansen JB, van Dongen R, et al. Results of bilateral thoracoscopic splanchnicectomy in patients with chronic pancreatitis. Br J Surg 2002; 89: 158–162.

    PubMed  CAS  Google Scholar 

  17. Dite P, Ruzicka M, Zboril V, et al. Randomized trial comparing endoscopic with surgical therapy for chronic pancreatitis. Endoscopy 2003; 35: 553–558.

    Article  PubMed  CAS  Google Scholar 

  18. Howell JG, Johnson LW, Sehon JK, Lee WC. Surgical management for chronic pancreatitis. Am Surg 2001; 67: 487–490.

    PubMed  CAS  Google Scholar 

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© 2005 Humana Press Inc., Totowa, NJ

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Toskes, P.P. (2005). Treatment of Chronic Pancreatitis Pain. In: Forsmark, C.E. (eds) Pancreatitis and Its Complications. Clinical Gastroenterology. Humana Press. https://doi.org/10.1385/1-59259-815-3:209

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  • DOI: https://doi.org/10.1385/1-59259-815-3:209

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-58829-179-0

  • Online ISBN: 978-1-59259-815-1

  • eBook Packages: MedicineMedicine (R0)

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