Pain in Chronic Pancreatitis and Pancreatic Cancer
Chronic, debilitating abdominal pain is arguably the most important component of chronic pancreatitis, leading to significant morbidity and disability. Attempting to treat this pain, which is too often unsuccessful, is a frustrating experience for physician and patient. Multiple studies to improve understanding of the pathophysiology that causes pain in some patients but not in others have been performed since the most recent reviews on this topic. In addition, new treatment modalities have been developed and evaluated in this population. This review discusses new advances in neuroscience and the study of visceral pain mechanisms, as well as genetic factors that may play a role. Updates of established therapies, as well as new techniques used in addressing pain from chronic pancreatitis, are reviewed. Lastly, outcome measures, which have been highly variable in this field over the years, are addressed.
aDepartment of Medicine, Division of Gastroenterology, Hepatology and Nutrition, University of Pittsburgh Medical Center, Mezzanine level 2, C-wing, 200 Lothrop Street, Pittsburgh, PA 15213, USA
bDepartment of Neurobiology, University of Pittsburgh School of Medicine, E1440, Biomedical Science Tower, 200 Lothrop Street, Pittsburgh, PA 15213, USA
cDepartment of Anesthesiology, UPMC Pain Medicine, 125 Daugherty Drive, Suite 200, Monroeville, PA 15146, USA
dDepartment of Surgery, Division of Surgical Oncology, University of Pittsburgh Medical Center, 497 Scaiffe Hall, 3550 Terrace Street, Pittsburgh, PA 15261, USA
eDepartment of Cell Biology & Physiology, University of Pittsburgh, S362 Biomedical Science Tower, 3500 Terrace Street, Pittsburgh, PA 15213, USA
fDepartment of Human Genetics, University of Pittsburgh, A300 Crabtree Hall, GSPH, 130 Desoto Street, Pittsburgh, PA 15213, USA
Corresponding author. Division of Gastroenterology, Hepatology, and Nutrition, University of Pittsburgh Medical Center, Mezzanine level 2, C-wing, 200 Lothrop Street, Pittsburgh, PA 15213.
ABSTRACT