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Pain management in chronic pancreatitis

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Author(s): Cathia Gachago, Peter V Draganov

Journal: World Journal of Gastroenterology
ISSN 1007-9327

Volume: 14;
Issue: 20;
Start page: 3137;
Date: 2008;
Original page

Keywords: Chronic pancreatitis | Pain | Endoscopy | Endoscopic ultrasound | Pancreas

ABSTRACT
Abdominal pain is a major clinical problem in patients with chronic pancreatitis. The cause of pain is usually multifactorial with a complex interplay of factors contributing to a varying degree to the pain in an individual patient and, therefore, a rigid standardized approach for pain control tends to lead to suboptimal results. Pain management usually proceeds in a stepwise approach beginning with general lifestyle recommendations. Low fat diet, alcohol and smoking cessation are encouraged. Analgesics alone are needed in almost all patients. Maneuvers aimed at suppression of pancreatic secretion are routinely tried. Patients with ongoing symptoms may be candidates for more invasive options such as endoscopic therapy, and resective or drainage surgery. The role of pain modifying agents (antidepressants, gabapentin, pregabalin), celiac plexus block, antioxidants, octreotide and total pancreatectomy with islet cell auto transplantation remains to be determined.
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