Pharmacological pain management in chronic pancreatitis

Table 2 Treatment of extrapancreatic causes of pain in chronic pancreatitis

	Treatment	Comments
Peptic ulcer	Proton pump inhibitor +/- eradication of H. pylori	Avoid NSAIDs in CP Patients
Pseudocysts	Endoscopic drainage, transcutaneous drainage or surgical drainage	Preferred treatment dependent on pseudocyst localization and morphology
Duodenal obstruction	Endoscopic dilation or surgical therapy	Endoscopic dilation preferred as first line therapy
Bile duct obstruction	Covered metal stent or plastic stent	Controversial, one study found no relationship between bile duct obstruction and pain

NSAID: Nonsteroidal anti-inflammatory drugs; CP: Chronic pancreatitis; H. pylori: Helicobacter pylori.