Management of pain in chronic pancreatitis with emphasis on exogenous pancreatic enzymes

Table 3 Mechanisms of pain in chronic pancreatitis

Increased intraductal pressure

Ductal obstruction from strictures/stones

Increased intrapancreatic pressure (compartment-like syndrome)

Fibrosis causing lack of distensibility

Neuropathic

Entrapment of nerves

Damage of nerves by enzymes

Increased nerve tissue

Pancreatic ischemia

Worsened during increased enzyme secretion