Review
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jan 7, 2015; 21(1): 47-59
Published online Jan 7, 2015. doi: 10.3748/wjg.v21.i1.47
Systematic mechanism-orientated approach to chronic pancreatitis pain
Stefan AW Bouwense, Marjan de Vries, Luuk TW Schreuder, Søren S Olesen, Jens B Frøkjær, Asbjørn M Drewes, Harry van Goor, Oliver HG Wilder-Smith
Stefan AW Bouwense, Marjan de Vries, Luuk TW Schreuder, Harry van Goor, Pain and Nociception Neuroscience Research Group, Department of Surgery, Radboud University Medical Center, 6500HB Gelderland, The Netherlands
Søren S Olesen, Jens B Frøkjær, Asbjørn M Drewes, Department of Gastroenterology and Hepatology and Clinical Medicine, Aalborg University Hospital, 9100 Aalborg, Denmark
Asbjørn M Drewes, Oliver HG Wilder-Smith, Center for Sensory-Motor Interaction, Department of Health Science and Technology, Aalborg University, 9100 Aalborg, Denmark
Oliver HG Wilder-Smith, Department of Anaesthesiology, Pain and Palliative Medicine, Radboud University Medical Center, 6500HB Gelderland, The Netherlands
Author contributions: Bouwense SAW, de Vries M, Schreuder LTW, Olesen SS, Frøkjær JB, Drewes AM, van Goor H and Wilder-Smith OHG had a substantial contribution to the design of this manuscript; all authors drafted and revised the manuscript; all authors gave their full approval to publication of this manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Oliver HG Wilder-Smith, MD, PhD, DSc, Department of Anaesthesiology, Pain and Palliative Medicine, Radboud University Medical Center, Nijmegen, 6500HB Gelderland, The Netherlands. oliver.wilder-smith@radboudumc.nl
Telephone: +31-24-3668120 Fax: +31-24-3613585
Received: July 1, 2014
Peer-review started: July 3, 2014
First decision: July 21, 2014
Revised: August 23, 2014
Accepted: November 18, 2014
Article in press: November 19, 2014
Published online: January 7, 2015
Processing time: 189 Days and 12.6 Hours
Core Tip

Core tip: Pain in chronic pancreatitis (CP) shows many similarities with other visceral pain syndromes. CP pain frequently leads to peripheral and central sensitization. When the latter is present, treating the nociceptive focus, with i.e., analgesic therapy, surgical or endoscopic procedures for local complications may fail even after technically successful procedures. In this case, treatment must be aimed at the central nervous system (CNS). Suitable tools to visualize altered central processing include quantitative sensory testing, electroencephalograpy and magnetic resonance imaging. Future research should be aimed at the circumstances under which CNS processing changes and how this is influenced by pain and therapies.