Nag DS, Swain BP, Anand R, Barman TK, Vatsala. Pain management in chronic pancreatitis. World J Clin Cases 2024; 12(12): 2016-2022 [PMID: 38680261 DOI: 10.12998/wjcc.v12.i12.2016]
Corresponding Author of This Article
Deb Sanjay Nag, MBBS, MD, Doctor, Department of Anaesthesiology, Tata Main Hospital, C Road West, Northern Town, Bistupur, Jamshedpur 831001, India. ds.nag@tatasteel.com
Research Domain of This Article
Anesthesiology
Article-Type of This Article
Editorial
Open-Access Policy of This Article
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/
Deb Sanjay Nag, Bhanu Pratap Swain, Rishi Anand, Tapas Kumar Barman, Vatsala, Department of Anaesthesiology, Tata Main Hospital, Jamshedpur 831001, India
Author contributions: Nag DS and Swain BP designed the overall concept and outline of the manuscript; Swain BP, Anand R, Barman TK and Vatsala contributed to the discussion and design of the manuscript; all authors contributed to the writing, and editing the manuscript and review of literature.
Conflict-of-interest statement: The authors declare no conflict of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Deb Sanjay Nag, MBBS, MD, Doctor, Department of Anaesthesiology, Tata Main Hospital, C Road West, Northern Town, Bistupur, Jamshedpur 831001, India. ds.nag@tatasteel.com
Received: December 25, 2023 Peer-review started: December 25, 2023 First decision: February 9, 2024 Revised: February 10, 2024 Accepted: March 28, 2024 Article in press: March 28, 2024 Published online: April 26, 2024 Processing time: 112 Days and 22.3 Hours
Abstract
Pain in chronic pancreatitis (CP) is difficult to manage. Many patients suffer from inadequate pain relief, completely incapacitating them in their daily activities. Historically, despite their well-known adverse effects, opioids have been the pillar of treatment regimens in painful CP. The management is now gradually evolving with a better understanding of the underlying pathophysiology of CP-related pain. Clinicians should follow a holistic approach to the management of CP-associated pain, which must involve lifestyle changes that are coupled with analgesic medications and other pain-relieving interventions. Furthermore, there is no easy cure for vanquishing CP-associated pain. Each patient must be evaluated on a case-by-case basis by a multidisciplinary team to decide which treatment option is best suited for that individual.
Core Tip: Management of pain associated with chronic pancreatitis (CP) is difficult because of the intricate pathophysiology of this pain and the lack of universal guidelines. Recent evidence suggests an altered central response to the chronic inflammatory changes in the pancreas, which may rewrite the approach to control pain in CP. Currently, several treatment modalities are available to clinicians. However, optimal patient care must be taken into account comprehensively with inputs from multiple disciplines.
