1. Medical Management of Pancreatitis Pain
SMART APPROACH
DOI:
https://doi.org/10.69734/2xkjd233Keywords:
pancreatitis, chronic pancreatitis, pain, pain syndrome, ESWAL, major depressive disorder, general anxiety disorder, quantitative sensory testing, QST, selective norepinephrine reuptake inhibitor, recurrent acute pancreatitis, endoscopic ultrasound, Pharmacogenetic , NSAID, opioid, opioid ladder, chronic pain, surgery, post-traumatic stress disorder , tricyclic antidepressant, gabapentinoid , TPIATAbstract
Chronic pain is the most distressing feature of recurrent acute pancreatitis (RAP) and chronic pancreatitis (CP). Pain can arise from injury, inflammation, obstruction of ducts, neuritis, and/or inherent problems with pain processing and tolerance in the brain and nervous system. Professor Singh provides expert guidance on how he approaches patients with chronic pancreatic pain.
References
References
Drewes AM, Bouwense SAW, Campbell CM, Ceyhan GO, Delhaye M, Demir IE, et al. Guidelines for the understanding and management of pain in chronic pancreatitis. Pancreatology. 2017;17(5):720-31. PMID: 28734722
Singh VK, Yadav D, Garg PK. Diagnosis and Management of Chronic Pancreatitis: A Review. JAMA. 2019;322(24):2422-34. PMID: 31860051
Dunbar EK, Saloman JL, Phillips AE, Whitcomb DC. Severe Pain in Chronic Pancreatitis Patients: Considering Mental Health and Associated Genetic Factors. Journal of pain research. 2021;14:773-84. PMID: 33762844
Hicks JK, Sangkuhl K, Swen JJ, Ellingrod VL, Muller DJ, Shimoda K, et al. Clinical pharmacogenetics implementation consortium guideline (CPIC) for CYP2D6 and CYP2C19 genotypes and dosing of tricyclic antidepressants: 2016 update. Clin Pharmacol Ther. 2017;102(1):37-44. PMID: 27997040
Olesen SS, Bouwense SA, Wilder-Smith OH, van Goor H, Drewes AM. Pregabalin reduces pain in patients with chronic pancreatitis in a randomized, controlled trial. Gastroenterology. 2011;141(2):536-43. PMID: 21683078
Kim E, Raji MA, Westra J, Wilkes D, Kuo YF. Comparative effectiveness of pain control between opioids and gabapentinoids in older patients with chronic pain. Pain. 2023. PMID: 37561652
Dunbar E, Greer PJ, Melhem N, Alkaade S, Amann ST, Brand R, et al. Constant-severe pain in chronic pancreatitis is associated with genetic loci for major depression in the NAPS2 cohort. J Gastroenterol. 2020;55(10):1000-9. PMID: 32681239
Dunbar EK, Greer PJ, Amann ST, Alkaade S, Banks P, Brand R, et al. Pain Experience in Pancreatitis: Strong Association of Genetic Risk Loci for Anxiety and PTSD in Patients With Severe, Constant, and Constant-Severe Pain. Am J Gastroenterol. 2021;116(10):2128-36. PMID: 34236339
Phillips AE, Faghih M, Drewes AM, Singh VK, Yadav D, Olesen SS. Psychiatric Comorbidity in Patients With Chronic Pancreatitis Associates With Pain and Reduced Quality of Life. Am J Gastroenterol. 2020;115(12):2077-85. PMID: 32740078
Knoph CS, Nedergaard RB, Olesen SS, Kuhlmann L, Drewes AM. Spinal Excitability in Patients with Painful Chronic Pancreatitis. Journal of pain research. 2023;16:2287-98. PMID: 37431436
Olesen SS, Graversen C, Bouwense SA, van Goor H, Wilder-Smith OH, Drewes AM. Quantitative sensory testing predicts pregabalin efficacy in painful chronic pancreatitis. PLoS One. 2013;8(3):e57963. PMID: 23469256
Faghih M, Phillips AE, Kuhlmann L, Afghani E, Drewes AM, Yadav D, et al. Pancreatic QST Differentiates Chronic Pancreatitis Patients into Distinct Pain Phenotypes Independent of Psychiatric Comorbidities. Clin Gastroenterol Hepatol. 2022;20(1):153-61 e2. PMID: 34108130
Johnston KJA, Adams MJ, Nicholl BI, Ward J, Strawbridge RJ, Ferguson A, et al. Genome-wide association study of multisite chronic pain in UK Biobank. PLoS Genet. 2019;15(6):e1008164. PMID: 31194737
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