Resumé

Introduction: Pain is the most common symptom in chronic pancreatitis and treatment remains a challenge. Management of visceral pain, in general, is only sparsely documented, and treatment in the clinic is typically based on empirical knowledge from somatic pain conditions. This may be problematic, as many aspects of the neurobiology differ significantly from somatic pain, and organs such as the gut and liver play a major role in tolerability to analgesics. On the other hand, clinical awareness and new methods for quantitative assessment of pain mechanisms, will likely increase our understanding of the visceral pain system and guide more individualized pain management. Areas covered: This review includes an overview of known pain mechanisms in chronic pancreatitis and how to characterize them using quantitative sensory testing. The aim is to provide a mechanism-oriented approach to analgesic treatment, including treatment of psychological factors affecting pain perception and consideration of side effects in the management plan. Expert opinion: A mechanism-based examination and profiling of pain in chronic pancreatitis will enable investigators to provide a well-substantiated approach to effective management. This mechanism-based, individualized regime will pave the road to better pain relief and spare the patient from unnecessary trial-and-error approaches and unwanted side effects.

OriginalsprogEngelsk
TidsskriftExpert Review of Clinical Pharmacology
Vol/bind12
Udgave nummer3
Sider (fra-til)249-258
Antal sider10
ISSN1751-2433
DOI
StatusUdgivet - 4 mar. 2019

Fingerprint

Chronic Pancreatitis
Pain Management
Visceral Pain
Nociceptive Pain
Pain
Analgesics
Pain Perception
Neurobiology
Expert Testimony
Pain Measurement
Therapeutics
Research Personnel
Psychology
Liver

Citer dette

@article{4053d972a1524e3a99fc2045f4885192,
title = "Mechanism-based pain management in chronic pancreatitis - is it time for a paradigm shift?",
abstract = "Introduction: Pain is the most common symptom in chronic pancreatitis and treatment remains a challenge. Management of visceral pain, in general, is only sparsely documented, and treatment in the clinic is typically based on empirical knowledge from somatic pain conditions. This may be problematic, as many aspects of the neurobiology differ significantly from somatic pain, and organs such as the gut and liver play a major role in tolerability to analgesics. On the other hand, clinical awareness and new methods for quantitative assessment of pain mechanisms, will likely increase our understanding of the visceral pain system and guide more individualized pain management. Areas covered: This review includes an overview of known pain mechanisms in chronic pancreatitis and how to characterize them using quantitative sensory testing. The aim is to provide a mechanism-oriented approach to analgesic treatment, including treatment of psychological factors affecting pain perception and consideration of side effects in the management plan. Expert opinion: A mechanism-based examination and profiling of pain in chronic pancreatitis will enable investigators to provide a well-substantiated approach to effective management. This mechanism-based, individualized regime will pave the road to better pain relief and spare the patient from unnecessary trial-and-error approaches and unwanted side effects.",
keywords = "Chronic pancreatitis, analgesics, chronic pain, neurophysiology, pain management, pain measurements, symptom assessment",
author = "Louise Kuhlmann and Olesen, {S{\o}ren S} and Olesen, {Anne E} and Lars Arendt-Nielsen and Drewes, {Asbj{\o}rn M}",
year = "2019",
month = "3",
day = "4",
doi = "10.1080/17512433.2019.1571409",
language = "English",
volume = "12",
pages = "249--258",
journal = "Expert Review of Clinical Pharmacology",
issn = "1751-2433",
publisher = "Taylor & Francis",
number = "3",

}

TY - JOUR

T1 - Mechanism-based pain management in chronic pancreatitis - is it time for a paradigm shift?

AU - Kuhlmann, Louise

AU - Olesen, Søren S

AU - Olesen, Anne E

AU - Arendt-Nielsen, Lars

AU - Drewes, Asbjørn M

PY - 2019/3/4

Y1 - 2019/3/4

N2 - Introduction: Pain is the most common symptom in chronic pancreatitis and treatment remains a challenge. Management of visceral pain, in general, is only sparsely documented, and treatment in the clinic is typically based on empirical knowledge from somatic pain conditions. This may be problematic, as many aspects of the neurobiology differ significantly from somatic pain, and organs such as the gut and liver play a major role in tolerability to analgesics. On the other hand, clinical awareness and new methods for quantitative assessment of pain mechanisms, will likely increase our understanding of the visceral pain system and guide more individualized pain management. Areas covered: This review includes an overview of known pain mechanisms in chronic pancreatitis and how to characterize them using quantitative sensory testing. The aim is to provide a mechanism-oriented approach to analgesic treatment, including treatment of psychological factors affecting pain perception and consideration of side effects in the management plan. Expert opinion: A mechanism-based examination and profiling of pain in chronic pancreatitis will enable investigators to provide a well-substantiated approach to effective management. This mechanism-based, individualized regime will pave the road to better pain relief and spare the patient from unnecessary trial-and-error approaches and unwanted side effects.

AB - Introduction: Pain is the most common symptom in chronic pancreatitis and treatment remains a challenge. Management of visceral pain, in general, is only sparsely documented, and treatment in the clinic is typically based on empirical knowledge from somatic pain conditions. This may be problematic, as many aspects of the neurobiology differ significantly from somatic pain, and organs such as the gut and liver play a major role in tolerability to analgesics. On the other hand, clinical awareness and new methods for quantitative assessment of pain mechanisms, will likely increase our understanding of the visceral pain system and guide more individualized pain management. Areas covered: This review includes an overview of known pain mechanisms in chronic pancreatitis and how to characterize them using quantitative sensory testing. The aim is to provide a mechanism-oriented approach to analgesic treatment, including treatment of psychological factors affecting pain perception and consideration of side effects in the management plan. Expert opinion: A mechanism-based examination and profiling of pain in chronic pancreatitis will enable investigators to provide a well-substantiated approach to effective management. This mechanism-based, individualized regime will pave the road to better pain relief and spare the patient from unnecessary trial-and-error approaches and unwanted side effects.

KW - Chronic pancreatitis

KW - analgesics

KW - chronic pain

KW - neurophysiology

KW - pain management

KW - pain measurements

KW - symptom assessment

UR - http://www.scopus.com/inward/record.url?scp=85061774464&partnerID=8YFLogxK

U2 - 10.1080/17512433.2019.1571409

DO - 10.1080/17512433.2019.1571409

M3 - Review article

VL - 12

SP - 249

EP - 258

JO - Expert Review of Clinical Pharmacology

JF - Expert Review of Clinical Pharmacology

SN - 1751-2433

IS - 3

ER -