Pain patterns in chronic pancreatitis and chronic primary pain

N. L. Tuck*, K. Teo, L. Kuhlmann, S. S. Olesen, M. Johnson, D. J. Bean, U. Rashid, A. D. MacCormick, G. Srikumar, A. M. Drewes, J. A. Windsor

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review

4 Citations (Scopus)

Abstract

BACKGROUND: Abdominal pain is the most distressing symptom of chronic pancreatitis (CP), and current treatments show limited benefit. Pain phenotypes may be more useful than diagnostic categories when planning treatments, and the presence or absence of constant pain in CP may be a useful prognostic indicator.

AIMS: This cross-sectional study examined dimensions of pain in CP, compared pain in CP with chronic primary pain (CPP), and assessed whether constant pain in CP is associated with poorer outcomes.

METHODS: Patients with CP (N = 91) and CPP (N = 127) completed the Comprehensive Pancreatitis Assessment Tool. Differences in clinical characteristics and pain dimensions were assessed between a) CP and CPP and b) CP patients with constant versus intermittent pain. Latent class regression analysis was performed (N = 192) to group participants based on pain dimensions and clinical characteristics.

RESULTS: Compared to CPP, CP patients had higher quality of life (p < 0.001), lower pain severity (p < 0.001), and were more likely to use strong opioids (p < 0.001). Within CP, constant pain was associated with a stronger response to pain triggers (p < 0.05), greater pain spread (p < 0.01), greater pain severity, more features of central sensitization, greater pain catastrophising, and lower quality of life compared to intermittent pain (all p values ≤ 0.001). Latent class regression analysis identified three groups, that mapped onto the following patient groups 1) combined CPP and CP-constant, 2) majority CPP, and 3) majority CP-intermittent.

CONCLUSIONS: Within CP, constant pain may represent a pain phenotype that corresponds with poorer outcomes. CP patients with constant pain show similarities to some patients with CPP, potentially indicating shared mechanisms.

Original languageEnglish
JournalPancreatology
Volume22
Issue number5
Pages (from-to)572-582
Number of pages11
ISSN1424-3903
DOIs
Publication statusPublished - 1 Jun 2022

Bibliographical note

Copyright © 2022 IAP and EPC. Published by Elsevier B.V. All rights reserved.

Keywords

  • Biopsychosocial model
  • Chronic pain
  • Chronic pancreatitis
  • Pain assessment
  • Pain phenotypes

Fingerprint

Dive into the research topics of 'Pain patterns in chronic pancreatitis and chronic primary pain'. Together they form a unique fingerprint.

Cite this