(123) Visceral Pain Mechanisms: Features of Constant Pain and Genetic Linkage in Chronic Pancreatitis Patients

Both the sensory and the motivational-affective component of pain must be taken into account in studies on sex differences as well as on neuropathic, postoperative, sympathetic, and visceral pain. In all these cases, therapeutic strategies should be aimed at controlling the peripheral, central, and psychological mechanisms underlying the global pain experience. Similarly, it should be recalled that some neuropeptides act on both sensory and affective pain mechanisms. [berkley; mcmahon; dickenson; coderre & katz; wiesenfeld-hallin et al.; blumberg et al.]

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961 Quality of Life (QOL) in Chronic Pancreatitis (CP) Is Determined by Constant Pain, Disability, Current Smoking and Associated Co-Morbidities

Gastroenterology ◽

10.1016/s0016-5085(16)30723-5 ◽

2016 ◽

Vol 150 (4) ◽

pp. S191-S192 ◽

Cited By ~ 1

Author(s):

Jorge D. Machicado ◽

Stephen Amann ◽

Michelle Anderson ◽

Judah Abberbock ◽

Stuart Sherman ◽

...

Keyword(s):

Quality Of Life ◽

Chronic Pancreatitis ◽

Current Smoking ◽

Pain Disability ◽

Constant Pain

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Visceral Pain: Mechanisms of Peripheral and Central Sensitization

Annals of Medicine ◽

10.3109/07853899509031965 ◽

1995 ◽

Vol 27 (2) ◽

pp. 235-239 ◽

Cited By ~ 104

Author(s):

Fernando Cervero

Keyword(s):

Central Sensitization ◽

Visceral Pain ◽

Pain Mechanisms

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Randomised clinical trial: pregabalin attenuates experimental visceral pain through sub-cortical mechanisms in patients with painful chronic pancreatitis

Alimentary Pharmacology & Therapeutics ◽

10.1111/j.1365-2036.2011.04802.x ◽

2011 ◽

Vol 34 (8) ◽

pp. 878-887 ◽

Cited By ~ 35

Author(s):

S. S. Olesen ◽

C. Graversen ◽

A. E. Olesen ◽

J. B. Frøkjaer ◽

O. Wilder-Smith ◽

...

Keyword(s):

Clinical Trial ◽

Chronic Pancreatitis ◽

Visceral Pain ◽

Randomised Clinical Trial

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Pain mechanisms in chronic pancreatitis: of a master and his fire

Langenbeck s Archives of Surgery ◽

10.1007/s00423-010-0731-1 ◽

2010 ◽

Vol 396 (2) ◽

pp. 151-160 ◽

Cited By ~ 56

Author(s):

Ihsan Ekin Demir ◽

Elke Tieftrunk ◽

Matthias Maak ◽

Helmut Friess ◽

Güralp Onur Ceyhan

Keyword(s):

Chronic Pancreatitis ◽

Pain Mechanisms

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Pain in chronic pancreatitis: the role of neuropathic pain mechanisms

Gut ◽

10.1136/gut.2007.146621 ◽

2008 ◽

Vol 57 (11) ◽

pp. 1616-1627 ◽

Cited By ~ 94

Author(s):

A M Drewes ◽

A L Krarup ◽

S Detlefsen ◽

M-L Malmstrom ◽

G Dimcevski ◽

...

Keyword(s):

Neuropathic Pain ◽

Chronic Pancreatitis ◽

Pain Mechanisms

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Management of Chronic Pancreatitis

10.2310/gastro.5466 ◽

2016 ◽

Author(s):

Darwin L. Conwell ◽

Veeral M. Oza

Keyword(s):

Chronic Pancreatitis ◽

Ct Scan ◽

Pancreatic Duct ◽

Main Pancreatic Duct ◽

Clinical Course ◽

Islet Cells ◽

Pain Mechanisms ◽

Computed Tomographic ◽

Future Challenges ◽

Criteria For Diagnosis

Chronic pancreatitis (CP) is a syndrome that is characterized by inflammation, irreversible fibrosis, and loss of acinar and islet cells. It has also been described as an “enigmatic process of uncertain pathogenesis, unpredictable clinical course, and unclear treatment.” This review describes the epidemiology, diagnosis, diagnostic challenges, differential diagnosis, treatment, complications, and clinical course and prognosis of CP, as well as future challenges. Figures show a computed tomographic (CT) scan of calcific CP, a secretin-enhanced magnetic resonance cholangiopancreatogram showing a dilated and tortuous main pancreatic duct, a CT scan of a large chronic pseudocyst compressing the stomach and pancreas, an endoscopic ultrasound (EUS) image of CP, a retrograde pancreatogram showing a dilated main pancreatic duct with stones and “blunted” side branches, sources of pain in CP, neuropathic pain mechanisms in CP, and an algorithm summarizing treatment of pain in CP. Tables list the TIGAR-O etiologic classification of CP, standard criteria for diagnosis of CP by EUS, Cambridge endoscopic retrograde cholangiopancreatography grading for CP, and a stepwise radiographic and endoscopic diagnostic approach to patients with suspected CP. Key words: bile duct obstruction, chronic pancreatitis, pancreatic calcifications, TIGAR-O system This review contains 8 highly rendered figures, 4 tables, and 54 references.

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Toward an effective peripheral visceral analgesic: responding to the national opioid crisis

AJP Gastrointestinal and Liver Physiology ◽

10.1152/ajpgi.00013.2018 ◽

2018 ◽

Vol 314 (6) ◽

pp. G637-G646 ◽

Cited By ~ 8

Author(s):

Michael Camilleri

Keyword(s):

Abdominal Pain ◽

Transient Receptor Potential ◽

Trp Channels ◽

Visceral Pain ◽

Receptor Potential ◽

Opioid Peptide ◽

Current Evidence ◽

Orphanin Fq ◽

Pain Mechanisms ◽

Opioid Crisis

This mini-review summarizes recent new developments in visceral analgesics. This promising field is important, as a new approach to address abdominal pain with peripheral visceral analgesics is considered a key approach to addressing the current opioid crisis. Some of the novel compounds address peripheral pain mechanisms through modulation of opioid receptors via biased ligands, nociceptin/orphanin FQ opioid peptide (NOP) receptor, or dual action on NOP and μ-opioid receptor, buprenorphine and morphiceptin analogs. Other compounds target nonopioid mechanisms, including cannabinoid (CB2), N-methyl-d-aspartate, calcitonin gene-related peptide, estrogen, and adenosine A2B receptors and transient receptor potential (TRP) channels (TRPV1, TRPV4, and TRPM8). Although current evidence is based predominantly on animal models of visceral pain, early human studies also support the evidence from the basic and animal research. This augurs well for the development of nonaddictive, visceral analgesics for treatment of chronic abdominal pain, an unmet clinical need.

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