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Outpatient Pain Management in Children With Chronic Pancreatitis: A Scoping Systematic Review
Emily R Perito1, John F Pohl2, Caitlin Bakker3
1From the Department of Pediatrics, University of California San Francisco, San Francisco, CA.
Pancreas
|April 11, 2022
Summary
Evidence-based guidelines for pediatric chronic pancreatitis (CP) pain are lacking. This review found no high-quality studies supporting specific therapies for children with CP, highlighting the need for multicenter research.
Area of Science:
- Pediatric Gastroenterology
- Pain Management
- Systematic Review
Background:
- Pain management is crucial for pediatric chronic pancreatitis (CP) care.
- No evidence-based guidelines currently exist for managing pain in children with CP.
Purpose of the Study:
- To conduct a scoping systematic review to identify effective pain management strategies for pediatric chronic pancreatitis.
- To evaluate existing literature on pain treatment for children with CP, drawing comparisons with adult CP and related conditions.
Main Methods:
- Systematic literature review of studies on pain management in pediatric and adult CP.
- Inclusion of studies on juvenile idiopathic arthritis and sickle cell disease for comparative pain course analysis.
- Screening of 8997 identified studies, with 287 meeting inclusion criteria.
Main Results:
- No published studies were found on specific treatments like medications, antioxidants, dietary changes, or nerve blocks for children with CP.
- Studies in adults with CP showed mixed results for nonopioid analgesics, pancreatic enzymes, and dietary interventions.
- Retrospective data suggest endoscopic retrograde cholangiopancreatography and surgical procedures, including total pancreatectomy with islet autotransplant, may improve pain in children with CP, but follow-up durations were short.
Conclusions:
- Currently, no therapy for pediatric chronic pancreatitis pain has sufficient high-quality evidence for strong support.
- There is a critical need for multicenter studies to establish evidence-based "best practices" for pain management in children with CP.
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