Manejo del dolor en la pancreatitis crónica

Pain in chronic pancreatitis remains difficult to treat, due to a lack of understanding of the underlying nociceptive process. Therefore, treatments are often based on anatomical changes, although morphological features are not correlated with pain intensity and severity. It is well established that the cause of pain in chronic pancreatitis involves multiple mechanisms. Traditional theories focused solely on the role of morphological abnormalities of the pancreas in pain are flawed; there is now clear evidence showing that the resulting pain resembles that observed in neuropathic pain. Therefore, antineuropathic drugs are frequently used to treat pain. Furthermore, other etiologies of nociception, such as inflammation and increased intraductal pressure, may contribute to abdominal pain. Chronic pancreatitis pain is likely the result of a complex interaction between multiple mechanisms, which could explain the success or partial failure of single-modality treatment approaches. There is no single approach that is effective for all individuals; a personalized care is preferred.