What are sources of pain in chronic pancreatitis?

Updated: Jul 15, 2019
  • Author: Jason L Huffman, MD; Chief Editor: BS Anand, MD  more...
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See the Guidelines section for guidelines for the understanding and management of pain by the Working Group for the International Consensus Guidelines for Chronic Pancreatitis. [15]

A number of factors may contribute to the pain in chronic pancreatitis, and the principal mechanisms of pain may change with the course of the disease. Sources of pain can include the following:

  • Acute disease with inflammation and pseudocyst formation may be superimposed on chronic disease

  • Obstruction of the pancreatic duct by strictures or stones may cause increased duct pressure and pain

  • Pancreatic ischemia, with decreased pancreatic oxygenation and a decreased tissue pH, caused by a compartment syndrome may cause pain that is relieved by duct decompression

  • Pancreatic nerves become enlarged, lose some of their cellular sheath, and are inflamed

  • Obstruction of the duodenum or biliary tract may worsen with acute episodes and improve with time

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