Can you Control Pancreatic Pain?
This is a very important aspect of the treatment of chronic pancreatitis.
- Pancreatic pain varies in severity from mild (controllable with simple analgesics such as paracetamol (eg Panadol)) to severe (requiring morphine-like drugs for control).
- Severe pancreatic pain can be constant, unremitting and lead to depression and even suicide.
- In addition to the preventive measures listed above, the basic principle is to use the drug lowest down the analgesic ladder which controls the pain.
- Since the pain is often worse at night and since both body and mind are at their lowest ebb in the early hours of the morning, the lowest rung of the analgesic ladder may be pethidine or morphine (eg MST continus tablets).
- Since the pain is chronic and severe, there’s a fine line between adequate analgesia and addiction.
- Newer pain relieving medicines, such as pregabalin, may be more effective for this nerve pain and have fewer side-effects. Risk of addiction is also lower.
- Antidepressants may reduce the requirement for pain killers or even help with pain relief themselves.
- Antidepressants may also help with the depression, so often associated with chronic pain itself.
- Pain management in chronic pancreatitis often requires specialist help.
- Most hospitals now have a dedicated pain clinic often run by anaesthetists with particular skills and helped by trained nurses.
- Your GP or hospital gastroeneterologist can help with referral to the pain clinic.
- As well as maximising the benefit from drug therapy the pain specialists may such blocking the nerves to the pancreas to reduce pain.
- It involves the injection of agents via needle into and around the pancreas but requires great skill and careful consideration. see Hayley’s (CPB) x’s 3
