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Moroz E.V.
GBOU VPO "Pervyĭ MGMU im. I.M. Sechenova", fakul'tetskaia terapevticheskaia klinika im. V.N. Vinogradova, universitetskaia klinicheskaia bol'nitsa #1, Moskva
Karateev A.E.
Nasonova Research Institute of Rheumatology, Moscow, Russia
Krukov E.V.
Main Military Clinical Hospital named after N.N. Burdenko, Moscow, Russia
Chronic abdominal pain in chronic pancreatitis: pathogenesis, clinical phenotypes and modern concept of therapy
Journal: Russian Journal of Pain. 2020;18(2): 40‑46
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To cite this article:
Moroz EV, Karateev AE, Krukov EV. Chronic abdominal pain in chronic pancreatitis: pathogenesis, clinical phenotypes and modern concept of therapy. Russian Journal of Pain.
2020;18(2):40‑46. (In Russ.)
https://doi.org/10.17116/pain20201802140
Chronic pancreatitis (CP) is a severe progressive disease, one of the main manifestations of which is chronic abdominal pain (CAP). The development of the CAP is complex. The central element of the CAP pathogenesis is peripheral sensitization associated with the direct activating effect of trypsin on nociceptors (PAR) and chronic inflammation. The cause of pain may be damage and inflammation of the pancreatic tissue, its compression by massive calcifications and pseudocysts, hypertension of the Virsung duct, etc. In addition, damage to the nerves — branches of the abdominal plexus that pass through the thickness of the pancreas, with the development of elements of neuropathic pain may occur. An important role also have the central sensitization and psychoemotional disorders. Control of the CAP should be include the rejection of bad habits (alcohol and smoking), enzyme replacement therapy, the use of analgesics (paracetamol, NSAIDs, opioids), as well as, if indicated, antidepressants and anticonvulsants.
Keywords:
Authors:
Moroz E.V.
GBOU VPO "Pervyĭ MGMU im. I.M. Sechenova", fakul'tetskaia terapevticheskaia klinika im. V.N. Vinogradova, universitetskaia klinicheskaia bol'nitsa #1, Moskva
Karateev A.E.
Nasonova Research Institute of Rheumatology, Moscow, Russia
Krukov E.V.
Main Military Clinical Hospital named after N.N. Burdenko, Moscow, Russia
Received:
16.04.2020
Accepted:
27.04.2020
List of references:
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