Help
Subscribe


GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy

 19 October 2017

Advanced search
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy Profile of Roy Pounder

Home

News  
Journals
Review Articles
Slide Atlas
Video Clips
Online Books
Advanced Digestive Endoscopy
Classical Cases
Conference Diary
PubMed
International GH Links
USA GH Links
National GH Links
National GI Societies
Other Useful Links




Emails on Gastroenterology and Hepatology
the National AIDS Treatment Advocacy Project
Visit the gastroenterology section of the EUMS

News

Management of pain in patients with pancreatic cancer

The latest issue of the Digestive Diseases & Sciences examines the prevalence, mechanisms, management and future of pain in patients with pancreatic cancer.

News image

Pain affects approximately 80% of patients with pancreatic cancer, with half requiring strong opioid analgesia, namely, morphine-based drugs on step 3 of the WHO analgesic ladder. 

The presence of pain is associated with reduced survival. 

Dr Andreas Koulouris and colleagues from the United Kingdom reviews the literature regarding pain: prevalence, mechanisms, pharmacological, and endoscopic treatments and identifies areas for research to develop individualized patient pain management pathways. 

The online literature review was conducted through PubMed, Clinical Key, Uptodate, and NICE Evidence. 

Case series report pancreatic duct stenting gives effective analgesia
Digestive Diseases & Sciences
The team found 2 principal mechanisms for pain, involving pancreatic duct obstruction and pancreatic neuropathy which, respectively, activate mechanical and chemical nociceptors. 

In pancreatic neuropathy, the research team reports several histological, molecular, and immunological changes occur which correlate with pain including transient receptor potential cation channel activation and mast cell infiltration. 

The researchers note that current pain management is empirical rather etiology-based, and is informed by the WHO analgesic ladder for first-line therapies, and then endoscopic ultrasound-guided celiac plexus neurolysis (EUS-CPN) in patients with resistant pain. 

For EUS-CPN, there is only one clinical trial reporting a benefit, which has limited generalizability. 

Case series report pancreatic duct stenting gives effective analgesia, but there are no clinical trials. 

Dr Koulouris' team comments, "Progress in understanding the mechanisms for pain and when this occurs in the natural history, together with assessing new therapies both pharmacological and endoscopic, will enable individualized care and may improve patients’ quality of life and survival."

Dig Dis Sci 2017: 62(4): 861–870
21 March 2017

Go to top of page Email this page Email this page to a colleague

 19 October 2017 
Surgical anastomosis at 1-year colorectal cancer surveillance
 19 October 2017 
Fecal immunochemical tests in colorectal cancer screening
 19 October 2017 
Current management of chylous ascites
 18 October 2017 
Predicting recurrence after curative rectal cancer surgery
 18 October 2017 
Hep E seroprevalence and hemodialysis
 18 October 2017 
Prebiotic and changes in the human gut microbiota
 17 October 2017 
Laparoscopic surgery use in Medicare patients with colon cancer
 17 October 2017 
Medication nonadherence and health care costs
 17 October 2017 
Asthma and IBD development
 16 October 2017 
Colorectal cancer screening and postpolypectomy surveillance colonoscopy
 16 October 2017 
Continuity of care after colorectal surgery
 16 October 2017 
Breastfeeding and the risk of IBD
 13 October 2017 
Treating patients with HCV and severe renal impairment
 13 October 2017 
Blood pressure management during abdominal surgery
 13 October 2017 
Food elimination diets for eosinophilic esophagitis
 12 October 2017 
Global recurrence of H. pylori
 12 October 2017 
Colonoscopy in an organized colorectal cancer screening program 
 12 October 2017 
Predicting advanced fibrosis in chronic hepatitis B
 11 October 2017 
Fecal microbiota transplantation for ulcerative colitis
 11 October 2017 
Sexual functioning in Hep C
 11 October 2017 
Ulcerative proctitis in pediatric-onset UC
 10 October 2017 
Quality standards in upper gastrointestinal endoscopy
 10 October 2017 
Eosinophilic esophagitis and swallowed topical corticosteroids
 10 October 2017 
Follow-up of positive results on fecal blood tests
 09 October 2017 
Diverticulitis and emergency department burden
 09 October 2017 
Clostridium difficile infection after ileostomy reversal
 09 October 2017 
Global recurrence rate of H. pylori
 06 October 2017 
Predicting nontreatment for Hep C
 06 October 2017 
Cow's milk–based formula and development of celiac disease
 06 October 2017 
Propofol for outpatient colonoscopy
 05 October 2017 
Pediatric candidates on the transplant wait list
 05 October 2017 
Incidence of sepsis in the USA
 05 October 2017 
Quality of life after chemoradiation in rectal cancer
 04 October 2017 
Peptic ulcer disease diagnosed in acute upper endoscopy
 04 October 2017 
Clinical practice guidelines in colon cancer
 04 October 2017 
Rural residence and risk of IBD
 03 October 2017 
Novel candidate risk genes for IBD
 03 October 2017 
Antibody tests and detecting celiac disease
 03 October 2017 
Environmental factors and IBD
 02 October 2017 
Full publication of Gastroenerology abstracts
 02 October 2017 
Interferon-free therapy in advanced liver disease
 02 October 2017 
Burden of NAFLD with advanced fibrosis in the USA
 29 September 2017 
Inpatient Gastroenterology training experience
 29 September 2017 
Proteomic analysis of IBD
 28 September 2017 
Incidence of biopsy-verified celiac disease
 28 September 2017 
Social networking-based discussion group by ERCP doctors
 27 September 2017 
Function of trypsin-3 in IBS
 27 September 2017 
Predictors of nonadherence in IBD
 27 September 2017 
Hep C treatment in the era of direct-acting anti-viral agents
 26 September 2017 
Chronic pancreatitis and pancreatic cancer risk
 26 September 2017 
Factors associated with the risk of metachronous gastric neoplasm
 26 September 2017 
Treatment of hyperactive delirium in advanced cancer
 25 September 2017 
Lenalidomide for advanced liver cancer
 25 September 2017 
Silibinin nanoparticles inhibit HCV infection
 22 September 2017 
Perforation after colonic endoscopic mucosal resection
 22 September 2017 
Medical management and colectomy rates
 22 September 2017 
MRI for liver metastatic colorectal cancer
 21 September 2017 
Adenomatous colorectal polyps in young cancer survivors
 21 September 2017 
Predicting mucosal healing in treated celiac disease patients
 21 September 2017 
Antireflux surgery and recurrence of GERD

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2017 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us