Pain patterns in chronic pancreatitis
| Autor: | Kempeneers, M.A., Issa, Y., Verdonk, R.C., Bruno, M., Fockens, P., Goor, H. van, Alofs, E., Bollen, T.L., Bouwense, S., Dalen, A.S.H.M. van, Dieren, S. van, Dullemen, H.M. van, Geenen, E.J. van, Hoge, C., Hooft, J.E. van, Kager, L.M., Keulemans, Y., Nooijen, L.E., Poley, J.W., Seerden, T.C.J., Tan, A., Thijs, W., Timmer, R., Vleggaar, F., Witteman, B., Ali, U.A., Besselink, M.G., Boermeester, M.A., Santvoort, H.C. van, Dutch Pancreatitis Study Grp |
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| Přispěvatelé: | Graduate School, Gastroenterology and Hepatology, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, Other Research, Surgery, APH - Methodology, Center for Liver, Digestive and Metabolic Diseases (CLDM), Interne Geneeskunde, MUMC+: MA Maag Darm Lever (9), RS: FHML non-thematic output, Gastroenterology & Hepatology |
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Male
Bio Process Engineering PROGNOSIS Nutrition and Disease MULTICENTER GUIDELINES 0302 clinical medicine Quality of life INSUFFICIENCY intractable pain QUALITY-OF-LIFE Risk Factors EXOCRINE Surveys and Questionnaires Voeding en Ziekte Longitudinal Studies Prospective Studies pancreatic surgery Longitudinal cohort Netherlands Pain Measurement medicine.diagnostic_test Gastroenterology Middle Aged ENDOSCOPIC TREATMENT Reconstructive and regenerative medicine Radboud Institute for Molecular Life Sciences [Radboudumc 10] 030220 oncology & carcinogenesis Neuropathic pain 030211 gastroenterology & hepatology DUCT Female medicine.medical_specialty Visual analogue scale SURGICAL DRAINAGE QUESTIONNAIRE Pain Other Research Radboud Institute for Molecular Life Sciences [Radboudumc 0] chronic pancreatitis 03 medical and health sciences Internal medicine Pancreatitis Chronic medicine Humans endoscopy business.industry medicine.disease Endoscopy Reconstructive and regenerative medicine Radboud Institute for Health Sciences [Radboudumc 10] Pain patterns quality of life Pancreatitis Intractable pain business |
| Zdroj: | Gut, 70(9), 1724-1733. BMJ Publishing Group Gut, 70(9), 1724-1733. BMJ PUBLISHING GROUP Gut, 70, 1724-1733 Gut, 70, 9, pp. 1724-1733 Gut 70 (2021) 9 Gut, 70(9), 1724-1733 |
| ISSN: | 0017-5749 |
| Popis: | ObjectivePain in chronic pancreatitis is subdivided in a continuous or intermittent pattern, each thought to represent a different entity, requiring specific treatment. Because evidence is missing, we studied pain patterns in a prospective longitudinal nationwide study.Design1131 patients with chronic pancreatitis (fulfilling M-ANNHEIM criteria) were included between 2011 and 2018 in 30 Dutch hospitals. Patients with continuous or intermittent pain were compared for demographics, pain characteristics, quality of life (Short-Form 36), imaging findings, disease duration and treatment. Alternation of pain pattern and associated variables were longitudinally assessed using a multivariable multinomial logistic regression model.ResultsAt inclusion, 589 patients (52%) had continuous pain, 231 patients (20%) had intermittent pain and 311 patients (28%) had no pain. Patients with continuous pain had more severe pain, used more opioids and neuropathic pain medication, and had a lower quality of life. There were no differences between pain patterns for morphological findings on imaging, disease duration and treatment. During a median follow-up of 47 months, 552 of 905 patients (61%) alternated at least once between pain patterns. All alternations were associated with the Visual Analogue Scale pain intensity score and surgery was only associated with the change from pain to no pain.ConclusionContinuous and intermittent pain patterns in chronic pancreatitis do not seem to be the result of distinctly different pathophysiological entities. The subjectively reported character of pain is not related to imaging findings or disease duration. Pain patterns often change over time and are merely a feature of how severity of pain is experienced. |
| Databáze: | OpenAIRE |
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