Inhibitory Pain Modulation Issues Seen in Pancreatitis

Study assesses descending pain modulation, pain processing in patients with chronic pancreatitis

THURSDAY, Aug. 19 (HealthDay News) -- Individuals with chronic pancreatitis appear to have impaired inhibitory pain modulation and central sensitization, according to research published in the August issue of Clinical Gastroenterology and Hepatology.

Soren Schou Olesen, of the Aarhus University Hospital in Aalborg, Denmark, and colleagues analyzed data from 25 patients with chronic pancreatitis and 15 healthy volunteers who underwent testing of diffuse noxious inhibitory control with cold pressor testing and pressure stimulation, and central pain processing using electrical, thermal, and mechanical stimulation of the rectosigmoid.

The researchers found that patients with chronic pancreatitis had reduced efficacy of diffuse noxious inhibitory control compared to healthy volunteers (13 versus 39 percent). They also had hyperalgesia to electrical and heat stimulation in the rectosigmoid as well as hyperalgesia to cold pressor pain. Individuals with chronic pancreatitis also had increased latency of the early P1 peak to rectosigmoid stimulation, suggesting central pain pathway reorganization.

"The present study provides evidence for impaired inhibitory pain modulation and central sensitization in patients suffering from chronic pancreatitis. The finding supports a growing body of evidence suggesting changes in central pain processing to be of major importance in pancreatic pain. This insight has clinical implications because the focus of pain treatment should not focus solely on the pancreatic gland, but also address medications with effects on the underlying pain mechanisms," the authors conclude.

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