{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T12:16:17Z","timestamp":1792066577570,"version":"4.4.0"},"reference-count":168,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,4,6]],"date-time":"2025-04-06T00:00:00Z","timestamp":1743897600000},"content-version":"vor","delay-in-days":5,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,4,1]],"date-time":"2025-04-01T00:00:00Z","timestamp":1743465600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pain Practice"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Chronic pancreatitis is defined as a disease of the pancreas in which recurrent inflammatory episodes result in replacement of the pancreatic parenchyma by fibrous connective tissue in individuals with genetic, environmental, and other risk factors. Pain is one of the most important symptoms of chronic pancreatitis and, in many cases, has chronic visceral nociceptive, nociplastic, and even neuropathic components, with evidence of both central and peripheral sensitization, neuroplasticity, and neurogenic inflammation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The literature on the diagnosis and treatment of pain in chronic pancreatitis was reviewed and summarized.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Treatment of abdominal pain in chronic pancreatitis is guided by pancreatic morphology on imaging, although the correlation between pain symptoms and pathoanatomical changes is not always straightforward. Patients with pancreatic duct obstruction are initially offered endoscopic or surgical therapies, while non\u2010obstructive disease is mostly managed medically. Lifestyle changes and psychological support are of particular importance for all chronic pancreatitis patients. Analgesic options range from non\u2010opioid medications to opioids and adjuvant agents. Interventional pain management may consist of radiofrequency treatment of the splanchnic nerves and spinal cord stimulation. To date, there are no randomized trials supporting their efficacy in the treatment of chronic pancreatitis pain, and the recommendation to consider these treatment options is justified by evidence from observational studies. Possible opioid\u2010sparing effects of interventional pain treatments are important to consider because opioid use and dependency are common in chronic pancreatitis patients and associated with worse outcomes. Celiac plexus block is not generally recommended for chronic pancreatitis due to the limited quality of evidence, overall short duration of effect, and invasiveness of the procedure. Central sensitization can impact the effectiveness of invasive treatments.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Managing pain in chronic pancreatitis is a complex task that requires a multidimensional and individualized approach. Due to the lack of randomized trials, treatment decisions are often guided by expert opinion. Integrating pharmacological and non\u2010pharmacological interventions and collaborating with a multidisciplinary team are key components of effective chronic pancreatitis pain management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/papr.70030","type":"journal-article","created":{"date-parts":[[2025,4,6]],"date-time":"2025-04-06T23:09:01Z","timestamp":1743980941000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["16. Pain in chronic pancreatitis"],"prefix":"10.1111","volume":"25","author":[{"given":"Laura","family":"van Zeggeren","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine Rijnstate Hospital  Arnhem The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raha","family":"Boelens Nabbi","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, UMCG Pain Center, University Medical Center Groningen University of Groningen  Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan Willem","family":"Kallewaard","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine Rijnstate Hospital  Elst The Netherlands"},{"name":"Department of Anesthesiology and Pain Medicine Amsterdam University Medical Centers  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0812-5089","authenticated-orcid":false,"given":"Monique","family":"Steegers","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine Amsterdam University Medical Centers  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven P.","family":"Cohen","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Neurology, Physical Medicine &amp; Rehabilitation, Psychiatry and Neurological Surgery Northwestern University Feinberg School of Medicine  Chicago Illinois USA"},{"name":"Department of Physical Medicine and Rehabilitation and Anesthesiology, Walter Reed National Military Medical Center Uniformed Services University of the Health Sciences  Bethesda Maryland 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