Pancreatitis, chronic analgesics

Long -term sequelae of chronic pancreatitis include dietary malabsorption, impaired glucose tolerance, cholangitis, and potential addiction to opioid analgesics. 

Pain management is an important component of therapy and is similar to that of acute pancreatitis. Non-opioid analgesics are preferred, but the severe and persistent nature of the pain often requires opioid therapy. Patients can require chronic doses of opioid analgesics, with a resulting risk of addiction. Pain can also be managed by removing the stimulus of exacerbation if identified.31,38... 

Make a plan for analgesia, in conjunction with a pain management service if possible, to control and prevent pain. Recommend an analgesic with ease of dosing and minimal side effects, realizing that patients with chronic pancreatitis may require large doses of opioids. 

Patients most often requiring provision of digestive enzymes include (hose with chronic pancreatitis, mostly secondary to alcoholism, children and adults with cystic fibrosis, and patients with pancreatic carcinomas (fig. 12). In addition to these conditions, pancreatic enzymes are sometimes used because of their analgesic effect for chronic pancreatitis [65]. 

---