Pain in chronic pancreatitis: assessment and relief through treatment.

AIM

To assess two scores of pain used in chronic pancreatitis, to analyse the morphological factors identified by imaging techniques and the extrinsic factors involved in causing pain and in pain evolution during treatment.

PATIENTS AND METHODS

Pain was assessed by means of a unidimensional numeric scale and a multidimensional Mc Gill score in 50 patients with chronic pancreatitis. We prospectively followed up 28 patients over a period of 17 months.

RESULTS

Pain assessment by means of the two scores was statistically comparable. The multidimensional score correlated with the presence of Wirsung stenoses in the univariate analysis and with Wirsung stenoses and their diameter in the multivariate one. The smokers had a smaller rate of pain relief during the treatment. In cases with more morphological changes of severe chronic pancreatitis, pain relief was lower than in cases with fewer changes.

CONCLUSIONS

The McGill score is more appropriate for the quantitative assessment of pain. Smoking reduces the chances of pain relief under treatment. Duct stenoses and Wirsung diameter have the best correlation with pain intensity. The severe chronic pancreatitis changes are negative predictive factors for pain relief under treatment