Wiener Medizinische Wochenschrift

, Volume 164, Issue 3–4, pp 63–72 | Cite as

Pancreatic pain

  • Hana Nechutova
  • Petr Dite
  • Marketa Hermanova
  • Ivo Novotny
  • Arnost Martinek
  • Pavel Klvana
  • Bohumil Kianicka
  • Miroslav Soucek
main topic

Summary

Pain is a common symptom of many diseases. Recently, the pain has been classified and analyzed exactly. Its particular components/types are described to the maximum of their depths and details. That is why each particular pain present in a specific disease (pancreatopathies included) has to be treated according to the presence of the specific type of pain. In diseases of pancreas, there are nociceptive, neuropathic, and inflammatory components of pain participating, frequently. Especially long-lasting, not well-controlled pain sets off the process of neuromodulation. The recent pioneering applications/administrations of various neuromodulatory therapeutic approaches represent the promising discoveries for the treatment of long-term, severe, drug-resistant pain syndromes, including chronic pancreatitis. In this article, we summarized the characteristics of pain, the therapeutic strategy, and algorithms of analgesic treatment (in general and applied for pancreatopathies), including new therapeutic trends and approaches.

Keywords

Pain Nociceptive Neuropathic and inflammatory pain Sensitization Neuroplastic changes Neuromodulation Pain in pancreatopathies Stratification of analgesic treatment 

Schmerz bei Pankreaserkrankungen

Zusammenfassung

Schmerz ist ein unspezifisches Symptom vieler Erkrankungen. Schmerz kann in seinen Qualitäten und Ursachen näher untersucht und klassifiziert werden. Die spezifischen Schmerzursachen und Schmerzkomponenten können mittlerweile detailliert erfasst werden. Auf Grund dessen muss jede Art von Schmerz bei einer Erkrankung, so auch bei Erkrankungen des Pankreas, spezifisch nach dem jeweiligen Schmerztyp behandelt werden. Bei Pankreaserkrankungen liegen regelmäßig nozizeptive, neuropathische und inflammatorische Schmerzkomponenten vor und spielen zusammen als Schmerzursachen eine Rolle. Langanhaltende und schlecht kontrollierte Schmerzzustände führen zu einer Neuromodulation. Rezente Neuerungen bei der Applikation und im Einsatz von verschiedenen neuromodulatorischen Schmerzmedikamenten stellen neue Therapieansätze dar, die die Hoffnung geben, auch bei schweren, lang anhaltenden und mit konventioneller Schmerztherapie schlecht kontrollierbaren Schmerzsyndromen Erfolge zu erzielen, so auch bei der chronischen Pankreatitis. Im vorliegenden Artikel werden die Schmerzkomponenten, die Therapiestrategien sowie die Algorithmen der Schmerztherapie im allgemeinen und speziell für Pankreaserkrankungen dargestellt. Dies beinhaltet auch neue therapeutische Ansätze und Entwicklungen.

Schlüsselwörter

Schmerz Noziceptive Neuropathische Inflammatorische Schmerzkomponente Schmerzempfindung Neuroplastische Veränderungen Neuromodulation Schmerz bei Pankreaserkrankungen Stratifikation der Schmerztherapie 

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Copyright information

© Springer-Verlag Wien 2014

Authors and Affiliations

  • Hana Nechutova
    • 1
    • 2
  • Petr Dite
    • 1
    • 5
  • Marketa Hermanova
    • 3
  • Ivo Novotny
    • 4
  • Arnost Martinek
    • 5
  • Pavel Klvana
    • 5
  • Bohumil Kianicka
    • 1
  • Miroslav Soucek
    • 1
    • 2
  1. 1.Second Department of Internal MedicineSt. Anne’s University Hospital BrnoBrnoCzech Republic
  2. 2.International Clinical Research CenterSt. Anne’s University Hospital BrnoBrnoCzech Republic
  3. 3.First Department of Pathological AnatomyMedical Faculty of Masaryk University and St. Anne’s University Hospital BrnoBrnoCzech Republic
  4. 4.Department of GastroenterologyMasaryk Memorial Cancer Institute BrnoBrnoCzech Republic
  5. 5.Medical Faculty Ostrava, Department of Internal MedicineUniversity Hospital Ostrava and Academic Center of GastrooncologyOstravaCzech Republic

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