Chronic Pancreatitis: Pain Management

Topic Overview

Pain is a frustrating, sometimes debilitating aspect of ongoing (chronic) pancreatitis. Many people have pain for many years.

Pain may decrease as the damaged pancreas loses its ability to produce enzymes. But it may take years for the pancreas to stop producing enzymes. In many people, this process never occurs.

If you are having debilitating pain from chronic pancreatitis, you may be referred to a pain clinic.

Treatment for pain includes avoiding alcohol, eating a low-fat diet, using pain medicine, and in some cases taking enzyme pills to help rest your pancreas.

• Analgesics. You may be able to help your pain with over-the-counter pain medicines like acetaminophen, aspirin, or nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen. Be safe with medicines. Read and follow all instructions on the label. If over-the-counter pain medicines don't control your pain, you may need to have your doctor prescribe an opioid pain reliever.
• Tricyclic antidepressants. These medicines (such as amitriptyline or imipramine) may help people sleep and cope with pain and depression.
• Pancreatic enzyme supplements. People can take oral enzyme supplements, which may reduce pain in some people, particularly those who have mild or moderate disease.
• Stents. A procedure called endoscopic retrograde cholangiopancreatography (ERCP) can be used to place small supports (stents) in a narrow pancreatic duct.
• Celiac plexus nerve block. An injection of alcohol or corticosteroids into this bundle of abdominal nerves may provide temporary relief.
• Surgery. Pain may be reduced by removing stones from the pancreas and draining pancreatic ducts. For some cases of chronic pain, total pancreatectomy (removal of the pancreas) may be considered.