Pain Phenotypes in Chronic Pancreatitis

Summary

Chronic pancreatitis (CP) is characterised by recurrent abdominal pain. The pathological hallmarks of CP is pancreatic stellate cell activation that results in persistent inflammation and progressive fibrosis. It has been shown in various clinical and experimental studies that with disease progression there could be pancreatic neural inflammation, spinal sensitization and eventually alteration in the pain modulating architecture within the brain (widespread sensitization). These events result in different types of pain (nociceptive and neuropathic) in patients with CP, which may dynamically change during disease progression.

Since the treatment for different mechanisms are unique, it becomes important to identify the predominant type of pain. Recently, pancreatic quantitative sensory testing (P-QST) has emerged as a valuable tool to identify different types of sensitization. This facility is currently available only in select centers and is being conducted under research protocols.

In this study, we propose to: 1. evaluate the patterns of pain in CP and the triggers; 2. identify clinical surrogates of sensitization, i.e. neuropathic pain.

The ultimate goal is to apply the best possible pain management strategy based on our research findings for patients with CP in a personalised manner.

Conditions

• Chronic Pancreatitis

Interventions

OTHER

Clinical history

Detailed clinical history including demographic details, pain details (character, pattern, location, change in character, involvement of new areas), duration of disease, co-morbidities, family history, adverse life events, sleep details, details of stress/anxiety.

OTHER

Clinical examination

Thorough clinical examination, anthropometric measurement, assessment of pain (Izbicki score, Visual analog scale, modified brief pain inventory, pain catastrophising score, painDetect)

OTHER

Evaluation of quality of life

Use of the EORTC QLQ c30 with PAN 28 to evaluate quality of life

OTHER

Evaluation of mental state

Use of Beck depression inventory and Hospital Anxiety Depression score to evaluate depression and anxiety

DIAGNOSTIC_TEST

Pancreatic quantitative sensory testing

Pancreatic quantitative sensory testing will be performed to evaluate temporal summation, pain detection threshold, pain tolerance threshold, and conditioned pain modulation.

Sponsors & Collaborators

• All India Institute of Medical Sciences

  collaborator OTHER

• SIDS Hospital and Research Center, Surat

  collaborator UNKNOWN

• Aalborg University Hospital

  collaborator OTHER

• Asian Institute of Gastroenterology, India

  lead OTHER

Eligibility

Min Age

18 Years

Max Age

60 Years

Sex

ALL

Healthy Volunteers

Yes

Timeline & Regulatory

Start

2021-08-01

Primary Completion

2023-02-28

Completion

2023-02-28

Countries

• India

Study Locations