Chronic Pancreatitis is so called because it is a long-term (chronic) inflammation (eg -itis) of the pancreas. It afflicts up to 23 people for every 100,000 Americans. It contributes some 56 000 hospitalizations to the US healthcare system every single year. But now, patients with the disease are facing a hard new reality. Whilst everyone from Donald Trump to the Chief Medical Officer of the State of Alaska has called for a crackdown on the opioid crisis that has ravaged communities across the USA few have paused to think about the millions of Americans suffering from chronic pain that will now be unable to redeem prescriptions from their Doctors. How will these patients, such as those with chronic pancreatitis pain, realistically achieve adequate pain relief?
Chronic Pancreatitis – Its Causes and Symptoms
Pain is an ever present and characteristic feature of chronic pancreatitis. It is the defining feature for many patients and getting on top of this agonising stomach pain is their main concern. The disease can be caused by a wide range of different underlying ailments. These include Alcohol Abuse (and so treatment of pancreatitis in many cases means the patient needs to stop drinking as soon as possible), Trauma, Gallstones, Pancreatic Tumours and some hereditary diseases such as Cystic Fibrosis.
Chronic Pancreatitis – Has Effective Treatment Been Stifled?
Getting on top of the pain and supporting the patient is often the treatment approach to Chronic pancreatitis. This usually means NSAIDs (short for non-steroidal anti inflammatory drugs) like Ibuprofen and Aspirin are first line. As many know, these aren’t particularly strong drugs and when these fail, as they most often do, doctors often resort to stronger pain killers like opioids. Morphine, Codeine and Fentanyl are all under crackdown and doctors are more and more hesitant to prescribe them. But for patients with chronic pancreatitis this leaves them with excruciating pain. As reported in this LasVegasNow article there is a suffering majoirty of chronic pain patients who are being hit hard by the crackdown.
There are only a few options for these patients. One reasonably new therapy that is not routinely offered is a nerve block. The pancreas sends pain signals up the splanchnic nerve and so blocking this with a local anaesthetic (a numbing agent) can be highly effects. Clinics do offer splanchnic nerve blocks. They are very effective curing more than half of patients who suffer from chronic pancreatitis pain.
With Opioids being shunned by clinician’s across the country – there is a need to find new treatments for chronic pain patients that provide the relief they need for their legitimate and real pain. Medicines goal is to relieve patients suffering, yet it seems at this time doctors are overstepping the mark and forgetting that patients often make a difficult choice between living in pain, or taking addictive substances like opioids. If doctors are to clamp down on these drugs, then some thought must go to what alternatives (such as splanchnic nerve blocks) are offered in their place.