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Cited by 189Pancreatitis Pathology and TreatmentGallbladder and Bile Duct DisordersIgG4-Related and Inflammatory Diseases

The DOI matches its Crossref record; 18 of the 18 references it cites were found in a registry or an index.

Chronic Pancreatitis Pain Pattern and Severity Are Independent of Abdominal Imaging Findings

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Wilcox, C. Mel, Yadav, Dhiraj, Ye, Tian, Gardner, Timothy B., Gelrud, Andres, Sandhu, Bimaljit S., Lewis, Michele D., Al-Kaade, Samer, Cote, Gregory A., Forsmark, Christopher E., Guda, Nalini M., Conwell, Darwin L., Banks, Peter A., Muniraj, Thiruvengadam, Romagnuolo, Joseph, Brand, Randall E., Slivka, Adam, Sherman, Stuart, Wisniewski, Stephen R., Whitcomb, David C., Anderson, Michelle A.·2015·Clinical Gastroenterology and Hepatology
DOI 10.1016/j.cgh.2014.10.015PMC PMC5019545
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Abstract

Background & aims Chronic pancreatitis is characterized by inflammation, atrophy, fibrosis with progressive ductal changes, and functional changes that include variable exocrine and endocrine insufficiency and multiple patterns of pain. We investigated whether abdominal imaging features accurately predict patterns of pain.Methods We collected data from participants in the North American Pancreatitis Study 2 Continuation and Validation, a prospective multicenter study of patients with chronic pancreatitis performed at 13 expert centers in the United States from July 2008 through March 2012. Chronic pancreatitis was defined based on the detection of characteristic changes by cross-sectional abdominal imaging, endoscopic retrograde cholangiopancreatography, endoscopic ultrasonography, or histology analyses. Patients were asked by a physician or trained clinical research coordinator if they had any abdominal pain during the year before enrollment, those who responded "yes" were asked to select from a list of 5 pain patterns. By using these patterns, we classified patients' pain based on timing and severity. Abnormal pancreatitis-associated features on abdominal imaging were recorded using standardized case report forms.Results Data were collected from 518 patients (mean age, 52 ± 14.6 y; 55% male; and 87.6% white). The most common physician-identified etiologies were alcohol (45.8%) and idiopathic (24.3%); 15.6% of patients reported no abdominal pain in the year before enrollment. The most common individual pain pattern was described as constant mild pain with episodes of severe pain and was reported in 45% of patients. The most common imaging findings included pancreatic ductal dilatation (68%), atrophy (57%), and calcifications (55%). Imaging findings were categorized as obstructive for 20% and as inflammatory for 25% of cases. The distribution of individual imaging findings was similar among patients with different patterns of pain. The distribution of pain patterns did not differ among clinically relevant groups of imaging findings.Conclusions Mechanisms that determine patterns and severity of pain in patients with chronic pancreatitis are largely independent of structural variants observed by abdominal imaging techniques. Pancreas-relevant quantitative and qualitative pain measures should be included in the evaluation of patients with chronic pancreatitis to assess pain severity independently of imaging findings.

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  • Severe abdominal pain is present in 85% of patients with chronic pancreatitis.

    “Severe abdominal pain is a cardinal symptom of pancreatitis, present in 85% of patients with chronic pancreatitis (CP) (4)”

    From Internet Cognitive-Behavioral Therapy for Painful Chronic Pancreatitis: A Pilot Feasibility Randomized Controlled Trial (2021) · cites this paper as [4]

    The Results (Pain patterns; page unavailable) report that 15.6% of patients had no abdominal pain in the preceding year, so approximately 84% had pain of any severity. They separately state that about two-thirds of patients characterized their pain as severe, not 85%. (LLM, conf=0.90)

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Metadata

Authors
Wilcox, C. M., Yadav, D., Ye, T., Gardner, T. B., Gelrud, A., Sandhu, B. S., Lewis, M. D., Al-Kaade, S., Cote, G. A., Forsmark, C. E., Guda, N. M., Conwell, D. L., Banks, P. A., Muniraj, T., Romagnuolo, J., Brand, R. E., Slivka, A., Sherman, S., Wisniewski, S. R., Whitcomb, D. C., & Anderson, M. A.
Affiliations
  • University of Alabama at Birmingham (US)
  • University of Pittsburgh Medical Center (US)
  • University of Pittsburgh (US)
  • Dartmouth–Hitchcock Medical Center (US)
  • Virginia Commonwealth University (US)
  • Mayo Clinic in Florida (US)
  • University of Florida Health (US)
  • Brigham and Women's Hospital (US)
  • Griffin Hospital (US)
  • Medical University of South Carolina (US)
  • Indiana University School of Medicine (US)
  • University of Michigan (US)
ORCID
Venue
Clinical Gastroenterology and Hepatology
Publisher
Elsevier BV
Published
2015-03
Volume
13
Issue
3
Pages
552-560
ISSN
1542-3565 (ISSN-L)
DOI
10.1016/j.cgh.2014.10.015
PMC
PMC5019545
OpenAlex
W1970823363
Cited by
187
References
18
Citations by year
2026: 13 · 2025: 7 · 2024: 17 · 2023: 13 · 2022: 17 · 2021: 31 · 2020: 24 · 2019: 14 · 2018: 12 · 2017: 23 · 2016: 9 · 2015: 5
FWCI
12.87
Type
journal article
Language
en
Open access
Licence
Locations
  • Clinical Gastroenterology and Hepatology (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institute of Diabetes and Digestive and Kidney Diseases (R01DK061451, R21DK098560, R01DK077906)
  • National Center for Research Resources (UL1RR024153)
Topics
  • Health Sciences › Medicine › Surgery › Pancreatitis Pathology and Treatment
  • Health Sciences › Medicine › Gastroenterology › Gallbladder and Bile Duct Disorders
  • Health Sciences › Medicine › Rheumatology › IgG4-Related and Inflammatory Diseases
Keywords
chronic pancreatitis, abdominal pain, pain patterns, pain intensity, abdominal imaging findings, pancreatic duct dilatation, pancreatic atrophy, pancreatic calcification, obstructive pancreatitis, alcoholic pancreatitis, idiopathic pancreatitis
MeSH terms
Adult, Aged, Female, Humans, Male, Middle Aged, Pain, Pancreas, Prospective Studies, Radiography, Abdominal, United States, Pancreatitis, Chronic

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