ABSTRACT
The mechanisms behind disrupted gastrointestinal (GI) motor function in patients with chronic pancreatitis (CP) have not been fully elucidated. We compared regional transit times in patients with CP to those in healthy controls, and investigated whether they were associated with diabetes mellitus, exocrine dysfunction, opioid treatment or quality of life. Twenty-eight patients with CP and 28 age- and gender-matched healthy controls were included. Regional GI transit times were determined using the 3D-Transit system, which consists of an ingestible electromagnetic capsule and a detector worn in an abdominal belt for 5 days. Exocrine function was assessed using the fecal elastase-1 test, and quality of life was assessed using the European Organization for Research and Treatment of Cancer questionnaire. Transit times were analyzed for associations with diabetes mellitus, exocrine pancreatic insufficiency (EPI), opioid treatment and quality of life. Compared with healthy controls, patients with CP had prolonged transit times in the small intestine (6.6â ±â 1.8 vs 4.8â ±â 2.2 hours, Pâ =â .006), colon (40â ±â 23 vs 28â ±â 26 hours, Pâ =â .02), and total GI tract (52â ±â 26 vs 36â ±â 26 hours, Pâ =â .02). There was no difference in gastric emptying time (4.8â ±â 5.2 vs 3.1â ±â 1.3 hours, Pâ =â .9). No associations between transit times and diabetes, EPI, or opioid consumption were found (all Pâ >â .05). Quality of life and associated functional and symptom subscales were not associated with transit times, except for diarrhea (Pâ =â .03). Patients with CP have prolonged small intestinal and colonic transit times. However, these alterations do not seem to be mediated by diabetes, EPI, or opioid consumption.
Subject(s)
Exocrine Pancreatic Insufficiency , Pancreatitis, Chronic , Analgesics, Opioid , Exocrine Pancreatic Insufficiency/etiology , Gastric Emptying , Gastrointestinal Transit , Humans , Pancreatic Elastase , Pancreatitis, Chronic/complications , Quality of LifeABSTRACT
Background: A survey of European Pain Federation 2019 attendees was conducted to identify unmet needs in chronic pain patients. Materials & methods: Four questions were asked focusing on functional impairment in chronic pain, including who are at increased risk and ways to better identify and manage these patients. Results: In total 143 respondents indicated that key issues were lack of knowledge, lack of resources/time to assess and manage chronic pain and lack of sufficient tools to identify patients at risk for functional impairment. Education and training of primary care physicians, simplified guidelines and practical tools for assessment and use of multidisciplinary teams to treat chronic pain were recommended. Conclusion: There are many unmet needs in the management of functional impairment in chronic pain patients.
