Pathogenesis of chronic pancreatitis-induced pain.

Pancreatic pain resulting from chronic inflammation of the pancreas is often intractable and clinically difficult to manage with currently available therapies. The mechanisms underlying such pain are numerous and poorly understood. Although increased intraductal and parenchymal pressure are important contributors of pancreatitis-induced pain, compelling evidence points to a neuropathic component as well. Moreover, recent studies have implicated supraspinal and higher brain centers in the maintenance of pancreatitis-induced pain. This review discusses the most recent theories regarding the pathogenesis of chronic pancreatitis pain, with a focus on both peripheral and central mechanisms associated with its generation and maintenance.