Pain Linked to Lower Physical and Mental Health in People With Chronic Pancreatitis

Researchers have shown that people who experience severe or constant abdominal pain due to chronic pancreatitis also have significant loss of physical and mental health, suggesting that they may benefit from ways to detect and manage pain-related conditions. While researchers continue to search for effective ways to treat—and ultimately cure—chronic pancreatitis, other important efforts have focused on ways to manage the most commonly reported symptom: pain, which can be debilitating. In other chronic diseases, pain has been shown to affect several aspects of health, causing anxiety and depression, for example. Knowing the effects of pain on the quality of life for people with chronic pancreatitis is important because it could guide treatment approaches that would help manage the disease.

To determine how pain might shape the lives of people with chronic pancreatitis, researchers gathered information from men and women (488 with pancreatitis and 254 without) participating in the Prospective Evaluation of Chronic Pancreatitis for Epidemiologic and Translational Studies (PROCEED). PROCEED is one of many clinical studies being conducted by the NIDDK- and NCI-sponsored Consortium for the Study of Chronic Pancreatitis, Diabetes, and Pancreatic Cancer, and is the first study in the United States to track chronic pancreatitis symptoms and progression in people over time. The researchers used a state-of-the-art assessment system for self-reported health called PROMIS (Patient-Reported Outcomes Measurement Information Systems), which was developed previously with NIH support. This assessment consists of questionnaires that provide highly reliable, precise measures of self- reported pain, along with measures of physical, mental, and social well-being. Applying PROMIS, the researchers found that the pain from chronic pancreatitis varies from person to person, ranging from no pain to severe pain, and from intermittent to constant pain. Most study participants, however, reported pain that was severe or constant, resulting in lower scores for overall physical and mental health. Severe or constant pain was also linked to declines in several specific health-related quality of life areas, including higher anxiety, depression, fatigue, and sleep disturbance. Participants with these categories of pain also had lower physical function, such as the inability to do everyday chores, and compromised ability to fulfill social roles.

This study provides strong evidence that, in addition to the life-threatening organ and tissue damage caused by chronic pancreatitis, the associated pain can have profound effects upon an individual’s mental and physical well-being. This suggests that people with chronic pancreatitis may benefit from additional screening and treatment to manage pain and pain-related conditions.